The cash long-term care benefit: employ directly and keep the difference

The Bituach Leumi long-term care benefit comes in two forms. As services: a care company sends a worker for a set number of hours and the money goes to the company. As cash: it is paid into the recipient's bank account so the family employs someone directly.

The difference is who holds the contract and who takes a margin. Under direct employment the family becomes the employer.

Five conditions

1. The recipient is an Israeli resident at retirement age or above.
2. A dependency level has been assessed by Bituach Leumi.
3. The caregiver works at least six days a week and at least twelve hours a day, is over 18, and is not a family member.
4. A foreign worker is registered with a licensed private agency and holds a Ministry of Interior work permit.
5. A written employment contract sets out the hours and the pay.

The amounts

As of April 2025, per form BL/2655. Note that from level 3 upwards the benefit is higher when employing an Israeli worker.

How long switching takes

Three to five weeks on average: the Bituach Leumi application, the worker's paperwork, the first payroll run. Care is not interrupted — the same person keeps working, only the payment route changes.

What becomes your job

Direct employment means you are the employer with every obligation that carries: running payroll around rest days and holidays, tracking leave, making contributions, remembering visa and permit renewals, and calculating severance correctly when the employment ends.

Some families do all of it themselves. Others hand it to a service — the saving is smaller, but so is the administrative load.