Applying for a combined benefit for persons with long-term care insurance
If you are cared for at home, you are entitled to care benefits in kind. These include body-related care services, nursing care measures or help with housekeeping. In addition, the care insurance pays you care allowance. The maximum monthly amount for long-term care benefits depends on your level of care:
- for care level 2 maximum EUR 689.00
- at care level 3 maximum EUR 1,298
- for care level 4 maximum EUR 1,612
- for care level 5 maximum EUR 1,995
You can combine care benefits in kind and care allowance. In this case, one speaks of a combination performance. The costs are calculated proportionately: the more care benefits you claim, the less care allowance you receive. If, for example, you claim 80 percent of all care benefits in kind to which you are entitled, you will no longer receive 100 percent of the maximum care allowance, but 20 percent. If, on the other hand, you make use of only a few long-term care benefits, you will receive correspondingly more care allowance.
Your decision on the relationship between cash and non-cash benefits is binding for 6 months.
You can, for example, submit the application for a combined benefit by post and – in the case of many care insurance funds – hand it in personally at the office or submit it online.
- Calculate the proportion of the maximum monthly amount of long-term care benefit that you are entitled to according to your level of care for long-term care benefits in kind.
- If, for example, the monthly costs of the care benefit in kind amount to 70 percent of the maximum amount, you will still receive 30 percent of the care allowance.
- Submit the application for a combined benefit to your long-term care fund. If you are unable to do so yourself, you can authorize someone in writing.
- If you have not yet been diagnosed with a degree of care of at least 2, the nursing insurance fund commissions the medical service or other independent expert services to check whether there is a need for care to the extent of at least care level 2.
- The nursing care fund evaluates the report, examines your application and informs you of the result.
- Your care fund can give you a list of approved care services where you can compare services and prices.
- Your nursing care fund settles the care benefit in kind directly with the outpatient care service.
- You have care level 2, 3, 4 or 5.
- They are cared for at home.
- They do not make full use of long-term care benefits in kind.
Which documents are required?
- if applicable: power of attorney, supervisor card
- if applicable: decision of the nursing care fund on determination of the degree of care (report of the medical service of the nursing care insurance)
- where applicable: medical documents
- if applicable: severely disabled person's pass
Depending on the individual case, further documents may be required. Please contact your nursing care insurance fund for more information.
What are the fees?
You do not have to pay anything for the application.
What deadlines do I have to pay attention to?
If you make use of a combined service, you are bound to this decision for 6 months. This means that you cannot change the ratio in which you combine care benefits in kind and care allowance. An exception is if your condition deteriorates greatly and you need more care.
Processing usually takes about 2 to 3 working 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.
If necessary, the Medical Service must be involved. The processing of your request is usually extended by about 2 to 3 weeks.
Applications / forms
- Forms: yes
- Online procedure possible: Many care insurance companies offer an online procedure.
- Written form required: no
- Personal appearance required: no
- 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.