Bnei Bayit

How to fill in the long-term care benefit claim form (BL/2600): part by part

A simple explanation of each part of National Insurance form BL/2600: what each section asks, which documents to attach, and how to submit the claim.

The National Insurance Institute form is called "תביעה לגמלת סיעוד" ("Claim for long-term care benefit"). Its number is בל/2600 (BL/2600), and the version 07.2026 is printed at the bottom of every page. According to the National Insurance Institute, it is intended "for insured people who have reached retirement age, live at home, and need another person's help with daily activities". The form exists in Hebrew only: the National Insurance form pages in Russian, Arabic and English also link to the same Hebrew file.

You can download the form as a PDF file, fill in an online claim or order a printed copy. We do not check personal eligibility. For a personal check there is a National Insurance calculator and the ‎*2637 line. Help with filling it in by phone: see the section "How to submit".

Before you start

Who fills it in. According to the form, it is meant to be filled in "by the claimant, a family member or an acquaintance, and not by a company providing care services". A claim can be submitted from retirement age. If the claimant cannot submit the claim themselves because of their health, the details of the person submitting the claim are also filled in on the form. Someone who has a power of attorney, a guardianship order, a court judgment or another document marks it on the form and attaches a copy. According to the National Insurance Institute, if the person who submits the claim and signs it is a guardian, a copy of the guardianship order is also attached.

Documents to prepare, according to the National Insurance submission page:

  1. The claim form for the long-term care benefit.
  2. Current medical documents: a medical information printout with a summary of the medical file, diagnoses, treatments and medications, or a hospitalisation summary from the last three months.
  3. Income confirmations of the claimant and of the spouse, for three months out of the last four months. No confirmations are needed for National Insurance benefits, nor for an annuity (rente) or allowance for Holocaust survivors and Nazi persecutees.
  4. A copy of the guardianship order, if the person submitting the claim is a guardian.
  5. A copy of a blind person's certificate, for someone who has such a certificate.

The instructions page of the form itself also lists: a current medical summary letter signed by a treating physician or a specialist, results of diagnostic and imaging tests, and documents on special treatments and on drug treatment. According to the form, you can attach information from other care providers, such as the clinic nurse, a physiotherapist, a social worker and specialist doctors. Additional confirmations may be required, and a notice will be sent about it.

Also according to the form: someone who is entitled to a special services allowance (קצבת שירותים מיוחדים) or similar allowances will have to choose between it and the long-term care benefit.

The form, part by part

Page 1 of the form is an instructions page. The claim itself is on pages 2 to 5, in sections 1 to 11. Page 6 has a medical confidentiality waiver, and pages 7 and 8 have an appendix for people aged 90 and over. The boxes marked "לשימוש פנימי בלבד" ("for internal use only") are not to be filled in. The form is written in the masculine form and applies equally to women and men.

1. The claimant's details (פרטי התובע)

ID number (מספר זהות), first name and surname (שם פרטי ושם משפחה), marital status (מצב משפחתי: רווק/ה single, נשוי/אה married, גרוש/ה divorced, אלמן/ה widowed, פרוד/ה separated, ידוע/ה בציבור common-law partner), landline phone (טלפון קווי), mobile phone (טלפון נייד) and e-mail (דואר אלקטרוני).

There is a box to tick: "אני מסרב לקבל הודעות הכוללות מידע אישי בערוצים הדיגיטליים" ("I refuse to receive messages that include personal information through the digital channels"). According to the form, someone who does not tick it will receive National Insurance messages through the digital channels, according to the information they provided.

Details of the person submitting the claim (פרטי מגיש התביעה). According to the form, this part is filled in if the claimant cannot submit the claim themselves because of their health: name (שם), relationship to the claimant (קשר לתובע), ID number (מספר זהות), phones and e-mail, and the same box for refusing digital messages. Here you also mark a power of attorney, a guardianship order, a court judgment or another document, and attach a copy.

Spoken languages (שפות דיבור). There is room for two languages, and a box to tick: "אני מעדיף שההערכה תבוצע בשפת האם ולא בעברית" ("I prefer that the assessment be carried out in my mother tongue and not in Hebrew").

2. Reason for submitting the claim (סיבה להגשת התביעה)

A few lines of free text. According to the form, you give the reason for submitting the claim, and describe the medical and functional condition (mobility, dressing, bathing, eating and toileting) and the cognitive condition (the need for supervision to prevent danger because of cognitive problems). You also give details of what help is needed at home.

3. Residence address (כתובת מגורים)

You mark whether the address is the one registered at the Ministry of the Interior or another address. For another address you write a name and a relationship. Then: locality (יישוב), street or P.O. box (רחוב או תא דואר), house number (מספר בית), entrance (כניסה), apartment (דירה), postal code (מיקוד), phones, e-mail and the same box for refusing digital messages.

The form asks whether other people live with the claimant. If so, for each one you write a name, relationship to the claimant and ID number. The form has room for two people.

Someone who lives in an institutional framework, or in an institution on a kibbutz, marks this and writes the name of the institution, the address and the date of entry. According to the form, if a confirmation from the institution is needed, National Insurance will contact the claimant to fill in a dedicated form. The National Insurance submission page says that in a nursing home or an institution the management of the place fills in section 9. But in the form version 07.2026, section 9 deals with the Ministry of Defense, and residence in an institution is marked in section 3.

4. Dependency assessment (הערכת תלות)

You choose one of the options: that the assessor completes the information in a phone call, that the assessor completes it in a visit at home, or "אין לזה חשיבות" ("it does not matter"). You can also ask that the assessment be done by a male assessor or a female assessor.

According to the form, the dependency assessment is done by an authorised assessor on behalf of National Insurance, and the assessment refers to the medical information attached to the claim. If needed, the assessor calls the claimant and the contact person who knows the medical condition, and arranges a time to complete the information by phone or in a visit at home.

5. Submitting a claim before or during hospitalisation (הגשת תביעה לפני אשפוז או במהלך אשפוז)

You mark "לפני אשפוז" ("before hospitalisation") and write the planned hospitalisation date, or "במהלך אשפוז" ("during hospitalisation") and write the name of the hospital, the ward and the planned discharge date.

6. Details about a third-party personal injury compensation claim (פרטים על תביעה לפיצוי נזיקין צד שלישי)

Two questions: whether the condition was caused in a road accident, and whether it was caused in another accidental event, such as negligence, a fall on the road or from a height, an assault or harm from another party. If so, you write the date of the accident, the place and the circumstances. If a lawyer represents the claimant in the claim, you write their name, phones and address. The form says: "חובה לענות על שאלות אלו" ("it is mandatory to answer these questions").

7. Declaration of income (הצהרה על הכנסות)

You mark the claimant's sources of income, and separately those of the spouse: employee (שכיר), self-employed (עצמאי), pension (פנסיה), or no income (אין הכנסות). Then you mark income not from work: rent (שכר דירה), a social benefit from abroad (קצבה סוציאלית מחו"ל), Ministry of Defense (משרד הביטחון), a pension from abroad (פנסיה מחו"ל), other payments (תגמולים אחרים), other income (הכנסה אחרת, with details), or no income (אין הכנסות). According to the form, you attach documents on the sources of income that were marked.

According to the form, National Insurance may approach employers to receive the income data digitally. Someone who does not agree marks "אני התובע מסרב" ("I, the claimant, refuse"), and a spouse (married or common-law partner) marks "אני בן זוג התובע מסרב" ("I, the claimant's spouse, refuse"). According to the form, someone who refuses will have to submit confirmations and payslips themselves.

8. My fixed expenses and my spouse's (הוצאות קבועות שלי ושל בן/בת זוג)

You mark fixed expenses: maintenance in an institution (החזקה במוסד), payment of rent (תשלום שכר דירה; on the form: "אם יש יותר מנכס אחד", "if there is more than one property") or alimony (דמי מזונות). According to the form, the deduction is made only after you submit a confirmation. A note on the form: someone who has income from renting out an apartment and lives in sheltered housing must provide a confirmation from the sheltered housing that covers only the housing-expenses part of the monthly payment.

9. Receiving payment or services for personal care or help at home from the Ministry of Defense (קבלת תשלום או שירותים בעבור טיפול אישי או עזרה בבית ממשרד הביטחון)

You mark "לא מקבל" ("does not receive") or "מקבל" ("receives"). Someone who receives marks whether it is a cash payment or services.

10. Bank account details (פרטי חשבון בנק)

The account to which every National Insurance payment for the claim will be transferred: names of the account holders (שמות בעלי החשבון), bank name (שם הבנק), branch name or its address (שם הסניף או כתובתו), branch number (מספר הסניף) and account number (מספר החשבון). A member of a kibbutz or a cooperative moshav chooses whether to transfer the payment to the account of the kibbutz or moshav or to their private account. There is also a question whether there are additional bank accounts, and if so, the bank, the branch and the account number.

The payment recipient signs and writes a date. By signing they agree, among other things, that the bank will return to National Insurance, at its request, an amount that was deposited by mistake or unlawfully and will pass on to it the details of those who withdrew the payment, and that National Insurance will approach the bank to verify that the account indeed belongs to the signer.

11. Declaration of the claimant or the person submitting the claim (הצהרת התובע או מגיש התביעה)

In the declaration, the signer declares that all the details in the claim and its appendices are correct and complete, and that the claimant or the spouse has no additional income beyond what was stated. According to the form, giving incorrect details or concealing data is an offence under the law. The signer also undertakes to report any change in the details within 30 days, and any departure from the country for a period of more than three months.

There is a box to tick for agreeing to pass information to bodies that provide concessions (הטבות), if there is eligibility for a concession. You sign on the line "חתימת התובע / מקבל הגמלה / מגיש התביעה" ("signature of the claimant / benefit recipient / person submitting the claim"), and write first name, surname and date. The instructions page says: "חובה לחתום על טופס התביעה" ("it is mandatory to sign the claim form").

Medical confidentiality waiver (כתב ויתור סודיות רפואית) (page 6)

Part 1, personal details of the insured person (פרטים אישיים של המבוטח): date of the claim, ID or passport number, first name and surname, and the health fund (קופת החולים: כללית Clalit, מאוחדת Meuhedet, מכבי Maccabi, לאומית Leumit or אחר other). The benefit code, 96, is already printed.

Part 2, declaration of the insured person or guardian (הצהרת המבוטח או האפוטרופוס): if a guardian signs, they write their name and their ID number. By signing, they waive medical confidentiality and agree, according to the form:

  • to give medical information and documents to National Insurance;
  • to give the long-term care provider the medical and social information needed for the care;
  • to give and receive medical and social information from the Immigration Authority, from the social services department in the local authority and from the health fund.

The results of the dependency assessments in this claim are also given to the health fund. The insured person or the guardian signs.

Appendix B (נספח ב') (for ages 90 and over, pages 7-8)

According to the instructions page, someone who has turned 90 can hand pages 7-8 to be filled in by a specialist physician in geriatrics, and filling them in replaces the functional assessment by an assessor on behalf of National Insurance. The physician fills in the appendix, not the family. According to the appendix, the examination is free of charge to the claimant, and it must not be done during a hospitalisation. In the appendix the physician also writes the name of the public medical institution.

How to submit

According to the National Insurance Institute, you can submit the claim and the documents in one of these ways:

  • Online: fill in an online claim and send it with the additional documents on the website.
  • Filled in by hand, sent through the website: fill in the form by hand, scan it with the additional documents and send it through the document-sending service.
  • Post, fax or service box: send by post or fax, or put it in the service box of the branch according to your place of residence.
  • By phone: the senior citizen counselling volunteers on the ‎*9696 line fill in the claim by phone and help with submitting the documents.
  • From the hospital: someone who is hospitalised can submit a claim through a social worker in the hospital. For an insured person who is hospitalised and wants to submit a first claim during the hospitalisation there is a consent form 2666, and the claim is sent from the hospital directly to National Insurance.

Additional documents can be sent on the website.

Help with submitting the claim and more information:

  • the ‎*9696 line or 02-6709857, or by e-mail 9696@nioi.gov.il;
  • lines by language: Hebrew 02-6463400, Arabic 02-6463401, Russian 02-6463402, Amharic 02-6463403, English 02-6463404;
  • a human answer is available Sunday to Thursday, 9:00 to 13:30, and after that you can leave a message;
  • for general questions the form also refers to the ‎*6050 line or 04-8812345.

What happens after submission

According to the National Insurance Institute, if the claimant meets the basic eligibility conditions, the claim is checked against the medical documents, and a long-term care assessor arranges a phone call to check the level of functioning. Someone who wants the assessor to come for a home visit tells them so in the call. In some cases eligibility can be set on the basis of medical documents alone, without an assessor's examination.

According to the functional test page, if details are missing, the assessor calls the claimant and the contact person (a family member) and arranges completion by phone or a home visit. During the examination it is advisable to have an accompanying person who knows the claimant, their limitations and their medical condition. When there is cognitive decline, a family member or a guardian must be present at the examination at home. According to the frequently asked questions, the visit is usually arranged in advance by phone, and the assessor carries an ID badge.

According to the long-term care benefit page, after the assessment the eligibility level is set, from 1 to 6. According to the form, for someone found eligible, a social worker from National Insurance calls to set a care plan, and you can follow the handling of the claim in the personal area. According to the long-term care benefit page, you receive an eligibility letter listing the chosen services, and you can also find it in the personal area. What each level gives, in hours and in money, is detailed in the guide on the long-term care benefit.

Sources

All pages were read on 03.11.2026.

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