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Zuschüsse zu Beiträgen für Krankenversicherung und Pflegeversicherung nach §32 SGB XII, wenn Sie in einer besonderen Wohnform wohnen, beantragen

Sachsen-Anhalt 99107055017003, 99107055017003 Typ 3

Inhalt

Leistungsschlüssel

99107055017003, 99107055017003

Leistungsbezeichnung

Apply for subsidies for health insurance and long-term care insurance contributions in accordance with §32 SGB XII if you live in a special form of accommodation

Leistungsbezeichnung II

Apply for subsidies for health insurance and long-term care insurance contributions in accordance with §32 SGB XII if you live in a special form of accommodation

Leistungstypisierung

Typ 3

Begriffe im Kontext

nicht vorhanden

Leistungstyp

Leistungsobjekt mit Verrichtung und Detail

Leistungsgruppierung

Sozialleistungen (107)

Verrichtungskennung

Bewilligung (017)

Verrichtungsdetail

for persons living in a special form of accommodation in accordance with the definition of the assumption of contributions by the social welfare provider set out in Section 32 SGB XII

SDG Informationsbereiche

  • Rechte und Pflichten im Bereich der sozialen Sicherheit in der Union, auch im Zusammenhang mit Renten

Lagen Portalverbund

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Einheitlicher Ansprechpartner

Nein

Fachlich freigegeben am

13.03.2025

Fachlich freigegeben durch

Ministry of Labor, Health and Social Affairs of the State of North Rhine-Westphalia

Teaser

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

This also applies if you live in a special form of accommodation.

Volltext

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, even if you live in special housing.

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 the amount of the halved contribution for statutory long-term care insurance
    • 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 or social assistance provider 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 or social assistance provider will take the halved contribution in the basic tariff into account when calculating your entitlement.

Apart from a few exceptions, the social welfare office or social assistance provider 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 or social assistance provider became aware of the need. Contributions in arrears are generally not paid.
The social welfare office or social assistance provider cannot recognize personal contributions either.

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

Erforderliche Unterlagen

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Voraussetzungen

  • You are entitled to social assistance and do not receive citizen's allowance or benefits for asylum seekers. You are obliged to pay contributions to (statutory, voluntary or private) 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

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 property

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.

Kosten

none

Verfahrensablauf

The subsidies for health insurance and long-term care insurance contributions can be applied for from the social welfare office or the supra-local social welfare provider. However, these must also be granted without an application if the social welfare provider (e.g. district or independent city) or the agencies commissioned by it learn that a person is in need of assistance or in an emergency situation and the requirements for granting assistance are met.

You can register your need for subsidies for health insurance and long-term care insurance online via the social platform.

  • The decision depends on the income and financial circumstances; a corresponding form may also need to be submitted.
  • Submit all the necessary documents together with the form.
  • The office will decide on your requirements.
  • The social welfare office or the local social welfare agency must decide on your application and inform you of the result.inform you of the result. This is done by means of a decision, which is usually sent to you by letter.
  • If your need has been determined, you will receive an approval notice, if it has not been determined, you will receive a rejection notice.
  • In both cases, the notification must contain the reasons for the decision as well as information on the possibility of lodging an appeal. It must also state the deadline within which you can lodge an appeal.
  • The approval notice must also state the amount of the benefit to be paid and the start date of the payment. From the date stated, the office will transfer the money to your account at the beginning of the month. You can also specify a third party account for the transfer.
  • Please note: You are obliged to inform the social welfare office or the supra-local social welfare agency immediately of any changes to your income and financial circumstances.
  • The benefit "Subsidies for contributions to health insurance and nursing care insurance within a special form of housing" must be applied for as part of the "Assistance with living expenses" application.

Bearbeitungsdauer

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Frist

none

Weiterführende Informationen

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Hinweise

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Rechtsbehelf

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Kurztext

  • Subsidies for health insurance and long-term care insurance contributions Approval, also for people living in special forms of accommodation
  • Persons who are in need of assistance and fully incapacitated for work (outdated: "unable to work") are entitled to subsidies for health insurance and long-term care insurance contributions, even if they live in a special form of accommodation.
  • Responsible authority: Local or supra-local social welfare provider (depending on the federal state)

Ansprechpunkt

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Zuständige Stelle

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Formulare

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