No longer entitled to reimbursements

In some cases, you may lose your entitlement to reimbursements. This can happen if you have not paid your health insurance contributions or if your social security contributions are not in order. This situation is commonly referred to as being “not in order”.

Not entitled to a reimbursement under the supplementary benefits

Your entitlement to reimbursement under the supplementary benefits is directly linked to the payment of your health insurance contribution. If you have not paid your contribution to Helan (or even to your previous health insurance fund), or if payments were not made on time, you lose your entitlement to these reimbursements.

Did you forget to pay your health insurance contribution to Helan?

If you do not pay your health insurance contribution for more than 3 months, your entitlement to reimbursement under the supplementary benefits will be suspended.

• Check in My Helan whether you still have an outstanding invoice
• Pay the invoice

Have you recently switched to Helan?

By law, Helan is required to take over the payment history from your previous health insurance fund. If there are still outstanding contributions there, you must first pay these invoices before becoming entitled to reimbursements with Helan as well.

• Pay the invoice or invoices from your previous health insurance fund
• Keep your bank statement as proof of payment
• Open My Helan and upload the statement via “proof of payment with another health insurance fund”

Not entitled to a reimbursement under the statutory health insurance

Your entitlement to reimbursement under the statutory health insurance is linked to the payment of (sufficient) social security contributions. To determine whether you are entitled to reimbursement of your medical expenses this year, we always look back two years.

Are you self-employed?

Everyone pays social security contributions, but how and how much you pay depends on your status:

• Employees usually do not have to think about this. Social security contributions are automatically deducted from their salary.
• Self-employed workers must arrange this themselves every quarter through their social insurance fund.
• People who received benefits for a minimum number of days due to retirement, unemployment, incapacity for work, or parental leave must also pay social security contributions.

How can you restore your entitlement to reimbursement?

Helan monitors your entitlements together with you. If your status is not in order, you will receive a letter with a personal proposal explaining how to restore your entitlement to reimbursement through compulsory health insurance. This can be done in several ways:

• By paying an additional contribution to the compulsory health insurance scheme. This contribution changes every year and also depends on your personal situation.
• By completing specific forms. If you have stopped working, you may possibly be registered as a dependent of your partner.
• By submitting an international convention form if you work abroad.
  • Do you work within the EEA? We need an S1 form from your foreign insurer.
  • Do you work in Albania, Algeria, Bosnia and Herzegovina, North Macedonia, Serbia, Tunisia, or Turkey? These are countries for which we require a bilateral form from your foreign insurer.