Apply for domestic help from the statutory health insurance

You can submit the application for domestic help by post and – with many statutory health insurance companies – hand it in personally at the office or submit it online.

• Fill out the application form from your statutory health insurance company and submit it to your health insurance company together with the medical certificate on the necessity and duration of the domestic help.
• Your health insurance company will check your entitlement to domestic help and advise you on suitable providers. Alternatively, you can choose a domestic help yourself, provided that this person is a contractual partner of your health insurance company.
• You hire the domestic help.
   

You must meet the following requirements if you are hiring domestic help during a hospital stay, medical care for mothers or fathers or
apply for medical rehabilitation:

• You have statutory health insurance.
• You have received a medical certificate stating the necessity and duration of domestic help.
• There is a child living in your household who
  • younger than 12 years of age at the beginning of domestic help, or
  • disabled and dependent on help.
• There is no other person living in your household who could continue it.

You must meet the following requirements if you are due to a serious illness, after a hospital stay or
apply for domestic help for 4 weeks after an operation:

• You have statutory health insurance.
• You are not in need of care with care level 2, 3, 4 or 5 (note: in this case, however, domestic help may be considered for the care of the child).
• You have received a medical certificate stating the necessity and duration of domestic help.
• There is no other person living in the household who could continue it.
• The entitlement is extended to up to 26 weeks if
  • There is a child living in your household who
    • younger than 12 years of age at the beginning of domestic help, or
    • disabled and dependent on help.
       

• medical certificate stating the necessity and duration of domestic help

The domestic help usually settles the costs directly with your health insurance company. For each day of domestic help, you pay a co-payment if you are over 18 years old. The co-payment is 10 percent of the costs, but at least EUR 5.00 and a maximum of EUR 10.00 per day.

The statutory co-payment does not apply if

• You need domestic help because of pregnancy or childbirth.
• You are exempt from the statutory obligation to pay co-payments.
   

You must apply for domestic help from your health insurance company before claiming the service. If you have hired a domestic help on your own without the consent of your health insurance company, the costs can only be reimbursed in exceptional cases.

It usually takes about 1 to 15 business days to process.
For a quick processing and decision, your health insurance company must have the necessary information and, if necessary, the necessary documents complete and meaningful.
The health insurance company decides on applications in a timely manner, whereby the statutory processing deadline is observed in order to protect patients' rights.
Please note that the stated processing time is an average value of all health insurance companies. 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 records are sent by post to you or your health insurance company.
If necessary, the medical service must be involved. This requires an additional 5 weeks to process your request.
 

- Forms: yes

- Online procedure possible: Many statutory health insurance companies offer an online procedure.

- Written form required: no

- Personal appearance required: no
 

• Contradiction
• Action before the Social Court
   

Federal Ministry of Health
 

25.10.2021

The text was automatically translated based on the German content.