Mohs Surgery Cost and Insurance Coverage in Israel

Navigating the Financial Side of Skin Cancer Treatment

When you receive a skin cancer diagnosis, your immediate concern is getting the best possible treatment. But practical questions about cost and insurance quickly follow. How much does Mohs surgery cost in Israel? Does my kupat cholim (health fund) cover it? Will I need supplementary insurance? What is the process for getting a referral?

These are important questions, and navigating Israel's healthcare system can feel complicated, especially when you are already dealing with the stress of a cancer diagnosis. This guide provides a clear overview of Mohs surgery costs and insurance coverage in Israel, helping you understand your options and plan accordingly.

Israel's Health Basket and Skin Cancer Treatment

Israel's National Health Insurance Law guarantees all citizens access to a defined basket of medical services through one of the four kupot cholim: Clalit, Maccabi, Meuhedet, and Leumit. This health basket, known as sal habriut, includes coverage for the diagnosis and treatment of skin cancer.

Standard surgical excision of skin cancer is covered by all health funds as a baseline service. This means that if you have BCC or SCC, you are entitled to surgical removal through your kupat cholim without additional cost beyond your regular health insurance contributions.

Mohs micrographic surgery, however, occupies a more nuanced position within the system. While Mohs surgery is recognized as the gold standard treatment for certain skin cancers, particularly those on the face and in other high-risk locations, its availability and coverage vary depending on your health fund and the specific insurance plan you hold.

Coverage for Maccabi Members

Maccabi Health Services members who require Mohs surgery may access the procedure through agreements with Assuta Medical Center, one of Israel's leading private hospital networks. Dr. Yehonatan Kaplan performs Mohs surgery at Assuta, and Maccabi members can receive treatment at this facility.

For Maccabi members with supplementary insurance (Maccabi Sheli or Maccabi Gold), Mohs surgery may be covered either partially or fully, depending on the specific plan and the clinical indication. The process typically involves obtaining a referral from a Maccabi-affiliated dermatologist who documents the medical necessity of Mohs surgery for the specific tumor.

The referral should specify why Mohs surgery is recommended over standard excision. Common indications that support the referral include tumors in high-risk facial locations (nose, eyelids, ears, lips), recurrent tumors after previous treatment, tumors with aggressive histological subtypes, large tumors where tissue conservation is important, and tumors in areas where functional preservation is important.

Maccabi members should contact their health fund directly to confirm the current level of coverage under their specific plan, as benefits may be updated periodically.

Coverage for Clalit Members

Clalit Health Services, the largest kupat cholim in Israel, provides access to surgical skin cancer treatment through its network of hospitals and clinics. Clalit members who require Mohs surgery may access the procedure at Herzliya Medical Center (HMC), where Dr. Kaplan also operates.

Clalit members with supplementary insurance plans (Clalit Mushlam or Clalit Platinum) may have enhanced coverage for specialized procedures like Mohs surgery performed at private or semi-private facilities. The coverage depends on the specific supplementary plan level and the medical justification provided.

As with Maccabi, the process begins with a referral from a dermatologist within the Clalit network. The referral should document the clinical rationale for Mohs surgery, and the health fund evaluates the request based on its criteria for approving specialized procedures.

Clalit members are encouraged to verify their specific coverage by contacting Clalit's service center or speaking with their assigned case coordinator.

Supplementary Insurance (Shaban)

Israel's supplementary health insurance plans, commonly known as shaban (sherut briut nosaf), are optional upgrades offered by each kupat cholim. These plans, available at modest monthly premiums, extend coverage beyond the basic health basket and often include access to specialist physicians, shorter wait times, and treatment at private facilities.

For skin cancer patients considering Mohs surgery, supplementary insurance can make a significant difference. Benefits that may be relevant include access to a specific surgeon of your choice, coverage for procedures at private hospitals like Assuta or Herzliya Medical Center, reduced co-payments for surgical procedures, and shorter wait times compared to the public system.

If you do not currently have supplementary insurance, it is worth noting that most plans have a waiting period after enrollment before benefits become active. If you have already been diagnosed with skin cancer, coverage for treatment of that specific condition may be subject to pre-existing condition limitations depending on the plan's terms.

The best time to enroll in supplementary insurance is before you need it. For individuals at higher risk of skin cancer, such as fair-skinned Israelis with significant sun exposure, supplementary coverage is a prudent investment.

Private Surgery Pricing

For patients who choose to undergo Mohs surgery privately, whether because they prefer not to use insurance, their insurance does not fully cover the procedure, or they want to be treated at a specific facility by a specific surgeon without waiting for approvals, the cost varies based on several factors.

The factors that influence the cost of Mohs surgery include the number of stages (layers) required, as more complex tumors needing more stages take longer to process. The complexity of the reconstruction following tumor removal also affects the price. The location of the tumor and the overall complexity of the case are additional factors.

A typical Mohs surgery for a single tumor includes the surgical procedure itself with all necessary stages, real-time on-site pathology processing and interpretation, reconstruction of the surgical defect, and all necessary follow-up visits for wound care and suture removal.

Patients considering private Mohs surgery are encouraged to schedule a consultation with Dr. Kaplan, during which the expected scope of the procedure, the anticipated number of stages, and the associated costs will be discussed in full transparency. There are no hidden fees, and patients receive a clear understanding of what is included before committing to treatment.

The Referral Process Through Kupat Cholim

Regardless of which health fund you belong to, the referral process for Mohs surgery typically follows a similar pathway.

First, you visit a dermatologist affiliated with your kupat cholim. During this visit, the dermatologist examines and biopsies the suspicious lesion. Once the biopsy confirms skin cancer, the dermatologist evaluates whether Mohs surgery is the most appropriate treatment based on the tumor's characteristics.

If Mohs surgery is indicated, the dermatologist writes a referral specifying the diagnosis, the tumor location, and the medical justification for Mohs surgery over standard excision. This referral is submitted to the health fund for approval.

The health fund reviews the referral and, if approved, provides authorization for the procedure. The authorization specifies which facility and surgeon are covered under the plan. Once authorized, you can schedule the surgery with Dr. Kaplan's clinic.

The timeline from referral to authorization varies by health fund and the complexity of the request but typically takes one to three weeks. Dr. Kaplan's team can assist with the administrative aspects of this process and answer questions about what documentation is needed.

Wait Times: Public vs. Private

One of the most significant practical differences between public and private pathways is the wait time from diagnosis to surgery.

In the public system, wait times for dermatologic surgery can vary considerably depending on the facility, the region, and the urgency of the case. Patients may wait four to twelve weeks or longer for non-urgent skin cancer surgery through public hospital queues. While urgent cases are expedited, many BCC and SCC cases are classified as non-urgent given their slow growth rates, resulting in longer waits.

In the private and semi-private settings where Dr. Kaplan operates, including Assuta and Herzliya Medical Center, wait times are substantially shorter. Patients can typically be scheduled for Mohs surgery within one to three weeks of receiving their referral and authorization. For patients who are privately funded, scheduling can be even faster.

This difference in wait times is not merely a matter of convenience. As discussed in other articles on this site, the period between diagnosis and treatment is one of the most anxiety-producing phases of the skin cancer experience. Shorter wait times translate directly into reduced patient distress.

What to Ask Your Health Fund

To navigate the insurance process effectively, consider asking your kupat cholim the following questions. Is Mohs surgery covered under my current plan? Do I need supplementary insurance for coverage? What is the referral process, and who can provide the referral? Which facilities and surgeons are included in my plan's network? What is my expected co-payment or out-of-pocket cost? How long does the authorization process typically take?

Having clear answers to these questions early in the process allows you to make informed decisions about your care without unexpected financial surprises.

Planning Ahead

Skin cancer treatment in Israel is accessible, and Mohs surgery, while specialized, is increasingly available through both the public and private healthcare systems. Whether you are covered through your health fund's basic plan, supplementary insurance, or choose the private route, the most important step is not to delay treatment while sorting out the financial details.

Dr. Kaplan's clinic staff are experienced in helping patients navigate the insurance landscape and can guide you through the referral and authorization process. If you have been diagnosed with BCC or SCC and are considering Mohs surgery, scheduling a consultation is the best first step. The clinical and financial aspects of your care can be addressed together, ensuring that your path to treatment is as smooth and straightforward as possible.