30 thousand shekels a year for mental health treatment: The gap between the HMO and the private clinic

Weekly psychotherapy is one of the largest private expenses that can be added to a household budget. A private session of 400 to 700 shekels creates an average monthly expense of about 1,730 to 3,030 shekels, and in a full year of 52 sessions, the amount reaches about 20,800 to 36,400 shekels. With senior psychologists and in high-demand fields, the price can reach 700 to 830 shekels per session.

The price per session tells only part of the story. Treatment sometimes includes an evaluation session, parental guidance, a couple's session, psychiatric diagnosis, or prescription renewal. Cancellation policies may charge the full price for a session cancelled with short notice. A family where a parent and child are in weekly treatment may face an expense of 4,000 shekels per month, even before parental guidance or additional consultation.

The public route is divided into several options. In the multi-disciplinary clinics of the HMOs (Kupot Holim) and with certain providers, the service is provided with full funding or with a quarterly co-payment, depending on the referral, diagnosis, and treatment plan. Another route allows choosing a psychologist, psychiatrist, or social worker from a list of independent therapists under agreement and paying a co-payment for each session.

Updated prices show similarity between the HMOs. In Clalit, an evaluation session costs 68 shekels and each additional session 164 shekels. In Maccabi, the prices are 70 and 170 shekels. In Meuhedet, 70.50 and 170 shekels, and in Leumit, 70.90 and 170.10 shekels. Group therapy usually costs 75 to 78 shekels per session. The amounts are updated from time to time and eligibility depends on the approval and conditions of the HMO.

In a scenario of 24 sessions, treatment under agreement costs about 3,840 to 3,980 shekels. The same sequence in the private market costs 9,600 shekels at a price of 400 shekels per session, 12,000 shekels at a price of 500 shekels, and 16,800 shekels at a price of 700 shekels. The savings on the HMO route range from about 5,700 to nearly 13,000 shekels. In a year of 52 sessions, the difference can reach about 28,000 shekels.

The main advantage of private treatment is a wider choice of therapist, time, and method, alongside the possibility of starting relatively quickly. On the HMO route, the selection is determined by the agreement list and availability in the area, and sometimes an evaluation session and plan approval are required. The duration of the session may also vary: in Maccabi, for example, treatment under agreement lasts 45 minutes.

Choosing frequency changes the budget. Treatment once a week at a private price of 500 shekels costs about 26,000 shekels per year. A session once every two weeks lowers the amount to about 13,000 shekels, and ten focused sessions cost about 5,000 shekels.

Group therapy is a cheaper alternative for conditions suitable for group work. A year of weekly sessions under agreement costs about 3,900 to 4,060 shekels.

Additional funding sources can shorten the path. Large employers sometimes offer several sessions through an employee assistance program, certain health policies include limited reimbursement, and university clinics or training institutes offer treatment by interns under supervision at a reduced price.

The cost of waiting also has significance. Distress that affects work, studies, or family functioning can create days of absence and lost income. On the other hand, a quick choice of an expensive private therapist creates a long monthly commitment. An intermediate route may start with an inquiry to the HMO and several agreement providers simultaneously, alongside checking availability in nearby towns and online therapy.

Before starting the process, one can calculate a budget of 12, 24, and 52 sessions. At a private price of 550 shekels, one gets 6,600, 13,200, and 28,600 shekels. On the agreement route around 170 shekels, one gets about 1,900, 4,000, and 8,700 shekels.

The demand for mental health treatment in Israel continues to rise, and with it, a new economic gap opens between the public route and the private clinic. The HMOs offer treatment in multi-disciplinary clinics, with independent therapists under agreement, and in other community services. The price may be very low, but the path to treatment sometimes includes evaluation, approval, and waiting. Those who wish to start quickly or choose a specific therapist turn to the private market and pay thousands of shekels within months.

In the multi-disciplinary clinics of the HMOs, treatment is included in the health basket and is usually provided for a quarterly fee or at no additional cost, depending on the service and eligibility. The framework may include a psychologist, psychiatrist, social worker, group therapy, and medication monitoring. In cases of distress against a security background, resilience centers also operate with public funding.

An intermediate route operates through independent psychologists, social workers, and psychotherapists under agreement with the HMO. The co-payment usually ranges around 70 shekels for an evaluation session and about 130 to 160 shekels for each follow-up treatment, with differences between the HMOs and routes. A series of 12 sessions may cost about 1,500 to 1,900 shekels. Weekly treatment that lasts a year, assuming 48 sessions, reaches about 6,200 to 7,700 shekels.

The low price comes with limitations. In some routes, the number of sessions is defined in advance, the choice of therapist is made from a list, and the continuation of treatment requires re-approval. The Ministry of Health recognizes significant loads and queues in some areas. The last comprehensive data published by the State Comptroller indicated an average wait of about six and a half months from the inquiry to diagnosis and the start of treatment. Since then, nearly 600 million shekels have been poured into the HMOs as part of the national mental health program, but the shortage of professionals continues to affect availability.

How much does private treatment cost over a year: The price of a private session with a psychologist or psychotherapist usually ranges between 400 and 700 shekels. Senior and in-demand therapists charge 700 to 830 shekels as well. Weekly treatment at a price of 500 shekels reaches about 24,000 shekels per year, and a price of 650 shekels raises the expense to about 31,200 shekels. Treatment once every two weeks reduces the amount to about 12 to 16 thousand shekels per year.

Psychiatric diagnosis, medication monitoring, couple's therapy, or parental guidance may be added to the direct cost. A private session with a psychiatrist can reach many hundreds and even more than a thousand shekels, depending on seniority and the duration of the consultation. Some private insurances provide limited reimbursement, usually subject to diagnosis, a ceiling, and a list of professionals.

The economic choice also depends on the duration of treatment. A short and focused treatment of 12 to 16 sessions may amount to 5,000 to 10,000 shekels on the private route. Treatment that lasts two years already creates an expense of 40,000 to 60,000 shekels for a household. For a family where a parent and child receive treatment in parallel, the amount can approach a monthly salary every few months.

The public route provides savings of tens of thousands of shekels, especially in long-term treatment. The private route buys mainly availability, choice, and flexibility in hours. It is possible to open an inquiry at the HMO already at the beginning of the search and simultaneously check therapists under agreement. This way, one can keep a place in the public queue and avoid an expensive annual commitment before the scope of the need is clarified.