A pharmacy sign is placed at the entrance of a pharmacy. © Oliver Berg/dpa/Symbolbild
Health insurance companies do not cover all the costs of medication. For citizen's allowance recipients, it can then quickly become tight. An overview.
Berlin – Going to the pharmacy is rarely free: health insurance companies do not pay for all medicines – or co-payments have to be made. This can quickly add up to money. Above all, citizen's allowance recipients will feel the effects. But in certain cases, health insurance companies or the job center can also help.
Citizen's money: What job centers and health insurance companies do not cover
Basically, the following applies: Citizen's allowance recipients are usually covered by statutory health insurance. Health insurance companies generally cover all costs that are incurred, such as visits to the doctor or prescription drugs. However, neither job centers nor health insurance companies cover the co-payments or co-payments that you may have to make when buying medication or hospitalization. The co-payments are usually between five and ten euros.
Citizen's money: When co-payments for medicines are reimbursed
But there are exceptions: children and adolescents up to the age of 18, for example, are generally exempt from co-payments, according to the employment agency. In addition, there is a load limit: According to this, citizen benefit recipients must pay a maximum of two percent of their annual gross income. In the case of chronically ill people, the stress limit takes effect as soon as one percent of their annual gross income has been exceeded.
To illustrate: If you are a single person and only receive the citizen's allowance standard rate of 502 euros and have no other income, you will receive 6,024 euros per year. The load limit according to the two-percent rule is then 120.48 euros.
If you are above this limit, you can be exempted from further co-payments from the health insurance company. Anyone who has already made co-payments in the current calendar year can then also be reimbursed for them. However, an application must also be submitted for this.
Citizen's money: hardship regulation for additional needs
The job center can also help recipients of citizen's allowance with expenses that are not covered by health insurance companies. However, very specific requirements must be met for this. This is the case, for example, when costs for skin care products are incurred for atopic dermatitis, writes gegen-hartz.de. These costs are not covered by the health insurance companies, but at the job center the hardship regulation for an additional need may apply. The same applies if recipients of citizen's allowance are dependent on costly nutrition due to illness.
