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

If your private caregiver is ill, on holiday or temporarily unable to care for you for other reasons, your nursing care fund will pay you the costs for replacement care upon request. This representation can, for example, be taken over by a family member or an outpatient care service. Replacement care is sometimes also called preventative care.

In order to be entitled to replacement care, you must, at the time of application:

  • be classified at care level 2, 3, 4 or 5 and
  • have been cared for at home by the prevented caregiver for at least 6 months.
  • Care level 2 does not have to have already existed during the 6-month pre-care period.
  • It is not necessary that the same caregiver must have cared for the patient for 6 months.
  • The replacement care must be ensured by the substitute nurse to the extent of the respective degree of care.
  • You can apply for replacement care for a total of up to 42 days per calendar year. A replacement care is possible both
  • by the hour, if your caregiver is prevented for less than 8 hours, as well as
  • daily.

The amount up to which 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 care level 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 reimbursed.
  • Alternatively, substitute 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 travel allowances or loss of earnings as a result of the replacement care, the nursing care fund can also increase the reimbursement amount to up to EUR 1,612.00.

For the period 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 services in concrete terms from your nursing care insurance fund or from recognised counselling centres, such as Pflegestützpunkte.

Process flow

You can, for example, submit the application for replacement care by post and – in the case of many care insurance 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 nursing service.
  • After the replacement care, you submit the original receipts or invoices to the nursing care fund.
  • The care insurance fund will examine your application and transfer the reimbursement amount to you.


  • You will be 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.
  • The replacement care must be ensured by the substitute nurse to the extent of the respective degree of care.

Which documents are required?

You do not have 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 bank statements. You can submit the proof of payment 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 apply for replacement care both before using the substitute care and afterwards.

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 complete and meaningful.
The nursing care fund decides on applications promptly.
Please note that the stated processing time is an average value of all care insurance 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 care insurance companies offer an online procedure.

- Written form required: no

- Personal appearance required: no

Application for replacement care via the cash register navigator of the GKV-Spitzenverband


  • Contradiction
  • Action before the Social Court

Technically approved by

Federal Ministry of Health

Professionally released on



The text was automatically translated based on the German content.

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