In short
Cross-border note
What Is Mas Briut and Why Do Olim Hit It On Day One?
היטל בריאות (mas briut) is a dedicated Israeli health levy that funds the universal basic basket administered by four non-profit Israeli kupot cholim. It sits on the payslip alongside income tax and ביטוח לאומי (Bituach Leumi) contributions, but it is a separate line and a separate calculation. Most new olim see it for the first time on their first Israeli tlush maskoret (payslip) and assume it is part of income tax. It is not. It is the price of universal coverage.
For US olim this is the part of the Israeli system that looks most like a payroll tax and least like an insurance premium. There is no enrolment form to fill in, no broker, no in-network/out-of-network grid. The state collects, the state assigns the money to your chosen kupat cholim, and the kupat cholim treats you. The cross-border catch: nothing about paying mas briut reduces what you owe to the United States or to the United Kingdom.
The Two Brackets, and the Minimum Floor
Mas briut is a flat-rate two-bracket levy. The structure has been stable for years; the income threshold between the two brackets is updated by Bituach Leumi each January and is anchored to average wage indexation.
The two brackets in effect for 2026:
| Income segment (monthly, NIS) | Mas briut rate | Who applies it |
|---|---|---|
| Below the reduced-rate ceiling (first NIS 7,703 monthly) | 3.23% | Employer withholds on payslip |
| Above the reduced-rate ceiling, up to the max insurable income | 5.17% | Employer withholds on payslip |
| Above the max insurable income cap | 0% on the excess | Cap resets each January |
| Non-working resident, working-age | Statutory minimum monthly payment | Bituach Leumi invoices directly |
The structural detail that catches olim: even when you are unemployed, in ulpan, or simply between jobs, you owe the minimum monthly contribution to keep your kupat cholim membership active.[1] The minimum is small in absolute terms but stopping payment for long enough can suspend access until arrears are cleared.
Worked Example: An Employed Olah on a 15,000 NIS Salary
An olah arriving in January 2026 starts a software job in Tel Aviv at 15,000 NIS monthly gross. Applying the two brackets to her gross income:
- First NIS 7,703 at 3.23%: approximately 249 NIS of mas briut on that segment.
- Remaining ~7,297 NIS at 5.17%: approximately 377 NIS of mas briut on that segment.
- Total monthly mas briut: roughly 626 NIS, line-item on her payslip as heitel briut.
Her Bituach Leumi contribution (a separate calculation with different rates) appears on a different line of the same payslip. Both go to Bituach Leumi; only the mas briut portion is routed onward to her kupat cholim.[2]
The Six-Month Olim Exemption (and What It Does and Does Not Do)
New olim receive an approximately six-month exemption from health-contribution payments, counted from the aliyah date.[3] Two precise points olim get wrong:
- The exemption is for the contribution, not for the coverage: you still register a kupat cholim and you still receive treatment. The state simply waives your mandatory payment for that window.
- Coverage at your kupat cholim begins after the first contribution is recorded by Bituach Leumi. In practice the kupat cholim card is issued shortly after registration; the technical accounting catches up later.
Employed olim who start work inside the six-month window will see mas briut withheld anyway. The exemption is processed through Bituach Leumi, not through the employer; resolve any double-payment at the Bituach Leumi branch, not with payroll.
Self-Employed Olim: A Different Cadence
Self-employed olim (osek patur or osek murshe) do not have an employer to withhold mas briut. Bituach Leumi sends quarterly invoices that bundle national insurance contributions and mas briut into a single bill, calculated from your declared income.[1]
The compliance risk here is binary. Falling behind on quarterly invoices does not just accrue interest; sustained non-payment can suspend kupat cholim membership entirely. For new self-employed olim the practical move is to set up the standing direct debit (hora'at keva) at the bank the moment Bituach Leumi opens the file.
For US olim: mas briut is a flat Israeli payroll levy. It is not the same as the US Medicare tax (1.45% / 2.35% on Additional Medicare), and the United States and Israel have no social-security totalization agreement.[5] That means working in Israel does not exempt a US citizen from US self-employment tax (15.3%) if the income is also US-source or if the activity meets the US definition of self-employment.
The Israeli health levy is not creditable on a US return: you cannot reduce US tax with mas briut paid in Israel. The Foreign Tax Credit applies to Israeli income tax, not to social-security-style contributions. This is one of the few places the cross-border friction works against you in cash terms; budget for it.
PFIC is out of scope for this article: mas briut is a payroll levy and no pooled investment vehicle is named, recommended, or compared on this page. PFIC for US olim is covered separately in the investing track.
What Mas Briut Does Not Buy You
Mas briut funds the basic basket. It does not fund the supplemental plan שב״ן (Bituach Mashlim) offered by each kupat cholim; those are billed separately and the 90-day no-questions-asked window for new olim is treated in a sibling article. It also does not fund private health insurance (bituach pratit), nursing-care insurance (bituach siudi), or dental insurance beyond the limited basket coverage.
Reading a tlush maskoret line by line: heitel briut is one line. Bituach Leumi contributions are a different line. Income tax (mas hachnasa) is a third. If your payslip shows a generic blob labelled in English as "health insurance" only, ask payroll to break out the heitel briut component; it is a statutory line and you have a right to see it.[4]
Frequently Asked Questions
Is mas briut the same as Bituach Leumi?
No. Bituach Leumi is the collecting agency, but the national-insurance contribution and the health levy are two separate calculations on different rate schedules. Bituach Leumi keeps the national-insurance portion and routes the mas briut portion to your kupat cholim. On the payslip they appear as two distinct lines.[1]
If I work but have not chosen a kupat cholim yet, where does the money go?
Bituach Leumi holds the contribution against your tik (file). Until you actively register with one of the four kupot cholim, you cannot use the coverage in practice. Olim should complete kupat cholim registration in the first month after arrival, even if employment has not started yet, so that the routing is in place when contributions begin.[2]
I have US citizenship. Does paying mas briut reduce my US tax bill?
No. Mas briut is a social-security-style health contribution, not income tax, so it is not creditable under the US Foreign Tax Credit. The US-Israel income-tax treaty does not address social-security contributions, and there is no separate totalization agreement between the two countries.[5] A US self-employed oleh can face the full Israeli mas briut plus the full US self-employment tax on the same income.
How long does the olim exemption from health contributions last?
The exemption runs for approximately the first six months from the aliyah date for new immigrants who are not employed or self-employed in Israel during that period.[6] Working olim are not exempt; their employer withholds mas briut from the first payslip, and any reconciliation is handled by Bituach Leumi directly.[3] The exemption is for the payment, not for the coverage.
What if I am between jobs for a long stretch?
Working-age residents who are not employed and not self-employed pay a statutory monthly minimum contribution. The exact figure is reset each January by Bituach Leumi. Falling behind for more than a short window can suspend your kupat cholim access; pay through the Bituach Leumi portal or by direct debit. Olim still inside the six-month exemption do not owe the minimum during that window.[1]
Can I be billed twice if my employer withholds during my exemption window?
Yes, briefly. The employer withholds based on the standard schedule and does not know your Bituach Leumi exemption status. Resolution is handled at the Bituach Leumi branch, not through payroll: bring your teudat oleh, the contested payslips, and your kupat cholim registration. Bituach Leumi will credit the over-withholding back to your file.
What To Do This Week
If you are inside your first six months in Israel, complete kupat cholim registration before anything else, even if you are not working yet. If you have started a job, find the heitel briut line on your tlush maskoret and confirm the rate. If you are self-employed, set up a direct debit at the bank for the Bituach Leumi quarterly invoice the day your tik is opened. The single most expensive mistake here is the one that leads to a suspended kupat cholim membership when you actually need treatment.
