Service Finder
Apply for full inpatient home care for people with long-term care insurance
Service Description
As a person with nursing care insurance, you are entitled to nursing care in a nursing home or another fully inpatient facility if home or semi-inpatient care is not possible or cannot be considered due to the special nature of your case.
In addition to the actual care services, the scope of benefits also includes social care and medical treatment care.
The maximum monthly amount that long-term care insurance companies pay for full inpatient care services depends on your care level (as of 2021):
- a maximum of EUR 770.00 for care level 2
- for care level 3, a maximum of EUR 1,262
- a maximum of EUR 1,775 for care level 4
- for care level 5 a maximum of EUR 2,005
In most cases, the costs of full inpatient care are higher than the amount covered by your care insurance fund. You then pay a co-payment. This is the same for all residents within a facility, regardless of the care level. For example, if you have care level 5, you will pay the same amount as someone with care level 2.
From January 2022, your own contribution to care-related expenses will be reduced. The long-term care insurance fund will then pay a supplement to your own contribution. The supplement depends on the duration of full inpatient care.
This supplement to your own contribution amounts to
- 5 percent if you receive full inpatient care for up to and including 12 months,
- 25 percent if you receive full inpatient care for more than 12 months,
- 45 percent if you receive full inpatient care for more than 24 months,
- 70 percent if you receive full inpatient care for more than 36 months.
The cost of care in a nursing home can vary greatly from one facility to another. You also bear the costs yourself:
- Costs for accommodation and meals
- possibly costs for calculable investments. These are costs incurred by the care home, for example for building rental or purchases. These costs can be passed on to the residents of the facility
- possibly costs for additional services. These are also referred to as "comfort services". This refers, for example, to a single room, special meals or special care services.
If you are unable to cover the additional costs yourself, your relatives will have to pay for them. However, children only have to contribute to the costs of the care facility if their annual gross income exceeds EUR 100,000. If your relatives are also unable to cover the costs, you will receive state support from the social welfare office.
If you live in a care home during the week and are cared for by relatives at home at the weekend, you can also apply for home care benefits, for example care allowance or care aids.
If you need help choosing a suitable care facility, contact your care insurance fund or your nearest care support center.
Process flow
You can submit your application for full inpatient residential care by post, for example, or - in the case of many long-term care insurance companies - in person at the office or online.
- You submit the application for full inpatient care to your care insurance fund. If you are not able to do this yourself, you can authorize someone in writing.
- If you have not yet been determined to have a care level of at least 2, the long-term care insurance fund will commission the Medical Service or other independent expert services to check whether you have a need for care of at least this level.
- The long-term care insurance fund evaluates the report, checks your application and informs you of the result.
- Your care insurance fund can provide you with a list of approved care homes where you can compare services and prices.
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Your care insurance fund will invoice the service directly to the care facility you have chosen.
Requirements
-
You have care level 2, 3, 4 or 5
- If you have care level 1, you can apply for the relief amount
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You cannot be cared for at home or on a semi-stationary basis
Which documents are required?
- If you already have a care degree: if applicable, notification from the care insurance fund about the care degree determination (expert opinion from the medical service of the care insurance)
- If applicable: power of attorney, guardian's certificate
- If applicable: medical documents
- If applicable: certificate of severe disability
Depending on the individual case, further documents may be required. Please contact your health insurance company 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. You should therefore submit your application in good time.
If the long-term care insurance fund does not issue the written decision within 25 working days of receipt of the application or if one of the assessment deadlines specified in the law is not met, the long-term care insurance fund must immediately pay you EUR 70.00 for each week that the deadline is exceeded. This does not apply if the long-term care insurance fund is not responsible for the delay or if you are already in full inpatient care and have already been awarded at least care level 2.
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 indicated 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 statutory long-term care insurance funds offer an online procedure.
- Written form required: no
- Personal appearance necessary: no
What else should I know?
In some federal states, you can apply for a care allowance in addition to the benefits provided by your care insurance fund.
You can change care home at any time.
Further Information
Author
The text was automatically translated based on the German content.
- Full inpatient care for people with statutory long-term care insurance Provision of information
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)