Service Finder
Apply for home health care for people with statutory health insurance
Service Description
Your doctor can prescribe home health care if you need support, for example, after an operation or serious illness.
If you have statutory health insurance, home health care must be approved in advance by your health insurer. You can then - with the help of your health insurance company if you wish - select a suitable care service that is a contractual partner of your health insurance company.
The care can take place in your home, with your family or in another suitable place. These are, for example, assisted living facilities as well as school and kindergarten for children and adolescents.
Home health care may include:
- Basic care: this includes, for example, personal hygiene, nutrition and mobility.
- Treatment care: Treatment care helps to cure the illness or prevent it from getting worse. This includes, for example, giving injections or wound care.
- Domestic care: This is help in the household, for example, shopping, washing or cleaning the apartment.
Support care
The so-called support care is necessary
- if you have a serious illness
- an illness worsens acutely
- and you need support, especially after a hospital stay, outpatient surgery or outpatient hospital treatment.
Supportive care usually includes basic care and household chores. The statutory health insurance funds cover supportive care for each case of illness for up to 4 weeks. An extension for medical reasons is possible.
Backup care
If home nursing care ensures the success of medical treatment, your statutory health insurance pays for so-called backup care. This covers treatment care for as long as it is medically necessary.
Some health insurers have stipulated in their statutes that basic care and domestic services can also be paid for in addition to treatment care.
Hospital avoidance care
You receive the so-called hospital avoidance care,
- if treatment in hospital is not possible,
- you can return home sooner after hospital treatment thanks to home nursing care,
- or hospital treatment can be avoided altogether through home health care.
Hospital avoidance care includes treatment care and - if necessary - also basic care as well as domestic care. Hospital avoidance care is covered by the statutory health insurance funds for up to 4 weeks per case of illness. An extension for medical reasons is possible.
Process flow
To get home health care, you usually do the following:
- Your doctor prescribes home health care for you.
- You select a nursing service that is a contractual partner of your health insurance company. If you wish, your health insurance company will assist you in selecting a suitable provider.
- You present the doctor's prescription to the nursing service. As a rule, the care service will take care of the application to your health insurance company. Alternatively, you can submit the doctor's prescription directly to your health insurance company.
- Your health insurance company will check whether you can receive home nursing care.
- If your health insurance company has approved the application, the nursing service settles directly with your health insurance company.
Requirements
- Home health care has been prescribed for you by a doctor.
- There is no one in your household who could care for you or provide you with care to the extent required.
- For supportive care: You are not in need of care with care degree 2, 3, 4 or 5.
Which documents are required?
- Medical prescription
What are the fees?
Adults pay EUR 10.00 for each prescription plus 10 percent of the costs as a statutory co-payment. This applies for the first 28 days per calendar year.
The statutory co-payment does not apply if
- you require home health care due to pregnancy or childbirth.
- you are exempt from the statutory co-payment obligation.
What deadlines do I have to pay attention to?
You do not have to observe any deadlines. You or your nursing service must submit the doctor's prescription to your health insurance fund before the start of home health care.
If you are already receiving home health care or want to receive it immediately, the health insurance fund will only cover the costs of the services provided by the care service until a decision is made on approval if the prescription is received by the health insurance fund no later than 3 working days after the prescription is issued.
Legal basis
Applications / forms
- Objection
- Action before the social court
Appeal
- Forms: no
- Online procedure possible: no
- Written form required: no
- Personal appearance required: no
Supporting institutions
You can reach the nationwide advice hotline* at:
0800 0 11 77 22 (German)
0800 0 11 77 23 (Turkish)
0800 0 11 77 24 (Russian )
(*free of charge from the German landline network, mobile phone rates for counseling in German vary)
UPD Counseling Center Erfurt
Eugen-Richter-Strasse 45
99085 Erfurt
Phone: (0361) 555 14 47 | Fax: (0361) 555 14 46 (chargeable)
Author
The text was automatically translated based on the German content per DeepL.
Technically approved by
Federal Ministry of Health
Professionally released on
25.12.2020
Source: Zuständigkeitsfinder Thüringen (Linie6PLus)
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