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Applying for day and night care for people in need of care in social long-term care insurance


If you have at least care level 2 and are cared for at home, you are entitled to temporary, semi-inpatient care in day and night care facilities.

Semi-inpatient care is intended to relieve the burden on family caregivers and ensure continuous care for those in need of care. Day care is usually provided by people in need of care whose relatives work during the day: those in need of care are picked up by a transport service in the morning and brought back home in the afternoon. Night care is a facility for people in need of care who also need to be cared for at night, for example for wound treatment or for seamless care in the event of dementia.

If you or an authorised person submit an application to your long-term care insurance fund, it will cover the costs of day or night care up to a certain amount. The long-term care insurance fund is affiliated with your statutory health insurance fund. So you can use the same contact details.

The long-term care insurance funds cover the costs of day or night care

  • only in approved establishments with which they have concluded supply contracts, and
  • only for nursing services, social care and transport services. Other costs, for example for your food, are borne by you.

The maximum monthly amount that long-term care insurance companies pay for day and night care depends on your level of care (as of 2021):

  • for care level 2 up to EUR 689.00
  • for care level 3 a maximum of EUR 1,298.00
  • for care level 4 up to EUR 1,612.00
  • for care level 5 a maximum of EUR 1,995.00

You can apply for the money for day and night care in addition to other benefits from your long-term care insurance fund. Care allowance and care benefits in kind will therefore continue to be paid to you in full.
 

Process flow

You can apply for day and night care, 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 day and night care 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 and inform you of the result.
  • You are looking for a facility for day care or night care. For example, you can find out about suitable providers from your long-term care insurance fund.
  • As a rule, the long-term care insurance fund settles directly with the facility.
     

Requirements

  • You have care level 2, 3, 4 or 5
  • They are cared for at home
    • If you have care level 1, you can apply for the relief amount
       

Which documents are required?

  • If applicable: power of attorney, supervisor ID card
  • Notification of the long-term care insurance fund on the determination of the degree of care (expert opinion of the medical service of the long-term care insurance)
  • if applicable: medical records
  • If applicable: Severely disabled person's pass
  • Proof of health and long-term care insurance

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?

As a rule, you do not have to observe any deadlines.

Processing duration

It usually takes about 2 working 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.
 

Applications / forms

- Forms: yes

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

- Written form required: yes

- Personal appearance required: no
 

Appeal

  • Contradiction
  • Appeal to the Social Court
     

Technically approved by

Federal Ministry of Health

Professionally released on

22.11.2021

Author

The text was automatically translated based on the German content.

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