Applying for long-term care benefits in kind for persons with long-term care insurance

You can apply for long-term care benefits in kind (home care assistance through outpatient services), for example, 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 long-term care benefits in kind 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 found a degree of care of at least 2, the nursing care fund commissions the medical service or other independent expert services to check whether there is a need for care at least to the extent of care level 2.
• The nursing care fund evaluates the report, examines your application and informs you of the result.
• Your long-term care fund may also give you a list of approved care services where you can compare services and prices.
• Your nursing care fund settles directly with the outpatient nursing service.
   

• You have care level 2, 3, 4 or 5
  • in the case of care level 1, you can only apply for the relief amount
• The care benefit in kind is provided by an approved outpatient nursing or care service (or individuals) who have concluded a contract with your nursing care fund.
   

• If you already have a nursing degree: Notification of the nursing care fund on determination of the degree of care (report of the medical service of the nursing care insurance)
• if applicable: power of attorney, supervisor card
• 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.
 

You do not have to pay anything for the application.

The entitlement to care benefit in kind is valid from the date of application, but at the earliest from the date on which the conditions for eligibility are met. If the application is not submitted in the calendar month in which the dependency occurred, but later, the benefits shall be granted from the beginning of the month in which the application was submitted. Therefore, you should submit the application in good time.
If the nursing care fund does not issue the written notification within 25 working days after receipt of the application or if one of the assessment deadlines specified in the law is not complied with, the nursing care fund must pay you EUR 70.00 immediately after expiry of the deadline for each week of exceeding the deadline. This does not apply if the nursing care fund is not responsible for the delay or if you are in full inpatient care and at least care level 2 has already been determined.
If you make use of a combined benefit of the person in need of care, you are bound for 6 months to the decision to divide the benefit in kind or in cash.
 

Processing usually takes about 1 to 2 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 the need for long-term care or the entitlement to care benefits has not yet been determined in your case or an application for an upgrade with regard to the degree of care is made, the Medical Service must be involved. In certain case constellations, the Medical Service must carry out an assessment within 1 or 2 weeks after receipt of the application.
 

- Forms: yes

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

- Written form required: no

- Personal appearance required: no
 

• Contradiction
• Action before the Social Court

Federal Ministry of Health

22.11.2021

The text was automatically translated based on the German content.