Before you start

Registered resident status — citizenship, a teudat oleh or recognised residency. B/1 holders and visitors are excluded
Registration with Bituach Leumi, which is what triggers health-fund enrolment
A Teudat Zehut or, for olim, a temporary ID number
An Israeli payment method for contributions and the supplemental plan

Step-by-step

1
Register with Bituach Leumi
Public healthcare flows from registered residency with the National Insurance Institute. Olim are usually registered on landing through the aliyah process; others register at a branch or online. This is also what applies the olim health-tax exemption for roughly the first six months.
In personWho: You, with Bituach LeumiImmediate for olim; 1–3 weeks for a change of status
2
Choose one of the four health funds
Every kupah must accept you and must provide the identical statutory basket, so they compete on clinics, apps and supplemental tiers rather than on cover. In Jerusalem all four have dense clinic networks; check which has a clinic in your actual neighbourhood, because the hills make a nominally close clinic inconvenient.
OnlineWho: You, through Bituach LeumiFree; the basic basket is funded by health tax
3
Add the supplemental plan (bituach mashlim)
Almost every resident adds their fund's own supplemental tier for faster specialist access, choice of surgeon, partial dental and overseas cover. It is a separate and much cheaper product than standalone commercial insurance.
Mobile appWho: Your kupahRoughly ₪50–150 a month depending on fund, age and tier
4
Register with a family doctor and learn the referral rule
Most specialist appointments need a hafnaya, a referral from your GP. Book and renew prescriptions through the fund's app. Copays are small and capped per quarter.
Mobile appWho: You
5
If you are on a B/1: confirm the employer's policy in writing
The Foreign Workers Law obliges your employer to provide private medical insurance. Get the policy document, the insurer's name and the hospital network before you need them — this is not the national system and it does not behave like it.
Via employerWho: Your employer

Documents you’ll need

Teudat Zehut, or teudat oleh and temporary ID for new immigrants
Bituach Leumi registration confirmation
Proof of Jerusalem address for clinic assignment
Payment details for contributions and the supplemental plan
For B/1 holders: the employer-provided private policy

Things most newcomers don’t know

Living and working in Jerusalem does not put you in the health system.

The universal system is tied to registered residency, not to presence or employment. B/1 foreign workers, remote workers and visitors sit outside it entirely, and an emergency-room bill lands wholly out of pocket. The Foreign Workers Law puts the duty on the employer for B/1 staff — which is only useful if you have actually seen the policy.

Source: Bituach Leumi — foreign worker entitlement; Foreign Workers Law 5751-1991

The four funds sell an identical legal basket, so optimise for geography instead.

Newcomers agonise over which kupah is best when the statutory benefits basket is the same by law. In a city built on hills, the question that actually affects you is which fund has a clinic and a pharmacy you can reach without a car on a winter evening. And the choice is reversible — you can switch a few times a year for free.

Source: Ministry of Health — National Health Insurance Law

Jerusalem's two hospital systems are on opposite sides of the city, and that is a real planning input.

Hadassah Ein Kerem sits in the far south-west, Hadassah Mount Scopus in the north-east, and Shaare Zedek in the west near Bayit VeGan. Which one your kupah routes you to, and how you would reach it at 3am on a Saturday when public transport is not running, is worth working out before you have a reason to.

Source: Hadassah Medical Organization; Shaare Zedek Medical Center

The olim health-tax waiver ends quietly, and contributions start without a reminder.

New immigrants with no or low income are typically exempt from health tax for roughly the first six months from aliyah. When that lapses, contributions begin automatically through Bituach Leumi. A gap in payments can disrupt cover, so put the end of the sixth month in your calendar rather than waiting for a letter.

Source: Bituach Leumi — registration and contributions for new olim

Common mistakes to avoid

Assuming that being resident in Jerusalem means being covered — B/1 holders, remote workers and visitors are outside the system.
Booking a specialist without a GP referral (hafnaya) and paying full price.
Letting the olim health-tax exemption lapse without noticing that contributions have begun.
Confusing the kupah's supplemental plan with standalone commercial insurance and buying the expensive one first.
Dialling a single emergency number — it is 101 for a Magen David Adom ambulance, 100 for police, 102 for fire.

Some of this may be out of date. Spotted something inaccurate? Help us keep it right for the next newcomer.