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Applying for long-term care allowance in social long-term care insurance


If you are in need of care, you decide for yourself who and where you are cared for. If you are cared for at home by family members, acquaintances or other volunteers, you will be paid care allowance under long-term care insurance. You can apply for this from your long-term care insurance fund. The long-term care insurance fund is affiliated with your statutory health insurance company, so you can use the same contact details.

You are entitled to care allowance if:

  • You are classified in care level 2, 3, 4 or 5 and
  • the person you choose will provide complete home care. This may include, for example, personal hygiene, laundry, and cooking.

The care allowance will be transferred to you monthly by your long-term care insurance fund. You can independently pass it on to the person who cares for you as recognition and expense allowance. The amount of the monthly care allowance is staggered according to your need for care:

  • Care level 2: EUR 316.00
  • Care level 3: EUR 545.00
  • Care level 4: EUR 728.00
  • Care level 5: EUR 901.00

During short-term care or substitute care, you will continue to receive 50 percent of the care allowance.

If you receive care allowance, you will receive a counselling visit at home every six months – for care level 2 or 3 – or every quarter – for care level 4 or 5. You decide for yourself who will carry out this procedure: you choose a nursing service or a recognised counselling centre and make an appointment. The law prescribes the counselling visits. These are designed to ensure that you are well taken care of at home. You and your caregiver will receive nursing tips and support at these appointments. In the case of long-term care insurance, the long-term care insurance fund pays the costs of the consultation visits and settles them directly with the service provider.
 

Process flow

You can apply for long-term care allowance, for example, by post or – in the case of many long-term care insurance companies – hand it in in person at the office or submit it online.  

  • You submit the application for long-term care allowance to your long-term care insurance fund. If you are unable to do so yourself, you can authorize someone in writing.
  • The long-term care insurance fund will review your application for long-term care allowance and
  • transfers your care allowance to you on a monthly basis.
     

Requirements

  • They are classified as care level 2, 3, 4, or 5
  • You will be cared for at home by a private, non-professional caregiver who will be able to provide your home care
     

Which documents are required?

You do not need to submit any documents to apply for care allowance.
Depending on the individual case, further documents may be required. Please contact your long-term care insurance company for more information.
 

What are the fees?

You don't have to pay anything for the application.

What deadlines do I have to pay attention to?

The entitlement to care allowance applies from the date of application, but at the earliest from the date on which the conditions for entitlement are met. If the application is not made in the calendar month in which the need for care arose, but later, the benefits are granted from the beginning of the month in which the application is submitted. Therefore, you should submit the application in good time.

Processing duration

It usually takes about 2 to 3 business days to process.
In order to process and make a decision quickly, your long-term care insurance fund must have the necessary information and, if necessary, documents complete and meaningful.
The long-term care insurance fund decides on applications in a timely manner.
Please note that the stated processing time is an average value for all long-term 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 records are sent by post to you or your long-term care insurance fund.
If necessary, the medical service must be involved.
 

Applications / forms

Forms: yes

Online procedure possible: Many long-term care insurance companies offer an online procedure.

Written form required: no

Personal appearance required: no

Appeal

  • Contradiction
  • Appeal to the Social Court
     

Technically approved by

Federal Ministry of Health

Professionally released on

28.10.2021

Author

The text was automatically translated based on the German content.

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