Hyperbaric Oxygen Therapy (HBOT): When It's in the Basket, When It's Private

Hyperbaric oxygen therapy (HBOT) — breathing pure oxygen inside a special pressure chamber — is a fully recognized medical treatment, but it isn't covered "across the board": the public health basket recognizes it only for a closed list of approved indications, and outside that list it's private treatment, plain and simple. If HBOT was recommended to you, or you're considering it as an additional option for a certain condition, the first question to ask isn't "how much does it cost" but "does my condition fall under the approved list of indications."

What HBOT is, and why it has a closed list of indications

In hyperbaric oxygen therapy, the patient enters a chamber where atmospheric pressure is higher than normal and breathes near-pure oxygen. The method significantly increases the amount of oxygen dissolved in the blood and body fluids, which can help with tissue healing, fighting anaerobic infections, and treating certain poisonings. Precisely because the physiological effect is significant, and because the treatment requires dedicated equipment and medical supervision, the Ministry of Health defines a closed list of diagnoses for which HBOT is recognized as evidence-based treatment covered by the public health basket — not for every possible use.

Which diagnoses are typically included in the basket

The recognized indications change from time to time as the Ministry of Health updates them, but consistently include conditions such as:

• Acute carbon-monoxide poisoning.
• Chronic wounds that don't heal with standard treatment methods, including certain diabetic foot wounds.
• Tissue necrosis and damage following radiation treatment (for example, after oncology treatment).
• Other acute conditions such as gas embolism or severe crush injuries, per the treating medical team's decision.

This is a list whose updates fall under the authority of the Ministry of Health, so it's always worth checking the most current list rather than relying on old information — these details change over time.

Who decides whether a specific case meets the indication

The decision on whether a given medical condition meets the approved indication isn't made by the patient or the facility itself, but by a physician specializing in underwater and hyperbaric medicine, usually within a hospital operating a recognized pressure chamber. The physician reviews the medical file, the specific diagnosis, and the clinical background, and decides whether the referral meets the criteria. In borderline cases — where the condition is similar but not identical to what's defined on the list — you can appeal to the health fund's or insurer's exceptions committee and request individual, exceptional approval.

What happens when HBOT isn't an approved indication

There are common uses of HBOT that aren't included in the basket's approved list of indications — for example, use for anti-aging purposes, general athletic recovery, or chronic conditions for which there isn't yet sufficiently established evidence. It's worth noting: HBOT is a medical procedure, not a drug, so an out-of-basket drug rider — which is meant to fund a defined medication — isn't the right place to look for coverage of a course of chamber treatments. In such cases it's worth checking whether your private policy or shaban plan has an ambulatory or procedure-specific benefit that explicitly names HBOT or a pressure chamber, and reviewing the article on ambulatory coverage to understand the general principles. Elective uses or uses not approved as recognized treatment are usually excluded from coverage, even under comprehensive policies.

Cost, frequency, and what's worth checking before starting

The number of sessions required varies greatly: an acute case like carbon-monoxide poisoning may need only a single treatment or a few urgent sessions, while healing a chronic wound can require a series of dozens of sessions over weeks. When treatment is private, the cumulative cost can be significant, so it's worth finding out in advance both the expected number of sessions from the medical team and whether there's partial coverage through private insurance or shaban — before starting the process, not midway through it.

Public facility vs. private facility

Public facilities in large hospitals operate pressure chambers under the national health basket for those who meet the approved indication, with a limited co-pay. Private facilities also exist, and sometimes offer faster availability, including for people who don't meet the official indication — but at full cost, and sometimes without the same close medical-regulatory oversight as a recognized public facility. If you're weighing between the two, make sure the private facility is supervised by medical staff qualified in hyperbaric medicine, not just one that "offers oxygen treatments" — a similar principle to the one highlighted in the article on the difference between public and private hospitalization. It's also worth remembering that HBOT is an example of a medical technology that requires dedicated equipment, as described in the article on medical technology.

What to check before starting treatment

• Whether your specific diagnosis is on the Ministry of Health's current list of approved indications.
• If so, whether the facility you were referred to is a recognized public facility under the basket.
• If not, whether your private policy covers treatments outside the basket, and to what extent.
• How many treatments are expected and the estimated total cost if you're paying privately.
• Whether you can appeal to an exceptions committee in a borderline case.

How Ravit can help

If you're not sure whether your private insurance covers out-of-basket HBOT treatment, or what the relevant rider defines, send Ravit your policy documents on WhatsApp, ask directly, and get an answer based on your actual wording — including a reference to the relevant clause. When the policy text isn't certain, Ravit says so plainly instead of guessing.

The information in this article is general only and does not constitute medical, insurance, legal, or pension advice, and is not a substitute for reading your policy terms or consulting a licensed professional. Coverage, amounts, and conditions vary between policies and change over time — always verify against your own specific policy and an authorized professional.