If you are unable to cover your basic living expenses with your own resources, you may be eligible for assistance with health and long-term care insurance premiums. If you have income, these premiums reduce the amount of income that is counted toward your eligibility for social assistance. Additionally, these premiums may be recognized as a separate need.

Eligible contributions include monthly premiums for voluntary statutory health insurance and social long-term care insurance, as well as the so-called supplementary premium. Contributions to a solidarity fund may 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:
  • half the premium under the basic plan
  • the premium under the standard plan
• For private long-term care insurance:
  • up to the amount of half the premium for statutory long-term care insurance
  • Premium under the standard plan

Under the basic plan, the benefits provided by private health insurance are comparable to those of statutory health insurance. You can request information from your insurance provider regarding how much your premium would be under the basic plan. The social services office then determines, based on the full premium for the basic plan, whether you are in need of assistance—that is, whether you are eligible for support. If that is the case, the premium for the basic plan is halved.

This reduction alone may mean that you are no longer in need of assistance and can once again support yourself. If you still need assistance, the Social Welfare Office will take the halved premium under the basic plan into account when calculating your eligibility.

With a few exceptions, the social welfare office cannot grant benefits for past periods. Therefore, there are no retroactive benefits.

Consequently, the consideration of contributions applies only to current contributions starting from the date the social welfare office became aware of your need. Overdue contributions are generally not covered.
The social welfare office also cannot cover copayments.

Contributions to a solidarity-based system are considered reasonable up to half of the maximum contribution for statutory health insurance.