Unterstützung zur Finanzierung von Beiträgen für Krankenversicherung und Pflegeversicherung beim Sozialhilfeträger beantragen

If your income or assets are not sufficient to cover your necessary living expenses, you will receive support in financing your contributions to health insurance and long-term care insurance under certain conditions.

If you are unable to finance your necessary living expenses from your own resources, you can receive support with regard to health and long-term care insurance contributions. If you have income, the contributions will reduce your income to be offset against social assistance. Otherwise, these contributions can be recognized as a separate need.

The monthly contributions to voluntary statutory health insurance and social long-term care insurance as well as the so-called supplementary contribution can be taken into account. Contributions to a solidarity association can also be taken into account.

Your contributions can only be taken into account if they are reasonable. Contributions to statutory health insurance and social long-term care insurance are always considered reasonable.

The following contributions are considered reasonable for private health and long-term care insurance:

• for private health insurance:
  • halved contribution in the basic tariff
  • Contribution in the standard tariff
• for private long-term care insurance:
  • up to half the amount of the statutory long-term care insurance contribution
  • Contribution in the standard tariff

In the basic tariff, the benefits of private health insurance are comparable to those of statutory health insurance. You can request information from your insurance company as to how high your contribution would be under the basic tariff. The social welfare office will then check whether you are in need of assistance, i.e. whether you could receive support, on the basis of the full contribution to the basic tariff. If this is the case, the contribution to the basic tariff is halved.

This halving alone may mean that you are no longer in need of assistance and can once again cover your living expenses yourself. If you still need support, the social welfare office will take the halved contribution in the basic tariff into account when calculating your entitlement.

Apart from a few exceptions, the social welfare office cannot grant benefits for past periods. There are therefore no retroactive benefits.

Contributions are therefore only taken into account for current contributions from the date on which the social welfare office became aware of the need. Contributions in arrears are generally not paid.
The social welfare office cannot recognize personal contributions either.

Contributions to a solidarity association are appropriate up to half of the maximum contribution of the statutory health insurance.

• Valid identity card or passport, confirmation of registration if applicable
• Proof of income, for example sick pay
• Proof of assets, for example bank statements and/or savings balances
• Proof of health and long-term care insurance, i.e. details of health insurance company and insurance status or contract for private health and long-term care insurance
• Proof of the monthly costs for the accommodation you live in

As a person entitled to benefits, you must provide proof of the amount of the contributions and the scope of the insurance cover. To do this, you must submit the premium statement or the insurance policy. If you have private insurance, you as the person entitled to benefits must also prove the amount of the notional individual basic tariff. This applies even if you are insured under a different tariff.

• You are entitled to social assistance. You are obliged to pay contributions to health or long-term care insurance under an existing insurance relationship.

• You are in need of assistance. This is the case if you:
  • cannot support yourself from your own income and assets
  • are also unable to support yourself with the help of other people, such as your wife or husband; this also applies to registered partnerships and cohabiting couples if the partners live together
  • have no or insufficient entitlement to other social benefits, for example
    • child benefit
    • housing benefit
    • pension
    • unemployment benefit
    • Sickness benefit
    • Parental allowance

• If you do not live alone, the social welfare office can take into account the entire income of the members of the household in order to determine your need for assistance. For this purpose, the income of all household members living together in the same home can be taken into account, provided they live together. The specific circumstances of your cohabitation are decisive here.
• Certain assets are not taken into account, for example
  • smaller amounts of cash, so-called protected assets:
    • EUR 10,000 per adult
    • EUR 500 per child
  • an appropriate house plot

• There are also allowances on certain incomes. This means that you do not necessarily have to use all of your disposable income and assets before you can receive social assistance.

There are no costs.

• Contradiction
  • Further information on how to lodge an objection can be found in the notification.

• Consideration of contributions for health insurance and long-term care insurance in accordance with § 32 and § 82 SGB XII by the social welfare provider
• Consideration of contributions for health insurance and long-term care insurance of the person entitled to benefits possible
• Prerequisites: Beneficiary
  • are obliged to pay contributions to health or long-term care insurance under an existing insurance relationship and
  • they cannot finance their living expenses from their own resources and means
• Please note: Certain assets are not included in the calculation, for example
  • Protected assets:
    • per adult: EUR 10,000
    • per child: EUR 500
  • adequate house property
  • Allowances on certain incomes
• can be taken into account:
  • for statutory health insurance and social long-term care insurance: monthly contributions, including the so-called additional contribution
  • for private health and long-term care insurance: only appropriate contributions
  • Contributions to a community of solidarity
• No retroactive benefits possible, with a few exceptions
• Contributions are taken into account from the time the social welfare office becomes aware of the need situation
• Application possible:
  • In person at the social welfare office, for example during a consultation or
  • online
• Recipients of social benefits without health insurance can regularly receive benefits from statutory health insurance in the event of illness, reimbursement of the costs by the social welfare office to the health insurance company carrying out the treatment
• Competent authority: local social welfare office