Kosten für Krankenbehandlung der sozialen Entschädigung bei Wohnsitz oder gewöhnlichem Aufenhalt im Ausland Erstattung

If you live abroad and required medical treatment there due to recognized consequences of injury, you can receive reimbursement of costs under certain conditions.

The benefits will only be provided if these needs cannot be covered by existing statutory or private insurance or state benefits.

For example, if your health insurance abroad only covers part of the costs of medical treatment, you may be able to have another part of the costs reimbursed.

Please note that your regional association (LVR or LWL) will decide whether and to what extent you will receive support.

If necessary, you must provide evidence:

• Proof of the costs of medical treatment for recognized consequences of injury
• Proof that the needs are not covered by existing statutory or private insurance or state benefits
• If applicable, proof of other costs incurred in connection with the medical treatment

• You have your place of residence or habitual abode abroad.
• You have one or more recognized consequences of injury.
• You require medical treatment and have covered the costs yourself.
• Your needs are not covered by existing statutory or private insurance or state benefits.

When you apply for social compensation benefits, the Landschaftsverband responsible for you (Landschaftsverband Rheinland or Landschaftsverband Westfalen Lippe) will check whether you are entitled to reimbursement of the costs of medical treatment if you are resident or ordinarily resident abroad. You will receive a notification of the decision and, if applicable, information on the benefits granted as well as other necessary documents.

Responsibility: The competent authorities are the pension offices or state social welfare offices. The regional associations in NRW deal with cases with residence or habitual abode in

• Poland, if the surname begins with N-Z: Landschaftsverband Westfalen-Lippe (LWL)
• Hungary: Landschaftsverband Westfalen-Lippe (LWL)
• Belgium: Landschaftsverband Rheinland (LVR)
• Netherlands: Landschaftsverband Rheinland (LVR)
• for the other countries, responsibility lies with other federal states.

You can apply for social compensation benefits online or in writing.

• If necessary, you can make an appointment with your contact person at the Landschaftsverband Rheinland (Social Compensation Department Tel: +49 221 809 5401; e-mail: SER@lvr.de) or Landschaftsverband Westfalen Lippe (Office for Social Compensation Law Tel: +49 251 591 01; e-mail: SER@lwl.org).
• We will then discuss with you whether you are entitled to social compensation benefits and what support services can be offered.
• If necessary, the case management team can discuss the further procedure and possible entitlements to benefits with you that go beyond the general duty to provide information and advice.
• If you are entitled to social compensation benefits, your contact person will discuss the next steps with you.
• The contact person will provide you with the relevant documents. If necessary, complete the documents, enclose the required evidence or supporting documents and send the documents back to the Landschaftsverband responsible for your application.
• Your entitlement will be determined ex officio on the basis of the documents. The authority will inform you of the result in the form of a decision, which is usually sent to you by letter.
• If entitlements to benefits have been determined, you will receive an approval notice. If no entitlements are determined, you will receive a rejection notice.
• However, you also have the option of submitting the application online. To do this, you must complete the online application and upload the necessary supporting documents.
• The eligible costs and approved cash benefits will be transferred to the account you have specified.

The prerequisite for processing is that all mandatory information has been provided.

Appeal: An appeal can be lodged against a decision within one month of its notification. Further information on the procedure and the competent authority to which you can lodge an appeal can be found in the notification of your application. The appeal can be submitted in writing and electronically.

• Costs of medical treatment for social compensation in the event of residence or habitual abode abroad
• Benefit requirements:
• One or more recognized consequences of injury
• Medically necessary medical treatment abroad has taken place and you have covered the costs yourself
• Needs are not covered by existing statutory or private insurance or state benefits in the country of residence
• Costs: the application is free of charge
• Discretionary benefit, no legal entitlement
• Responsibility: the responsible authorities are the pension offices or state offices for social affairs. The regional associations in NRW look after cases with residence or habitual abode in
  • Poland, if the surname begins with N-Z: Landschaftsverband Westfalen-Lippe (LWL)
  • Hungary: Landschaftsverband Westfalen-Lippe (LWL)
  • Belgium: Landschaftsverband Rheinland (LVR)
  • Netherlands: Landschaftsverband Rheinland (LVR)
  • For the other countries, responsibility lies with other federal states.