Federal Treatment Certificate
Der Federal Treatment Certificate is a central administrative law document in German asylum and residence law. Its main purpose is to ensure medical care for asylum seekers and certain other groups without regular health insurance coverage. Its issuance, legal basis, scope of benefits, and practical significance are governed by various laws and regulations.
Legal basis
§ 4 Asylum Seekers Benefits Act
The statutory basis for the Federal Treatment Certificate is found in the Asylum Seekers Benefits Act (AsylbLG), particularly in § 4 and § 6. According to § 4 AsylbLG, eligible persons receive medical care in the event of illness as long as they do not have membership in the statutory health insurance. The treatment certificate is intended for making use of these benefits.
Application in asylum procedure law
The federal validity results from the AsylbLG being federal law and its use throughout Germany. The treatment certificate, which is issued especially for persons newly entering Germany or staying in state custody, is therefore referred to as the Federal Treatment Certificate .
Issuance and Procurement
Responsible authorities
The authority responsible for the accommodation of the given person is regularly responsible for issuing the Federal Treatment Certificate. This is usually the benefits authority (generally the social welfare office or foreigners’ authority). In initial reception centers, treatment certificates are usually issued directly to asylum seekers.
Period of validity and scope of application
The certificate is valid for a limited period and assigned to the relevant period of stay or benefit month. It is required for both outpatient treatments and inpatient hospital stays, provided no prior approval for specific services is required.
Eligible person groups
Asylum seekers
The Federal Treatment Certificate is primarily intended for individuals eligible for benefits under the AsylbLG, in particular asylum seekers as well as tolerated persons with a residence permit under the Asylum Procedure Act.
Other eligible groups
Persons with the status of tolerance (Duldung), civil war refugees, or people with a residence ban but actual stay in Germany are also often entitled, as long as they are not compulsorily or voluntarily insured in the statutory health insurance.
Scope of benefits and limitations
Statutory basic benefits
According to § 4 Section 1 AsylbLG, the Federal Treatment Certificate entitles holders to treatment for acute illnesses and pain. There is also entitlement to assistance with pregnancy and childbirth.
Additional medical services
According to § 6 AsylbLG, further benefits may be granted if they are ‘essential to safeguard health.’ This is typically a discretionary benefit, which must be approved by the competent authority on a case-by-case basis.
Exclusions and limitations
The full range of statutory health insurance benefits is not included. Especially in the case of dental treatments, preventive examinations, or extended therapies, additional approval from the authority is required.
Practical application in the healthcare system
Presentation to the service provider
The certificate must be presented when consulting a physician, dentist, or clinic. The doctor settles accounts on the basis of the treatment certificate with the statutory health insurance, which is responsible for the respective federal state, statutory health insurance which, through administrative agreements, is responsible for processing.
Billing procedure
Billing is initially done via the statutory health insurance, after which the costs are borne by the relevant authority based on the AsylbLG.
Avoidance of arbitrariness and ensuring care
The Federal Treatment Certificate system is designed to clearly regulate who receives medical benefits, which services are covered, and how these are billed. This ensures comprehensive basic medical care regardless of residence status, while state control over the scope of services is maintained.
Legal consequences of misuse or improper issuance
Cases of abuse
The unlawful issuance or use of the Federal Treatment Certificate may lead to administrative measures, fines, or criminal consequences. Physicians are required to ensure proper documentation of services rendered.
Review procedure and recovery
In the event of incorrect billing or abuse, the benefits authority may reclaim wrongly paid benefits and assert any civil law claims.
Developments and legal policy discussions
Electronic health card for asylum seekers
In some federal states, the issuing of Federal Treatment Certificates has been replaced by the electronic health card for asylum seekers to simplify the billing process. However, the Federal Treatment Certificate remains the central instrument for ensuring medical care in many regions.
Legal policy discussion on expanding benefits
The scope and access to medical care for asylum seekers is regularly debated both publicly and politically. There are demands to align the scope of benefits more closely with that of statutory health insurance.
Overview: Functions of the Federal Treatment Certificate
- Proof of entitlement to medical services for asylum seekers
- Limitation of benefits to areas defined by law
- Clarification of responsibilities between service provider, insurer, and authority
- Administrative instrument for the effective implementation of the AsylbLG
Conclusion
The Federal Treatment Certificate is a significant instrument for ensuring basic medical care for asylum seekers in Germany. It is based on federal statutory provisions, regulates access to health services, and at the same time constitutes an extensive administrative mechanism to secure state control over costs. The continuing development toward a potential nationwide introduction of the electronic health card and debates surrounding the scope of benefits underscore the ongoing dynamics and relevance of this topic.
Frequently Asked Questions
When is there a right to a Federal Treatment Certificate?
The right to a Federal Treatment Certificate basically exists for asylum seekers and certain groups of tolerated persons and other individuals without regular health insurance coverage who reside in Germany but do not have access to statutory health insurance. This entitlement is mainly governed by the Asylum Seekers Benefits Act (AsylbLG). According to §§ 4 and 6 AsylbLG, eligible persons are entitled to medical care for the treatment of acute illnesses and pain, including appropriate medicine and bandages, as well as benefits during pregnancy and childbirth. A Federal Treatment Certificate is usually issued in regions where health care for asylum seekers is centralized through state initial reception facilities or when distributed to municipalities. A prerequisite for eligibility is generally registration as an asylum seeker or assignment to other eligible groups under the AsylbLG, as well as the absence of other health insurance.
Which services are covered by the Federal Treatment Certificate?
The Federal Treatment Certificate entitles holders to receive medical services determined by the Asylum Seekers Benefits Act. In particular, this includes treatment of acute illnesses and pain, necessary medical care including the provision of prescribed medicine and bandages, as well as vaccinations and preventive measures. There is also entitlement to medical and nursing care during pregnancy and after delivery (§ 4 AsylbLG). Further medical or dental services as well as treatment of chronic or psychological illnesses may be granted under § 6 AsylbLG upon application if essential to safeguard health. Dental prostheses, visual aids or remedies are generally not included in the immediate scope of benefits, but may exceptionally be approved if there is a serious risk to health. The exact benefit provision may be reviewed and limited by the responsible authorities on a case-by-case basis.
Who is responsible for issuing the Federal Treatment Certificate?
In general, the social welfare offices or foreigners’ authorities at each location are responsible for issuing the Federal Treatment Certificate. In initial reception centers and specific municipalities, centrally appointed offices—such as health authorities or benefit offices as per the AsylbLG—may also be responsible for issuance. Issuance is carried out according to § 62 SGB XII in conjunction with the regulations of the AsylbLG. Depending on the federal state, responsibilities and procedures may vary, particularly regarding the introduction of electronic health cards. It is important that the treatment certificate must be applied for and issued by the responsible authority before any medical treatment is received, provided no electronic health card under § 264 Section 1 SGB V has been issued.
How long is the Federal Treatment Certificate valid and what needs to be observed upon expiry?
The validity of a Federal Treatment Certificate is time-limited and depends on the internal administrative regulations of the issuing authority. It is generally valid for one month, but may be issued for individual treatments or for longer periods if necessary. After expiry, the recipient must apply for a new certificate in order to access further medical care. The application must be submitted in good time before the validity expires, as medical treatments after expiry are generally not covered. In cases of ongoing treatment or medical necessity, an extension may be granted upon application. If a transfer to another place of residence occurs, a new certificate must be obtained from the authority responsible at the new location.
What legal restrictions are associated with the Federal Treatment Certificate?
The Federal Treatment Certificate does not confer entitlements to the full range of statutory health insurance benefits, but is subject to the restrictions of the Asylum Seekers Benefits Act (AsylbLG). In particular, treatments are limited to acute illnesses and pain; preventive measures, screening examinations, or treatment of chronic conditions are only granted in exceptional cases (§§ 4, 6 AsylbLG). Medical treatment must be necessary to the required extent and approved by the authority. Moreover, the approval of the responsible social authority is required before further or non-acute treatments are performed. Certain positions for remedies and aids as well as rehabilitative measures are fundamentally excluded, unless there is a risk to life or serious threat to health.
Can benefits under the Federal Treatment Certificate be denied retrospectively?
Yes, benefits can, in principle, be denied retrospectively or excluded from reimbursement if they were provided outside the agreed scope of benefits or without the prior consent of the competent authority. § 6 AsylbLG stipulates that medical services which are not immediately necessary require official approval. If this approval is not obtained in advance, the service provider (doctor, hospital) bears the risk of being left with the costs. In individual cases, retrospective approval or assumption of costs may occur; however, this is subject to strict legal requirements and lies within the authority’s discretion.
In which cases is the Federal Treatment Certificate replaced by the electronic health card?
In some federal states and municipalities, the electronic health card for asylum seekers is gradually being introduced to simplify medical care. The legal basis for this is § 264 SGB V, which allows states to enter into agreements with health insurance providers for the issuance of the card. Where such a card has been issued, a Federal Treatment Certificate is no longer necessary, as claims are settled directly via the electronic health card. However, the scope of benefits is still determined by the AsylbLG and is not equivalent to regular statutory health insurance. The implementation varies by federal state and usually initially affects asylum seekers who have lived in Germany for longer than 15 months. As long as no card has been issued, the Federal Treatment Certificate remains the central access instrument for medical care.
