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Social assistance benefits as preventive health-related counselling


If you need help with your livelihood and do not have health insurance – statutory or private – medical care is ensured by the social welfare provider.

The social assistance institution checks whether you are allowed to receive benefits. They are entitled to preventive health assistance. These include:

  • Preventive medical services
  • Investigations for the prevention and early detection of diseases
  • medical treatments to prevent illness or damage to health

Process flow

Beneficiaries (without health insurance) apply for a treatment certificate to the social welfare office of the competent institution for their subsistence benefits.

The latter examines the application in particular with regard to priority claims and, if necessary, further instigation (e.g. with regard to § 264 SGB V or submission to the responsible social welfare office) and makes the approval decision if the conditions are met.

Here: Issue of treatment certificate

Competent authority

The following are responsible:

  • the social welfare office of the respective local social assistance institution

or

  • the social welfare office of the municipality belonging to the district or region used by the local social assistance provider,

in which the domicile is located.

Local social assistance agencies in Lower Saxony: districts, independent cities and the Hanover region

Requirements

Health aids are given to persons,

  • who do not have statutory or sufficient private health insurance,
  • the provision of benefits via the health insurance fund (§ 264 Abs. 4 SGB V) is out of the question
  • and for whom it is not reasonable to raise the funds for the necessary assistance from income and assets.

Which documents are required?

The following documents are required:

  • Informal application/assertion for the issuance of a treatment certificate/assurance of assumption of costs
  • Current decision on subsistence benefits (SGB II, SGB XII or AsylBLG)
  • Identity card or passport
  • any prescriptions and/or, if applicable, proof of payment, necessary confirmations of advice, cost estimates, any rejection notices, etc.

The competent social assistance institution shall provide information on the documents required in individual cases.

What are the fees?

Fee: free of charge

What deadlines do I have to pay attention to?

In the case of a direct decision on health assistance, the competent social assistance institution can, in principle, only issue a treatment certificate from the time when it becomes aware of the need. Therefore, it is important to indicate the need as soon as possible. This notification can be made informally. In the case of justified self-help, a subsequent reimbursement of costs can be made.

Processing duration

A decision on the application will be taken as soon as possible, in particular if there is a clear sense of urgency. The processing time depends, among other things, on the completeness of the information and the submission of the supporting documents required for the processing of the application.

Applications / forms

An informal application is possible. Form forms can be requested – regularly also online – from the responsible social welfare office and the respective contact persons, or are already stored on the homepage.

Appeal

An objection may be lodged against decisions of the competent social assistance institutions within one month of notification.

After completion of the opposition proceedings by means of an objection decision, an action may be brought before the Social Court within one month of notification.

Technically approved by

Lower Saxony Ministry of Social Affairs, Health and Equality

Author

The text was automatically translated based on the German content.

Source: Serviceportal Niedersachsen (Portalverbund des Bundes und der Länder)