Tofes 17 (טופס 17) — Get This Before Your Hospital Appointment in Israel

If you have ever been referred to a hospital, needed an MRI, or been sent to a specialist outside your Kupat Cholim's clinics — you have likely encountered the words "Tofes 17" (טופס 17).

For many new Olim this sounds like just another piece of Israeli bureaucracy. In reality it is one of the most important documents in the Israeli healthcare system — and not having it ready before a medical appointment can cost you thousands of shekels.

This guide explains exactly what Tofes 17 is, when you need it, how to get it, and how to make sure you never walk into a hospital appointment without one.

What Is Tofes 17 — Israel's Most Important Form

Tofes 17 (טופס 17) — also called a Hitchayvut (התחייבות — literally "commitment" or "obligation") — is a financial authorization document issued by your Kupat Cholim (קופת חולים — health fund). It is a formal written commitment from your Kupat Cholim to pay a hospital or external medical provider for a specific procedure or treatment on your behalf.

Think of it as a pre-approved payment voucher. Without it, the hospital or clinic will ask you to pay out of pocket — often thousands of shekels — on the spot.

With it, the cost is covered by your Kupat Cholim and you pay nothing, or only a small co-payment.

It is formally known in Israel as "Tofes Kibul Hitchayvut" (טופס קבלת התחייבות) — the Form of Receipt of Financial Obligation — and different Kupot Cholim may use slightly different names for it, but the function is identical across all four health funds.

Tip: New to the Israeli healthcare system? Before you can request a Tofes 17 you need to be registered with a Kupat Cholim. Click here to read our complete guide to Choosing a Kupat Cholim in Israel — everything you need to know before you register.

When Do You Need a Tofes 17?

You need a Tofes 17 any time a covered medical service is performed outside your Kupat Cholim's own clinics — including:

• Hospitalization — any planned or emergency admission to a hospital

  
  

• Surgeries performed at a public hospital

  
  

• MRI, CT scans, and specialized imaging at external facilities

  
  

• Specialist consultations at hospitals or external institutes not within your Kupat Cholim's network

  
  

• Specific treatments not available at your Kupat Cholim's branches

  
  

• Certain laboratory tests at external labs

A Simple Rule

If you are walking into a building that does not have your Kupat Cholim's name on it, and you expect your Kupat Cholim to cover the cost — you almost certainly need a Tofes 17.

Emergency Situations

If you are rushed to an emergency room (Cheder Miyun — חדר מיון) in a life-threatening situation, go immediately — do not wait for a Tofes 17.

However depending on the circumstances you may need to submit one to the hospital within a defined timeframe after discharge. Confirm this with your Kupat Cholim as soon as possible after the emergency.

When You Do NOT Need a Tofes 17

You generally do NOT need a Tofes 17 for:

• Visits to your Kupat Cholim's own doctors and clinics within the network

  
  

• Visits to urgent care centers (Moked Refuah Dchufa — מוקד רפואה דחופה) within your Kupat Cholim — these usually just require a small co-payment

  
  

• Regular GP (Rofeh Mishpacha — רופא משפחה) appointments

  
  

• Standard blood tests at your Kupat Cholim's laboratory

The Step-by-Step Process — How to Get a Tofes 17

Step 1 — Get a Referral First (Hafnaya — הפנייה)

You cannot request a Tofes 17 directly. You first need a Hafnaya (הפנייה — referral) from a doctor within your Kupat Cholim — typically your GP (Rofeh Mishpacha) or a specialist who has seen you and determined you need a procedure or treatment at an external facility.

Without the Hafnaya, your Kupat Cholim will not issue the Tofes 17. The Hafnaya is the medical justification — the Tofes 17 is the financial authorization that follows.

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Step 2 — Submit the Hafnaya to Your Kupat Cholim

Once you have the referral, submit it to your Kupat Cholim requesting the Tofes 17. You can do this through:

• Your Kupat Cholim's app — the fastest and easiest method — upload the referral document directly

  
  

• Your Kupat Cholim's website — through the personal digital area

  
  

• Your local branch secretary — in person or by email or fax

  
  

• Phone — by calling your Kupat Cholim's service center

Each Kupat Cholim has its own process:

• Clalit (כללית): Request online through Clalit's personal area at clalit.co.il — you can view, request, and print your Tofes 17 directly through the website or Clalit app

  
  

• Maccabi (מכבי): Request through Maccabi's digital services portal at maccabi4u.co.il — submit the referral and request authorization online

  
  

• Meuhedet (מאוחדת): Through the Meuhedet app or website personal area — upload the referral and track the approval status

• Leumit (לאומית): Through the Leumit app or website — similar digital submission process

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Step 3 — Wait for Approval

Once submitted, your Kupat Cholim reviews the request. Approval timelines vary:

• Simple requests — sometimes approved within hours or the same day

  
  

• Complex or expensive procedures — may take 2-6 weeks for the Kupat Cholim to review and approve

  
  

• Some requests may be partially declined — the Kupat Cholim may say the procedure should be performed at their own clinic rather than the external facility you requested

  
  

If your request is declined or delayed and you believe you are entitled to the coverage — you have the right to appeal. Contact your Kupat Cholim's patient rights department.

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Step 4 — Receive and Present the Tofes 17

Once approved, the Tofes 17 is sent to you digitally — by email or through your Kupat Cholim's app. You present it at the hospital or clinic at the time of your appointment.

Critical

Always check that you have received the Tofes 17 before you leave for your appointment. Never assume it has been issued just because you submitted the request. Check your app, your email, or call your Kupat Cholim to confirm before you walk in.

What Happens If You Show Up Without a Tofes 17?

The hospital or clinic secretary will ask for it. If you cannot produce it:

• You will be asked to pay out of pocket — the full cost of the procedure — often thousands of shekels

• You may be asked to reschedule until the authorization is in place

• In some cases the procedure will not be performed at all without it

This is one of the most common and costly mistakes new Olim make in the Israeli healthcare system — and it is entirely preventable.

Tips for Olim

Start The Trocess Early

Complex procedures can take 2-6 weeks to authorize. As soon as your doctor gives you a referral, submit the Tofes 17 request immediately — do not wait until the week before your appointment.

Use The app

All four Kupot Cholim have apps with digital Tofes 17 services. Submitting through the app is faster than going to a branch and gives you a digital record of your submission and approval status.

Check Before You Go

On the morning of any hospital appointment — check your phone to confirm the Tofes 17 has been issued and is accessible. Have it ready to show.

Save It Digitally

Once you receive the Tofes 17, save it to your phone photos or files so you always have it available even without internet access.

Emergency Room Visits

If you go to the emergency room — go immediately and do not wait for paperwork. But contact your Kupat Cholim as soon as possible afterward to sort out the Tofes 17 retroactively if needed, within the timeframe the hospital specifies.

Know The Hebrew Terms

When speaking to your doctor or Kupat Cholim, use these words:

• Tofes 17 (טופס 17) or Hitchayvut (התחייבות) — the authorization form

  
  

• Hafnaya (הפנייה) — the referral you need first

  
  

• Sal Briut (סל בריאות) — the basket of covered services you are entitled to

If Your Tofes 17 Is Declined

Ask your doctor to write a more detailed medical justification. Sometimes initial requests are declined because the paperwork is insufficient. A stronger medical explanation from your doctor often resolves this.

Frequently Asked Questions (FAQ)

Q: What is Tofes 17 in Israel?

A: Tofes 17 (טופס 17) — also called a Hitchayvut (התחייבות) — is a financial authorization form issued by your Kupat Cholim (health fund) that commits them to pay for a specific medical procedure or hospitalization at an external hospital or clinic. Without it you pay out of pocket. With it the procedure is covered.

Q: Do I need a Tofes 17 for every hospital visit?

A: Not for emergency room visits — go immediately in emergencies. But for any planned hospitalization, surgery, MRI, CT scan, or specialist appointment at a hospital or external clinic outside your Kupat Cholim's own network — yes, you need a Tofes 17 before the appointment.

Q: How do I get a Tofes 17?

A: First get a referral (Hafnaya) from your Kupat Cholim doctor. Then submit that referral to your Kupat Cholim through their app, website, branch, or phone — requesting the Tofes 17. Once approved it is sent to you digitally.

Q: How long does it take to get a Tofes 17?

A: It varies. Simple requests can be approved the same day. Complex or expensive procedures can take 2-6 weeks. Start the process as soon as you receive the referral.

Q: How do I request a Tofes 17 from Clalit?

A: Through Clalit's personal area online at clalit.co.il or through the Clalit app — upload your referral and submit the request digitally.

Q: How do I request a Tofes 17 from Maccabi?

A: Through Maccabi's digital services portal at maccabi4u.co.il — submit the referral online and track the approval through your personal area.

Q: What if my Tofes 17 request is declined?

A: Ask your doctor to write a stronger medical justification and resubmit. If you believe you are entitled to coverage and it is still declined, contact your Kupat Cholim's patient rights department and request a formal review.

Q: Can I get a Tofes 17 for emergency room visits?

A: In a genuine emergency — go to the emergency room immediately without waiting for paperwork. Contact your Kupat Cholim as soon as possible after the visit to arrange the Tofes 17 retroactively within the timeframe specified by the hospital.

Q: Is Tofes 17 the same for all Kupot Cholim?

A: The function is the same — a financial commitment to pay an external provider — but the name, form, and process differ slightly between Clalit, Maccabi, Meuhedet, and Leumit. Each has its own digital portal for submitting requests.

Final Tip — Never Walk In Without It

The Israeli healthcare system is genuinely excellent — and as an Oleh you are entitled to the full basket of health services (Sal Briut — סל בריאות) covered by your Kupat Cholim. But that coverage only kicks in automatically if you have the right paperwork in place.

Tofes 17 is the single most important form in that system. Get your referral from your doctor. Submit the Tofes 17 request immediately through your Kupat Cholim's app. Confirm it has been approved before your appointment. And keep it accessible on your phone.

It costs you nothing and takes minutes to request. Not having it when you need it could cost you thousands.