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Apply for replacement care in the social long-term care insurance

If your private caregiver is ill, on vacation or can temporarily not care for you for other reasons, your nursing care fund will pay you the costs for replacement care on request. This representation can be taken over, for example, by a family member or an outpatient care service. Replacement care is sometimes called preventive care.

To be eligible for replacement care, you must, at the time of application,

  • be classified in care level 2, 3, 4 or 5 and
  • be cared for at home by the prevented caregiver for at least 6 months.
  • The nursing grade 2 does not have to have been present during the 6-month pre-care period.
  • It is not necessary for the same caregiver to have cared for the person in need of care for 6 months.
  • Replacement care must be ensured by the substitute nurse to the extent of the respective level of care.
  • You can apply for replacement care for a total of up to 42 days in a calendar year. Replacement care is possible as well as
  • by the hour, if your caregiver is unable to attend for less than 8 hours, as well as
  • daily.

Up to what amount your nursing care fund reimburses the costs depends on who takes over the replacement care.

  • If a family member up to the second degree or a person living in your household provides replacement care, proven costs can be reimbursed up to 1.5 times the care allowance, which are:
    • for care level 2 EUR 474,00
    • for care level 3 EUR 817,50
    • for nursing degree 4 EUR 1.092,50
    • for care level 5 EUR 1.351,50.
  • For all other persons or a nursing service up to EUR 1,612.00 will be refunded.
  • Alternatively, replacement care can take place in an inpatient facility such as a nursing home. Here, too, the nursing care fund pays a maximum of EUR 1,612.00 of the costs.

If the close family member or the person living in your household incurs expenses such as fare or loss of earnings as a result of the substitute care, the nursing care fund can also increase the reimbursement amount to up to EUR 1,612.00.

For the time of replacement care, half of your previous care allowance will continue to be paid.

You can top up replacement care benefits with up to 50 percent of your annual entitlement to short-term care. Your entitlement to short-term care will then be reduced accordingly. You can find out how you can combine the benefits in concrete terms from your nursing care fund or from recognised advice centres, such as care centres.
 

Process flow

For example, you can submit the application for replacement care by post and – with many care funds – hand it in personally at the office or submit it online.

  • You submit the application for replacement care to your nursing care fund.
  • During replacement care, you will have receipts or invoices issued by the caregiver or the nursing service.
  • After replacement care, submit the original receipts or invoices to the nursing care fund.
  • The nursing care fund will check your application and transfer the reimbursement amount to you.
     

Requirements

  • They are cared for at home by a private caregiver.
  • They are classified at least in care level 2.
  • The prevented caregiver has been caring for you for at least 6 months.
  • Replacement care must be ensured by the substitute nurse to the extent of the respective level of care.
     

Which documents are required?

You do not need to submit any documents for the application for replacement care.

You can prove the costs of replacement care to the nursing care fund with original invoices, or by receipts or other payment receipts such as account statements. You can submit the payment receipts informally or by form to your nursing care fund.
 

What are the fees?

You do not have to pay anything for the application.

What deadlines do I have to pay attention to?

You can submit the application for replacement care both before using the replacement care and subsequently.

Processing duration

Processing usually takes about 2 to 3 business days.
For a quick processing and decision, your nursing care fund must have the necessary information and, if necessary, necessary documents completely and meaningfully.
The nursing care fund decides on applications promptly.
Please note that the specified processing time is an average value of all nursing care funds. It may vary in individual cases.
The exact processing time also depends on the complexity of the individual case and can be extended accordingly. The same applies if documents or documents are sent by post to you or your nursing care fund.
 

Applications / forms

- Forms: yes

- Online procedure possible: Many nursing care funds offer an online procedure.

- Written form required: no

- Personal appearance required: no

Application for replacement care via the health insurance navigator of the GKV-Spitzenverband

Appeal

  • Contradiction
  • Action before the Social Court
     

Author

The text was automatically translated based on the German content.

Technically approved by

Federal Ministry of Health

Professionally released on

28.10.2021

competent Bodies

GKV-Spitzenverband

Address: Reinhardtstraße 28, 10117 Berlin, Stadt

Building Access:
elevator available : unknown
wheelchair-accessible : unknown

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.