Since I'd spent a while translating & researching, I'm going to post the information here. If you don't live in Israel, this will probably not help you.
The list included below is translated from: http://www.maccabi-health.co.
Terem is an emergency medical care facility which charges around 70 shekels for a visit. In certain cases, you may be referred to Terem by a doctor, in which case the health fund (kuppa) will pay the 70 shekel deductible. In some cases, the Terem doctor may send you to the emergency room (ER).
If you have an emergency at a time that Terem is not open/available, you call your kuppa's moked (maccabi is *3555) and ask to speak to the nurse. If it is an ER situation, they will fax the ER a "hithayvut" and you will not have to pay for it.
If you go to the ER between 1am and 6am without a "hithayvut," you are charged 139 shekels
Between 6am and 1am, you are charged full price (566 shekels) if you don't have hithayvut or a referral from a doctor.
*There are a whole bunch of situations in which you don't have to pay for ER treatment:
1. a new broken bone
2. a serious dislocation of shoulder or elbow
3. a wound which requires stitches or similar "sealing"
4. inhalation of a foreign object
5. objects in the eye
6. Cancer patients
7. Hemophilia patients
8. CF patients
9. A pregnant woman in labor
10. Anyone who is brought in by ambulance from a public place
11. Babies under 2 months of age with a fever of 38.5 or higher
12. Dialasys patients
13. Rape victims
14. Victims of domestic violence
15. Terror victims