351.5
ELG
CH-SG
CH-SG
Art. 4bis Ergänzungsleistungsgesetz (ELG) - Krankheits- und Behinderungskosten a) Grundsatz
I. Ordentliche Ergänzungsleistungen
Art. 4bis ELG · Krankheits- und Behinderungskosten a) Grundsatz
1. Der Anspruch auf Vergütung der ausgewiesenen Krankheits- und Behinderungskosten nach Art. 14 Abs. 1 Bst. a bis g des Bundesgesetzes über Ergänzungsleistungen vom 6. Oktober 2006 beschränkt sich auf die im Rahmen einer wirtschaftlichen und zweckmässigen Leistungserbringung erforderlichen Ausgaben, soweit diese nicht Versicherer oder Dritte decken.
2. Pflichtleistungen, die von Versicherern der obligatorischen Sozialversicherungen angerechnet wurden, gelten als wirtschaftlich und zweckmässig. Kosten, die den Leistungskatalog einer obligatorischen Sozialversicherung übersteigen, werden nicht vergütet.
3. ...
4. Als Höchstbeträge gelten die in Art. 14 Abs. 3 bis 5 des Bundesgesetzes über Ergänzungsleistungen vom 6. Oktober 2006 festgelegten Ansätze.
5. Die Regierung regelt die Einzelheiten durch Verordnung.
Gerichtsentscheide zu dieser Bestimmung (18)
EL.2022.35 · sg (Art. 4bis ELG/SG)
Spousal Home Care Compensation and Hypothetical Earnings Loss
Cited as the cantonal law providing for the reimbursement of proven sickness and disability costs, including home care.
EL.2022.35 · sg (Art. 4bis ELG/SG)
Compensation for Spousal Caregiver Exclusion in Supplementary Benefit Calculation
This article establishes the cantonal obligation to compensate for illness and disability costs, including home care.
EL.2021.16 · sg (Art. 4bis Abs. 5 ELG/SG)
Claimant v. Social Insurance Institution (Lost Earnings for Child Care)
Cited in the reasoning as the basis for the cantonal government regulating compensation details.
EL.2021.16 · sg (Art. 4bis Abs. 5 ELG/SG)
Mother's Claim for Lost Earnings Due to Caregiving Offset by Existing Income
This article delegates the regulation of details regarding the entitlement to compensation for sickness and disability costs to the Cantonal Government, which enacted the relevant cantonal ordinance.
EL.2020.19 · sg (Art. 4bis Abs. 5 ELG/SG)
Appeal Dismissed for Ketogenetic Diet Cost Reimbursement
This provision, along with Art. 5 VKB/SG, defines what constitutes proven, essential additional costs for a medically necessary diet eligible for reimbursement in St. Gallen.
EL.2020.19 · sg (Art. 4bis Abs. 5 ELG/SG)
Keto Diet Reimbursement Appeal Dismissed
Cited in the preamble, defining compensable diet costs as those for a medically necessary diet under cantonal law.
EL.2019.36 · sg (Art. 4bis Abs. 1 ELG/SG)
Recipient Appeal: Denial of Oxygen Therapy Transportation Reimbursement and Public Transport Pass
The court applied this article to establish that the refund of proven sickness and disability costs is only granted within the scope of economically efficient and appropriate service provision.
EL.2019.36 · sg (Art. 4bis Abs. 1 ELG/SG)
Refusal of Reimbursement for Non-Recognized Therapy Transport Costs and General Public Transport Subscription for Supplementary Benefit Recipients
This provision governs the scope of compensation for sickness and disability costs under St. Gallen law, requiring costs to be economically sensible and appropriate, which was central to denying compensation for the disputed therapy costs.
EL.2018.21 · sg (Art. 4bis Abs. 5 ELG/SG)
Appeal for Lost Earnings Due to Caregiving Compensation
This cantonal provision establishes the legal entitlement to compensation for care and support by family members, which is the subject of the claim.
EL.2017.13 · sg (Art. 4bis des St. Galler ELG)
Appeal Regarding Supplementary Benefits Imputation of Hypothetical Unemployment Income and Childcare Costs Denial
Mentioned in the reasoning as the basis for the St. Gallen Ordinance on the reimbursement of sickness and disability costs (VKB).
EL.2014.28 · sg (Art. 4bis Abs. 5 ELG/SG)
Appeal Regarding Compensation for Caregiver's Lost Earnings Denied Due to Daycare Availability
Cited in the reasoning section (Erwägungen 1) regarding the reimbursement conditions for care provided by family members.
EL.2014.28 · sg (Art. 4bis Abs. 5 ELG/SG)
Caregiver Compensation Appeal: Loss of Earnings Assessment Remanded
Cited in conjunction with Art. 12 VKB regarding compensation for care provided by family members, only if it causes a significant loss of earnings.
EL.2013.67 · sg (Art. 4bis Abs. 5 ELG/SG)
Appeal Dismissed for Caregiver Reimbursement and Legal Aid Denial
This provision delegated the regulation of details concerning the scope of reimbursement for care and support to the government.
EL.2013.67 · sg (Art. 4bis Abs. 5 ELG/SG)
Visual Impairment Care Compensation Appeal Dismissed
This provision delegates the regulation of details to the government, which established the criteria (mother's earning loss) used to rule on the claim.
EL.2011.34 · sg (Art. 4bis ELG/SG)
Claimant v. Social Security Administration (Home Care Reimbursement and Lost Earnings Assessment)
This cantonal law provision, related to the limitation of claimable expenses for care and support by family members, is directly referenced in the order overturning the previous decision concerning the claim for care costs.