Before you start

Resident status: Israeli citizenship, a teudat oleh (new-immigrant certificate), or recognized resident status — non-residents and B/1 workers are NOT eligible for the national system
Registration with Bituach Leumi (National Insurance Institute), which establishes your status and triggers health-fund enrollment
A teudat zehut (national ID) or, for olim, a teudat oleh / temporary ID number
An Israeli bank account or payment method for monthly Bituach Leumi / supplemental contributions

Step-by-step

1
Register as a resident with Bituach Leumi
Your right to public healthcare flows from being registered as a resident with the National Insurance Institute (Bituach Leumi). Olim are often registered automatically at Ben Gurion on landing (or via the Aliyah process); others register at a local Bituach Leumi branch or online. This sets your insurance status and, for olim with no/low income, applies the standard exemption from health-tax for roughly the first 6 months from the date of Aliyah.
In personWho: Bituach Leumi (btl.gov.il) — Tel Aviv branch or airport desk for olimImmediate for olim on landing; 1-3 weeks if registering a change of statusFree to register
2
Choose ONE of the four health funds (kupah)
Pick Clalit, Maccabi, Meuhedet, or Leumit. By law every kupah must accept you and provide the identical state benefits basket — they compete on clinics, app quality, specialist networks, and supplemental plans. In central Tel Aviv all four have dense clinic coverage; Clalit and Maccabi have the largest networks and best-rated apps. You can switch funds a few times a year via Bituach Leumi at no cost, so the choice is not permanent.
OnlineWho: Your chosen kupah, registered through Bituach LeumiEnrollment effective within days; a switch between funds takes effect after a short waiting periodFree; basic basket is funded by the health-tax
3
Add the kupah's supplemental plan (bituach mashlim)
Almost every resident adds their kupah's own supplemental tier — e.g. Maccabi 'Sheli'/'Zahav', Clalit 'Mushlam', Meuhedet 'Adif/Si', Leumit 'Zahav'. It covers faster private-track specialists, choice of surgeon, partial dental and optometry, overseas cover, and second opinions. This is separate from (and cheaper than) standalone commercial insurance. Many residents stack a private commercial policy on top for major surgery and drugs outside the basket.
Mobile appWho: Your kupah (via its app, website, or clinic)Same day to enroll; some benefits have a waiting period~₪50-150/month depending on fund, age, and tier
4
Activate care: assign a GP, get prescriptions, use the app
Pick a family doctor (rofe mishpacha) at your local clinic; you generally need a GP referral (hafnaya) to see most specialists. Book appointments and renew prescriptions through the kupah app, and fill medications at a kupah pharmacy or Super-Pharm. Specialist visits and prescriptions carry small copays — typically tens of shekels per quarter, with a quarterly out-of-pocket ceiling so costs stay capped. For emergencies dial 101 for a Magen David Adom ambulance.
Mobile appWho: Your kupah clinic and pharmacy networkImmediate once enrolledSmall copays: ~₪30+ per specialist visit; quarterly ceiling caps total

Documents you’ll need

Teudat zehut (national ID) or teudat oleh / temporary ID for new immigrants
Bituach Leumi registration confirmation
Proof of address in Tel Aviv (lease or utility bill) for clinic assignment
Bank account / payment details for monthly contributions
For B/1 foreign workers: the private medical insurance policy provided by your employer

Things most newcomers don’t know

New olim get full health coverage from the day they make Aliyah, and if they have no or low income the health-tax is waived for roughly the first 6 months — so you can register with a kupah and see a doctor before you ever earn a shekel.

It removes the usual newcomer coverage gap entirely; there is no waiting period and no need to buy bridge private insurance for the basics, unlike many countries where residency-based cover lags arrival.

Source: Bituach Leumi — Registration to HMO and contributions for New Olim

B/1 foreign workers and remote/digital nomads are NOT in the national system at all — being employed or living in Tel Aviv does not enroll you.

People assume Israel's universal system covers anyone resident, then discover an ER bill is fully out-of-pocket. The Foreign Workers Law (5751-1991) puts the insurance duty on the employer for B/1 staff, and everyone else needs private/travel cover.

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

The four kupot deliver an identical legally-defined benefits basket, so don't agonize over the basic choice — and you can switch funds a few times a year for free.

Newcomers waste time comparing 'which kupah is best' as if basic coverage differs; it doesn't. Optimize instead for the supplemental (mashlim) tier, specialist network near you, and app usability — and remember the switch is reversible.

Source: Israel Ministry of Health — National Health Insurance Law / benefits basket

Common mistakes to avoid

Assuming residence in Israel equals coverage — B/1 foreign workers, tourists, and remote workers are outside the national system and must rely on employer-provided or private insurance
Skipping the GP referral (hafnaya): most specialist visits require a referral from your family doctor, or you pay full price
Letting the olim 6-month health-tax exemption lull you — once it ends, contributions begin automatically and a lapse in Bituach Leumi payments can disrupt coverage
Confusing the kupah's supplemental (mashlim) with standalone commercial insurance — they are different products; buying private without the cheaper mashlim usually overpays
Dialing the wrong emergency number: it's 101 for a Magen David Adom ambulance (100 police, 102 fire), not a single combined line