Service Finder
Applying for home care for disabled persons with long-term care insurance
Service Description
Do you live as a person with a disability in a residential home or another fully inpatient facility that enables you to participate socially and helps you to integrate into working life? Then your care insurance fund will cover 15% of the costs under certain conditions.
However, the care insurance fund pays a maximum of EUR 266.00 per month and you bear the remaining costs yourself. If your income is not sufficient for this, you are entitled to basic security benefits in old age and in the event of reduced earning capacity or housing benefit. To do this, you must submit an application to the social welfare office. This is usually the social welfare office in your place of residence.
This also applies to special forms of housing such as a residential home or a residential group for people with disabilities. This must
- the focus must be on communal living and integration into society,
- the Housing and Care Act must be applied and
- the scope of care must largely correspond to the care provided in a fully inpatient facility.
If you are at home with your relatives at the weekend or during the vacations, you are entitled to the following benefits for this time:
- Care benefits in kind: This refers to the services of an outpatient care service. Your entitlement to care benefits in kind is reduced by the amount that the care insurance fund pays for accommodation in a residential home or boarding school during this month. For example, if you are at home 10 days a month, the amount paid by your care insurance fund for the 20 days you spent in a residential home or boarding school will be deducted from the amount you are entitled to in kind each month.
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Care allowance: If you are supported by relatives or volunteers during your time at home, you can receive care allowance. For each day you spend at home, you will receive 1/30 of the monthly care allowance. The day of arrival and departure counts as a full day at home. You will also receive care allowance if you receive care services in kind at the same time. This does not reduce your care allowance.
Process flow
You can submit the application for cost coverage for care in a fully inpatient facility for people with disabilities by post, for example, or - with many long-term care insurance companies - in person at the office or online.
- Submit the application for full inpatient care in facilities for people with disabilities to your care insurance fund. If you are unable to do this yourself, you can authorize someone in writing.
- The care insurance fund will check your application and inform you of the result.
- Once your application has been processed, your care insurance fund will transfer the monthly benefit contribution directly to your facility.
- Your care insurance fund can also provide you with a list of approved facilities for the disabled where you can compare services and prices.
Requirements
- You have care level 2, 3, 4 or 5.
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You live in a
- full inpatient facility for people with disabilities or a
- comparable form of accommodation.
Which documents are required?
- If applicable: Power of attorney, guardian's certificate
- Notification from the long-term care insurance fund about the determination of the degree of care (expert opinion from the medical service of the long-term care insurance)
- If applicable: medical documents
- If applicable: certificate of severe disability
- Proof of health and long-term care insurance
Depending on the individual case, further documents may be required. Please contact your care insurance fund for more information.
What are the fees?
You do not have to pay anything for the application.
What deadlines do I have to pay attention to?
You will only receive the benefit from your long-term care insurance fund from the month in which you submit the application, but at the earliest from the date on which the eligibility criteria are met. If the application is not submitted in the calendar month in which the need for care arose, but later, the benefits will be granted from the beginning of the month in which the application was submitted.
Processing duration
Processing normally takes around 2 to 6 working days.
In order to process and decide quickly, your long-term care insurance fund must have the necessary information and any required documents in a complete and meaningful form.
The long-term care insurance fund decides on applications promptly.
Please note that the processing time stated is an average value for all long-term care insurance funds. It may vary in individual cases.
The exact processing time also depends on the complexity of the individual case and may be longer. The same applies if documents or records are sent to you or your long-term care insurance fund by post.
If the need for care or the entitlement to care benefits has not yet been established in your case or if an application is made to upgrade the level of care, the Medical Service must be involved. This usually extends the processing of your application by around 3 to 4 weeks.
Applications / forms
- Objection
- Action before the social court
Appeal
- Forms: yes
- Online procedure possible: Many long-term care insurance companies offer an online procedure.
- Written form required: no
- Personal appearance necessary: no
Further Information
Author
The text was automatically translated based on the German content.
- Care in fully inpatient facilities for people with disabilities Cost coverage
Remark: Display of performance in the source portal
Technically approved by
Federal Ministry of Health
Professionally released on
22.11.2021
Source: Zuständigkeitsfinder Thüringen (Linie6PLus)