VERDICT
in the legal dispute
xxx,
– Plaintiff –
Legal representative: Attorney Sven Adam
, Lange-Geismar-Str. 55, 37073 Göttingen
against
City of Stuttgart – Office for Social Affairs and Participation,
represented by the Mayor,
Eberhardstr. 33, 70173 Stuttgart
– Defendant –
Included:
BKK Gildemeister Seidensticker,
represented by the board of directors
, Winterstr. 49, 33649 Bielefeld
The 11th Chamber of the Stuttgart Social Court,
without oral proceedings, decided on July 28, 2026 in Stuttgart
through Judge xxx as presiding judge
, and Lay Judges xxx and xxx.
recognized as rightful:
The decision of 17 November 2025, as amended by the appeal decision of 22 December 2025, is hereby revoked, and the defendant is obligated, with modification of the benefit provision from 1 January 2025, to take into account the plaintiff's contributions to health and long-term care insurance as a need within the framework of the mandatory follow-up insurance.
The defendant shall bear the plaintiff's extrajudicial costs.
FACTS
The parties are in dispute over who will pay the health and long-term care insurance contributions under the mandatory follow-up insurance for the period from 01.1.2025 onwards.
The plaintiff was born on xx.xx.1996, receives ongoing benefits from the defendant under the Asylum Seekers' Benefits Act (AsylbLG) and has been insured with the intervener since 14 December 2021 under the mandatory follow-up insurance pursuant to Section 9 Paragraph 1 No. 2 SGB V in conjunction with Section 188 Paragraph 4 SGB V for health insurance and for long-term care insurance pursuant to Section 20 Paragraph 3 SGB XI.
As of January 1, 2025, the defendant ceased to cover the plaintiff's health and long-term care insurance contributions.
By decision dated 17 November 2025, the defendant rejected the plaintiff's application for review regarding the assumption of contributions to voluntary health and long-term care insurance from 1 January 2025.
The plaintiff filed an objection to this decision on November 24, 2025, which the defendant rejected as unfounded in a decision dated December 22, 2025. The insurance contributions arising from voluntary membership in health and long-term care insurance could not be covered as part of the benefits provided under the Asylum Seekers' Benefits Act (AsylbLG). The assumption of these insurance contributions was not essential for safeguarding the plaintiff's health, as all necessary health-related benefits were provided under Sections 4 and 6 of the AsylbLG.
The plaintiff filed a lawsuit with the Stuttgart Social Court on December 30, 2025.
The plaintiff argues that, according to Section 6 Paragraph 1 Sentence 1 of the Asylum Seekers' Benefits Act (AsylbLG), he is entitled to reimbursement of his health and long-term care insurance contributions. He contends that such reimbursement is essential to secure his livelihood.
The plaintiff requests
that the defendant's decision of November 17, 2025, as amended by the appeal decision of December 22, 2025, be overturned and that the defendant be ordered, by amending the benefit provision for the period from January 1, 2025, to grant the subsistence benefits taking into account the contributions to the mandatory follow-up insurance.
The defendant requests that
the action be dismissed.
The defendant refers to her statements in the objection decision.
By decision of 04.3.2026, the court necessarily joined BKK Gildemeister Seidensticker as the responsible health and long-term care insurance provider to the proceedings pursuant to Section 75 Paragraph 2 of the Social Court Act (SGG).
The parties have declared their consent to a decision without oral proceedings in accordance with Section 124 Paragraph 2 of the Social Court Act (SGG).
For further details of the facts and the submissions of the parties, reference is made to the court files and the administrative files of the defendant.
REASONS FOR DECISION
With the consent of the parties involved, the court was able to decide by judgment without an oral hearing in accordance with Section 124 Paragraph 2 of the Social Courts Act (SGG).
The lawsuit is admissible and well-founded.
The decision of November 17, 2025, as amended by the appeal decision of December 22, 2025, is unlawful and infringes the plaintiff's rights. The plaintiff has a claim against the defendant for the assumption of ongoing contributions for health and long-term care insurance, as well as a corresponding amendment to the benefit payments for the period from January 1, 2025, pursuant to Section 9 Paragraph 4 Sentence 1 No. 1 of the Asylum Seekers' Benefits Act (AsylbLG) in conjunction with Section 44 Paragraph 1 of the German Social Code, Book X (SGB X).
The basis for the plaintiff's claim is Section 9 Paragraph 4 Sentence 1 No. 1 and Sentence 2 of the Asylum Seekers' Benefits Act (AsylbLG) in conjunction with Section 44 Paragraph 1 Sentence 1 of the German Social Code, Book X (SGB X). Accordingly, an administrative act, even after it has become legally binding, must be revoked with retroactive effect if, in a specific case, it is found that the law was incorrectly applied or that the decision was based on facts that prove to be incorrect, and if, as a result, social benefits were wrongfully withheld or contributions were wrongfully collected. While no incorrect facts are alleged here, the defendant's application of the law is incorrect, as it refused to cover the health and long-term care insurance contributions within the framework of the mandatory follow-up insurance.
The need claimed by the plaintiff arises from Section 6 of the Asylum Seekers' Benefits Act (AsylbLG), because the disputed health and long-term care insurance contributions do not fall under the basic benefits according to Sections 3 and 3a of the AsylbLG, nor under Section 4 of the AsylbLG. According to Section 3 Paragraph 1 of the AsylbLG, the basic benefits under Sections 3 and 3a cover benefits to cover the need for food, accommodation, heating, clothing, healthcare, and household goods and consumables (necessary needs, sentence 1), as well as benefits to cover personal needs of daily life (necessary personal needs, sentence 2). Health and long-term care insurance contributions are clearly not included in this. In particular, they do not constitute healthcare benefits, as these only cover non-prescription goods such as thermometers, bandages, etc. (see Frerichs in: Schlegel/Voelzke, juris PraxisKommentar SGB XII, 4th ed., as of April 8, 2025, § 3 AsylbLG para. 100). Pursuant to § 4 AsylbLG, benefits in case of illness are also not granted in the form of the assumption of insurance contributions, but rather as benefits in kind, whereby the benefits are provided by the statutory health insurance providers in accordance with § 264 SGB V against reimbursement by the benefit provider under the AsylbLG (see Social Court Freiburg (Breisgau), judgment of March 17, 2025 – S 7 AY 3255/24, para. 27, juris).
According to Section 6 of the Asylum Seekers' Benefits Act (AsylbLG), the benefit provider may provide other benefits if they are essential in individual cases to secure the livelihood or health (Section 6, Paragraph 1, Sentence 1, Alternative 1). According to Sentence 2 of the provision, benefits are to be granted as benefits in kind, or, in special circumstances, as cash benefits. The court is convinced that the contributions to statutory health and long-term care insurance owed by the plaintiff are benefits that, while not essential for securing health in individual cases, are essential for securing the livelihood (see Social Court Freiburg (Breisgau), Judgment of March 17, 2025 – S 7 AY 3255/24, juris; Social Court Stuttgart, Judgment of November 6, 2025 – S 2 AY 3937/25; Social Court Stuttgart, Judgment of February 24, 2026 – S 14 AY 4771/25)
Section 6 of the Asylum Seekers' Benefits Act (AsylbLG) is an enabling clause to ensure, in individual cases, the constitutionally guaranteed minimum subsistence level, which could otherwise not be adequately met, as the law predominantly provides for lump-sum benefits. This provision allows for the granting of benefits that deviate from Sections 3, 3a, and 4 of the AsylbLG in cases of special, atypical needs, in order to address the diverse circumstances of individuals and to ensure a dignified minimum subsistence level in each case, as required by Article 1 Paragraph 1 in conjunction with Article 20 Paragraph 1 of the Basic Law (GG) (see Social Court Heilbronn, judgment of June 23, 2025, S 15 AY 1361/25 ER, para. 17 juris; Frerichs, in: Schlegel/Voelzke, jurisPK-SGB XII, 4th edition, as of December 23, 2024, Section 6 AsylbLG, para. 21). The term "essential" in the law limits benefits to those that are indispensable for securing one's livelihood. This is the case if, taking into account all circumstances of the individual case and including fundamental rights, the subsistence level would be undercut or there is a concrete risk of it being undercut (see SG Heilbronn, loc. cit., para. 18 juris; BeckOK MigR/Decker, 20th ed. 1.1.2025, AsylbLG § 6 para. 9).
Although the legislator did not provide for compulsory health insurance under the Asylum Seekers' Benefits Act (AsylbLG), but rather addressed the existing need for healthcare services through Sections 4 and 6 of the AsylbLG (Draft Law Amending the Asylum Seekers' Benefits Act and the Social Courts Act Concerning the Structure of the Standard Rate Regarding Section 3, BT-Drs 18/2592, page 24), according to the jurisprudence of the Federal Social Court (BSG) (see judgment of March 10, 2022 – B 1 KR 30/20 R, para. 21 et seq., juris), these benefits are not equivalent to health insurance coverage under Section 188 para. 4 sentence 2 of the German Social Code, Book V (SGB V). Therefore, pursuant to Section 188 para. 4 sentence 1 SGB V, compulsory follow-up insurance takes effect after the end of compulsory insurance coverage (see also Social Court Heilbronn, loc. cit., para. 18 juris). The plaintiff therefore cannot evade the corresponding insurance obligation and the associated obligation to pay contributions.
If the plaintiff had to pay the insurance premiums of €324.69 per month from his own resources, he would only have €72.31 per month left to cover his living expenses, given the basic benefits of €397 granted by the defendant pursuant to Sections 3 and 3a Paragraph 1 of the Asylum Seekers' Benefits Act (AsylbLG). This amount is clearly insufficient to cover the plaintiff's living expenses, and his subsistence level would fall below the minimum subsistence level without the defendant's assumption of the premiums. Therefore, the defendant's assumption of the premiums in dispute is essential to secure the plaintiff's livelihood. The legislature also proceeded on this basis, as the aforementioned draft law (see Bundestag printed matter 18/2592, page 24) states: "For those entitled to benefits under Section 3 who are nevertheless covered by statutory health insurance, supplementary coverage is provided via Section 6." The atypical nature of the need required under Section 6 of the Asylum Seekers' Benefits Act (AsylbLG) arises from the fact that, although the plaintiff, as a beneficiary of benefits under the AsylbLG, may be subject to mandatory follow-up insurance, the AsylbLG (unlike the Social Code II and XII, which also serve to secure the constitutionally protected minimum subsistence level) does not contain any provision for considering unavoidable mandatory contributions to statutory health and long-term care insurance as separate needs (see Higher Social Court of Baden-Württemberg, decision of August 5, 2025 – L 7 AY 1344/25 ER-B; Social Court of Stuttgart, judgment of November 6, 2025 – S 2 AY 3937/25).
In the present case, the discretion generally granted to the defendant under Section 6 of the Asylum Seekers' Benefits Act (AsylbLG) is also reduced to zero, meaning that the insurance premiums must be considered as a need. In this context, the court sees no considerations that would justify excluding the plaintiff's insurance premiums from the needs assessment, despite the ongoing significant shortfall in coverage. Since the insurance premiums are payable in cash, and thus benefits in kind are clearly unsuitable for covering the needs, there are also special circumstances justifying the provision of benefits in cash (cf. similar cases: Social Court Freiburg, judgment of March 17, 2025 – S 7 AY 3255/24, para. 39 et seq. juris; Social Court Heilbronn, ibid., para. 19 juris).
The decision on costs is based on § 193 SGG.
The following is information on legal remedies.
