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Benefits due to long-term care from long-term care insurance (SGB XI) if necessary from social assistance funds

The risk of becoming in need of care can affect anyone. In principle, therefore, everyone is obliged to insure themselves against this risk with a social or private care fund.

Under the current legal situation, there is a need for long-term dependency on the part of persons who, because of illness or disability, need substantial assistance for the ordinary and regularly recurring daily activities. However, it is not illness or disability that determine the need for care that is decisive, but rather the resulting need for help in day-to-day operations.

As of January 1, 2017, the current care levels "0", 1, 2 and 3 for the classification of the care-deprivedness of persons affected have been replaced by the five new care levels 1, 2, 3, 4 and 5.

The medical service of the Health Insurance (MDK) is responsible for determining whether and to what extent there is a need for care. The MDK is commissioned by the responsible nursing care fund when an application for long-term care insurance benefits is submitted.

With the new NBA assessment instrument, the MDK uses the new nba assessment instrument to determine how independent a person is according to a points system. The following applies: The more points the person receives, the higher the level of care and the more care and care services the respective care fund approves.
The following classification of the care levels with the respective required scores applies:

  • Care level 1: Low impairment of self-employment (12.5 to less than 27 points)
  • Care level 2: Significant impairment of self-employment (27 to less than 47.5 points)
  • Care level 3: Severe impairment of self-employment (47.5 to less than 70 points)
  • Care level 4: Severe impairment of self-employment (70 to less than 90 points)
  • Care level 5: Severe impairment of self-employment with special requirements for nursing care (90 to 100 points).

The social assistance institution is also bound by the findings of the MDK. If someone is not covered by care insurance, the social assistance institution will call in the respective health authority with a request for an opinion on the need for care.

Patients are entitled to basic care and home care in kind (home care assistance)
Alternatively, it is possible to receive a care allowance if patients can use it to provide basic care and home care themselves.
A combination of money and benefits in kind (combined service) is possible.

The scope of care insurance also includes offers in case of prevention of the caregiver (home care), day or night care (partial inpatient care) as well as short-term care (temporary inpatient care).
Patients in need of care are entitled to care in full-time care facilities if home or semi-stationary care is not possible or is not considered because of the specificity of the individual case.
In addition, care aids and technical assistance, grants for measures to improve the individual living environment as well as care courses for relatives and volunteer carers can be granted.
Carers or caring neighbours and friends may, where appropriate, receive social security benefits for the carer in the form of contributions to the relevant pension insurance institution.

The long-term care insurance benefits are covered by the long-term care insurance depending on the type of benefit up to certain limits that you will receive from your care fund in the specific case. In the case of full-time care, the costs of accommodation and meals, which you would also have to bear in the home environment, are not covered.
If patients are unable to cover uncovered residual costs, social assistance benefits (SGB XII) may be eligible.
However, social assistance as state aid only occurs if and to the extent that self-help and the help of dependants – usually relatives in a straight line or spouse – are not sufficient.

Who should I contact?

The first contact person for the application for care services is the respective responsible care fund.

Which documents are required?

  • Application to the competent care fund, if applicable to the social assistance institution

What are the fees?

There are no charges.

What deadlines do I have to pay attention to?

Since there is no retroactive provision of care and social assistance benefits, it is advisable to contact the relevant authorities at an early stage, in any case before claiming care services. The benefits of long-term care insurance or social assistance are granted as soon as you meet the requirements, at the earliest since the date of application.

What else should I know?

Social assistance can only be applied for when it is established that benefits from the care fund cannot be granted or are insufficient. The contact person is the respective social office.
The application for social assistance benefits is usually made through the local social service (social workers in the field).

Supporting institutions

Nursing centres, senior services, care advice by the care funds

Author

The text was automatically translated based on the German content.

The text was automatically translated based on the German content.

Technically approved by

Lower Saxony Ministry of Social Affairs, Health and Gender Equality

competent Bodies

Landkreis Emsland - Fachbereich Soziales

Address: Ordeniederung 1 , 49716 Meppen

Postal address: Post Office Box 15 62

Telephone: 05931 44-0
Fax: 05931 44-3621
Transport Connection:
Building Access:
elevator available : yes
wheelchair-accessible : yes
Postal address: Post Office Box 1134

Address: Gerhardyweg 1, 26899 Rhede (Ems)

Telephone: 04964 9182-12
Telephone: 04964 9182-13
Fax: 04964 9182-40
Transport Connection:
Parking:
Handicapped Parking Place: Number: 2, Fees: no
Parking Place: Number: 60, Fees: no
Building Access:
elevator available : yes
wheelchair-accessible : yes
bank account:
recipients: Gemeinde Rhede (Ems)
bank: Emsländische Volksbank
IBAN: DE08266614940000164300
recipients: Gemeinde Rhede (Ems)
bank: Sparkasse Emsland
IBAN: DE06266500010017000019

Ansprechpartner

Point of contact:
Frau Linda Agnesmeyer
Address: Gerhardyweg 1, 26899 Rhede (Ems)
Telephone: 04964 9182-13
Fax: 04964 9182-40
Department:
Sozialamt
Room:
13
responsible for:
Frau Christina Eilers
Address: Gerhardyweg 1, 26899 Rhede (Ems)
Telephone: 04964 9182-12
Fax: 04964 9182-40
Department:
Sozialamt
Room:
13
responsible for:
Herr Holger Knak
Address: Gerhardyweg 1, 26899 Rhede (Ems)
Telephone: 04964 9182-19
Fax: 04964 9182-40
Department:
Ordnungsamt, Sozialamt, Bürgeramt, Standesamt, Gewerbeamt
Room:
19
responsible for:

Data protection information

Gemeinde Rhede (Ems) - Ordnungsamt/Gewerbe/Feuerwehrwesen

Postal address: Post Office Box 1134

Address: Gerhardyweg 1, 26899 Rhede (Ems)

Telephone: 04964 9182-19
Fax: 04964 9182-40
Transport Connection:
Parking:
Handicapped Parking Place: Number: 2, Fees: no
Parking Place: Number: 60, Fees: no
Building Access:
elevator available : yes
wheelchair-accessible : yes
bank account:
recipients: Gemeinde Rhede (Ems)
bank: Emsländische Volksbank
IBAN: DE08266614940000164300
recipients: Gemeinde Rhede (Ems)
bank: Sparkasse Emsland
IBAN: DE06266500010017000019
payment methods:
Sepa Credit Transfer, Bank Transfer, Cash Payment, Sepa Direct Debit, Paypal

Ansprechpartner

Point of contact:
Herr Holger Knak
Address: Gerhardyweg 1, 26899 Rhede (Ems)
Telephone: 04964 9182-19
Fax: 04964 9182-40
Department:
Ordnungsamt, Sozialamt, Bürgeramt, Standesamt, Gewerbeamt
Room:
19
responsible for:

Landkreis Emsland

Address: Ordeniederung 1 , 49716 Meppen

Postal address: Post Office Box 15 62

Telephone: 05931 44-0
Fax: 05931 44-3621
Transport Connection:
Building Access:
elevator available : yes
wheelchair-accessible : yes
bank account:
recipients: Landkreis Emsland
bank: Emsländische Volksbank
BIC: GENODEF1LIG
IBAN: DE26266600600120050000
recipients: Landkreis Emsland
bank: Sparkasse Emsland
BIC: NOLADE21EMS
IBAN: DE39266500010000001339
recipients: Landkreis Emsland
bank: Postbank Hannover
BIC: PBNKDEFF250
IBAN: DE36250100300012132306

Ansprechpartner

Point of contact:
Marc-André Burgdorf
responsible for:
Bernd Otten (Datenschutzbeauftragter)
Telephone: 05931 44-1605
Fax: 05931 44-391605
Room:
605
responsible for:

Landesbeauftragte für den Datenschutz Niedersachsen

Address: Prinzenstraße 5, 30159 Hannover

Telephone: +49 511 12045-00
Fax: +49 511 12045-99
Building Access:
elevator available : unknown
wheelchair-accessible : unknown

Source: Serviceportal Niedersachsen (Portalverbund des Bundes und der Länder)

Further Links

Single points of contact of the state of Lower Saxony, Single points of contact of the countries of Europe, advice and assistance for EU citizens and their families.