Gesundheitshilfe

Individuals without health insurance who receive only short-term subsistence assistance may be eligible for health assistance benefits.

If you do not have health insurance and are receiving continuous subsistence assistance for a short period of time (expected to be less than one month), the Social Welfare Office will immediately provide the necessary medical care by issuing a treatment certificate.

This includes

• Preventive health assistance for the prevention and early detection of diseases
• Assistance in case of illness
• Help with family planning
• Assistance in pregnancy and maternity
• Assistance with sterilization

Health assistance is subordinate to priority claims of other social benefit providers (for example, health insurance, accident insurance, care for victims of war, the Asylum Seekers' Benefits Act). They are therefore only granted if no health insurance coverage exists or cannot be established.

If there is no right of access to health insurance, registration by the competent social welfare agency (the Social Welfare Office) in accordance with Section 264 of the Fifth Book of the Social Code (SGB V) with a health insurance fund of the beneficiary's choice may be considered first.

If the requirements of Section 264 of Book V of the Social Code are also not met (for example, in the case of a very short period of need of less than one month), the social welfare agency provides the necessary assistance as part of the assistance for health. Beneficiaries must obtain a treatment certificate from the social welfare office before any medical treatment (exception: emergency, treatment on Sundays and public holidays). The medical service provided is then paid directly to the doctor by the Social Welfare Office.

The benefits of the health care assistance correspond essentially to the benefits catalog of the statutory health insurance. Those who receive health assistance are therefore entitled to, among other things:

• free choice of doctor,

• medical and dental treatment and care, and midwifery assistance,

• hospital treatment,

• supply of medicines, remedies and aids,

• dressings,

• dentures,

• preventive and rehabilitation services,

• assumption of costs for contraceptives for persons under 20 years of age,

• home care services according to § 65 paragraph 1 SGB XII,

• Subsidy for inpatient and partially inpatient care in hospices.

• Informal application for the issuance of a/ treatment certificate
• Current notification of subsistence benefits
• Identity card or passport
• Prescriptions and/or proof of payment, if applicable,
• Required consultation confirmations, cost estimates, rejection notices

The scope of the documents required depends on the specifics of the individual case.

• Exclusion of priority benefits (including health insurance, accident insurance, care for victims of war, asylum seekers' benefits law)
• Treatment certificate (assistance is to be provided in the form of goods and services)
• In case of justified self-help (e.g. emergency) the reimbursement of already laid out costs is possible

There are no fees to pay.

You contact the social welfare office responsible for you with the request to issue an electronic health card or a treatment certificate.

The social welfare office will review the application. If all requirements are met, you will receive an electronic health card or a treatment certificate.

A decision on the application will be made as soon as possible, especially if there is a recognizable urgency.

The responsible social welfare agency can only issue a treatment certificate once it has become aware of the need. It is therefore important to submit an application as soon as possible.

Health assistance is social assistance under the Twelfth Book of the Social Code (SGB XII). They are subordinate to potential entitlements to benefits compared to other social security institutions.

Locally responsible social assistance institution

The locally responsible social welfare agency (county, independent city) is responsible.

An informal application to the social welfare office responsible for you is sufficient.

Appropriate forms are available from the relevant social welfare agency (Sozialamt). If necessary, application forms are also available online.