Israel Journal of Health Policy Research · Published 2026-04-15 · DOI 10.1186/s13584-026-00759-y
Abstract Background Health Insurance Literacy (HIL) is critical for navigating healthcare systems and making informed insurance decisions. In Israel, which has a universal system with voluntary insurance, disparities in HIL may contribute to inequitable access. This study assessed HIL among diverse Israeli groups using a validated, culturally adapted, multidimensional tool. Methods A nationally stratified sample of Hebrew-speaking and Arabic-speaking Israeli adults (1,012) completed an online cross-sectional survey in September 2024. A 75-item questionnaire combined an adapted Health Insurance Literacy Measure (HILM), self-reported assessments, and objective knowledge tests. Analyses (ANOVA, regression) examined relationships between demographics and HIL dimensions. Results HIL levels were moderate (mean HILM score: 2.39/4), with significant disparities across demographic groups. Non-Ultra-Orthodox Israeli-born Jews showed the highest literacy, while Arab and foreign-born Jews displayed lower comprehension. Key predictors included income, self-reported health, and insurance type (p < 0.001), while education was weaker than expected. Conclusions Findings highlight systemic and cultural barriers to HIL in Israel and the need for targeted educational interventions, simplified communication tools, and culturally tailored programs. This study offers a framework for evaluating HIL in publicly funded systems and insights for other multicultural settings.
Abstract from DOAJ. Public domain (CC0 1.0).
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