The lawsuit claims that the Maccabi Health Fund charged the plaintiff a deductible in higher amounts than stipulated by law, for the purchase of medicaments at Maccabi pharmacies.
The claim was that when a member of a fund seeks to purchase medicament in a different quantity than that provided in a standard package (according to the prescription) he pays a participation fee for a full and complete package even if he is provided with a smaller quantity. According to the plaintiff, Maccabi can only charge a proportionate part of the deductible in the case of a partial package.
The parties reached a compromise agreement which was approved by the court (even after being transferred to an external examiner). Maccabi returned to the team members 70% of the amounts that were overcharged in the 7 years prior to the filing date.
As a result of the settlement agreement, Maccabi paid the group members (as well as an additional amount donated by it to the fund for the purchase of medicines for serious diseases that are not in the medicine basket) a total of approximately NIS 6.4 million.
