Terminal Illness & End-of-Life Planning in Israel: 5-Step Official Checklist

1. 1

   Coordinate Palliative Care, Home Hospice, and Health Fund Coverage

   Under Israel's National Health Insurance Law, every resident is entitled to multidisciplinary palliative and supportive care through their statutory health maintenance organization (Kupat Cholim - Clalit, Maccabi, Meuhedet, or Leumit) under the supervision of the Ministry of Health (Misrad HaBriut, call center *5400) [1]:

   • Activating community home hospice or inpatient palliative care: Request a referral from the attending hospital specialist (such as oncology, neurology, or internal medicine) or family physician to the health fund's specialized Home Hospice Unit (Yechida LeTipul Bayit / Hospice Bayit) or to an accredited inpatient hospice facility [1]. Home hospice teams provide 24/7 telephone support, regular home visits by palliative physicians and nurses, pain and symptom management, medical equipment loans, and social-work support at no copayment under the national health basket (Sal HaBriut) [1].
   • Oncology and severe chronic illness exemptions: Once the health fund updates the patient's medical code to reflect an active oncology or qualifying life-limiting diagnosis, the ill person receives statutory exemptions from quarterly health-fund visit copayments and reduced ceilings on prescription medication outlays [1].
   • Supplementary health insurance (SHABAN) and private long-term care policies: Review whether your family member holds supplementary coverage through their health fund (such as Clalit Mushlam/Platinum or Maccabi Sheli) or a private commercial nursing/critical-illness policy (Bituach Si'udi), which can fund additional private home nursing hours or second-opinion consultations [1][4].
2. 2

   Record Advance Medical Directives and a Healthcare Proxy Under the Dying Patient Act

   Israel regulates end-of-life medical decision-making through the Dying Patient Act, 2005 (Chok HaCholeh HaNoteh LaMut), administered by the Center for Advance Medical Directives at the Ministry of Health [1][2]:

   • Executing Advance Medical Directives (Hanchayot Refu'iyot Makdimot): While retaining full legal capacity, an adult aged 17 or older can complete the statutory form specifying which life-prolonging medical interventions (such as mechanical ventilation, cardiopulmonary resuscitation, dialysis, or artificial nutrition) they wish to refuse or request if two senior physicians later determine they have an incurable condition with a life expectancy of six months or less [1][2]. Because the Ministry of Health form requires detailed clinical explanations, a physician or registered nurse must explain the medical terminology and sign the verification section before two independent witnesses (who have no financial interest in the estate and are not the appointed proxy) sign the document [1][2].
   • Appointing a Healthcare Proxy under the Dying Patient Act: Either alongside or instead of detailed treatment instructions, the ill person can submit the statutory Power of Attorney for Medical Treatment under the Dying Patient Act to the Ministry of Health, empowering a trusted representative to communicate with the medical team and make end-of-life treatment decisions if capacity is lost [1][2].
   • National database registration: Send the completed original forms to the Center for Advance Medical Directives at the Ministry of Health so they are scanned into the secure national medical registry accessible to all Israeli hospitals and health funds (directives remain valid for five years and can be renewed or revoked at any time) [1][2].
3. 3

   Execute an Enduring Power of Attorney (Yipui Koach Mitmashech) and Bank Mandates

   To avoid the need for a formal court guardianship order (Apotroposut) if the ill person later loses decision-making capacity, execute legal and banking mandates while capacity is completely intact [3]:

   • Enduring Power of Attorney (Yipui Koach Mitmashech): Under Israel's Legal Capacity and Guardianship Law, the ill person can execute an Enduring Power of Attorney covering financial/property matters, personal welfare, and general medical matters [3]. This instrument must be drafted on the digital portal and witnessed by an Israeli lawyer who has completed mandatory certification training from the Guardian General (HaApotropos HaKlali) at the Ministry of Justice (call center *6107), and it must be deposited electronically with the Guardian General to be legally valid [3].
   • Medical Enduring Power of Attorney: If the ill person wishes to appoint a representative exclusively for routine and hospital medical decisions (outside the specific terminal six-month window of the Dying Patient Act), a standalone Medical Enduring Power of Attorney can be signed before a physician, nurse, social worker, clinical psychologist, or lawyer and deposited with the Guardian General [1][3].
   • Bank account continuity clause (Arichut Yamim): Remember that standard bank powers of attorney become void automatically upon account-holder incapacity unless structured as an activated Enduring Power of Attorney, and all powers of attorney expire automatically when a person dies [3][6]. If the ill person shares a joint Israeli bank account with a family member, both co-holders should verify that they have signed the bank's standard Survivorship / Longevity Clause (Se'if Arichut Yamim), which allows the surviving joint owner to continue operating the account for essential household payments without waiting for probate [6].
4. 4

   Activate Bituach Leumi Disability, Attendance, and Caregiver Benefits

   The National Insurance Institute of Israel (Bituach Leumi, call center *6050) operates fast-track ('Green Track') medical evaluations for individuals facing severe or terminal illnesses so claims are processed on the basis of medical documentation without requiring in-person attendance before a medical board [4][5]:

   • General Disability Pension (Kitzbat Nechut Klalit) and Attendance Allowance (Sharam): If your family member is an Israeli resident between age 18 and statutory retirement age whose earning or functioning capacity is severely reduced, file a fast-track claim with the National Insurance Institute of Israel for a monthly General Disability Pension [4] and for the Attendance Allowance for Special Services (Kitzbat Sherutim Meyuchadim - Sharam) [5]. Sharam provides a substantial tax-free monthly allowance (tiered by dependency level) to individuals who require extensive daily assistance with personal care or who are undergoing active oncology or life-limiting treatments [5].
   • Long-Term Care Benefit (Gimlat Si'ud) and foreign caregiver permit: If the ill person has already reached Israel's statutory retirement age and lives at home, apply to the National Insurance Institute of Israel for the Long-Term Care Benefit (Gimlat Si'ud), which provides up to 6 levels of in-home nursing care hours, absorbent products, emergency distress buttons, or a cash allowance [4][5]. High dependency ratings under Sharam or Gimlat Si'ud also qualify the family to apply to the Population and Immigration Authority for a permit to employ a full-time home caregiver.
   • Tax Exemption for Serious Illness (Ptor MiMas Hachnasa) and Caregiver Sick Leave: Individuals certified with a 90% to 100% medical disability rating (including active oncology patients) can apply to the Israel Tax Authority for an income tax exemption [4]. In addition, under Israel's Sick Pay Law, employed family members (spouses, parents, or adult children in qualifying cases) are entitled to charge statutory paid sick leave days against their accrued employer sick-leave balance when caring for a severely ill relative.
5. 5

   Review the Will, Beneficiary Designations, and Cross-Border Estate Documents

   Organizing succession and property records in advance prevents administrative disputes and freezes later on [3][6]:

   • Reviewing or executing a valid Israeli will (Tzava'a) and voluntary deposit: Under the Israeli Succession Law of 1965, review or execute a formal will - either a handwritten and dated holographic will (Tzava'a BiKtav Yad), a will signed before two independent adult witnesses (Tzava'a BeEdim), a will signed before a notary (Tzava'a Bfnei Rashut), or a will made before a judge or religious court [6]. For maximum security, the testator may personally deposit the original will with the Registrar for Matters of Inheritance (Rasham HaYerushot under the Ministry of Justice, call center *2416), ensuring it is automatically located in the central registry [6].
   • Updating pension, provident fund (Kupot Gemel), and insurance beneficiaries: In Israel, death benefits held in pension funds (Kranot Pensia), provident funds (Kupot Gemel), study funds (Kranot Hishtalmut), and life insurance policies pass outside the probate estate directly to the named beneficiaries on file with the fund, unless the policy states otherwise [6]. Have the ill person download a consolidated holdings report from the Ministry of Finance Har HaBituach and Har HaKesef portals and submit updated beneficiary designation forms (Motavim) directly to each institutional provider.
   • Property records (Tabu) and cross-border coordination: Verify that any apartment or real estate in Israel is properly registered in the Israel Land Registry (Tabu) or Israel Land Authority (RMI). If the ill person holds citizenship, real estate, or bank accounts outside Israel, or if key family members reside abroad, ensure that any foreign power of attorney is authenticated with a Hague Apostille and coordinate with legal counsel in both jurisdictions so the Israeli will and Enduring Power of Attorney do not inadvertently revoke or conflict with foreign estate instruments [3][6].

Official Authorities & Verified Contacts

Official Sources Checked by Clarvia

1. [1]
   Center for Advance Medical Directives (Dying Patient Act) — Ministry of Health (Gov.il)
2. [2]
   Submit Advance Medical Directives or Power of Attorney under the Dying Patient Act — Ministry of Health (Gov.il)
3. [3]
   The Guardian General and Official Receiver - Enduring Power of Attorney — Ministry of Justice (Gov.il)
4. [4]
   General Disability Pension and Fast-Track Medical Claims — National Insurance Institute of Israel (Bituach Leumi)
5. [5]
   Attendance Allowance for Disabled Persons (Sharam) — National Insurance Institute of Israel (Bituach Leumi)
6. [6]
   Registrar for Matters of Inheritance - Wills and Succession Orders — Ministry of Justice (Gov.il)