Reimbursement of loss of earnings in the case of accompaniment of mentally or physically handicapped persons in hospitalisation Grant
You can be admitted as an accompanying person if a person with a disability is hospitalized. For example, you will spend the night with or near the hospital and also receive your meals there.
It must be decided by a doctor whether an accompanying person is medically necessary. From 01.11.2022, you will receive sickness benefit as a legally insured accompanying person under certain conditions if you have a loss of earnings due to the inpatient admission.
Both you and the accompanying person must have statutory health insurance.
In addition, the person with a disability to be accompanied must meet the following requirements:
- She receives integration assistance benefits in accordance with Part 2 SGB IX, § 35a SGB VIII or § 27d (1) no. 3 BVG.
- It is not accompanied by employees of a service provider of integration assistance for inpatient hospital treatment.
- As an accompanying person of a person with a disability, you must also meet the following requirements so that the health insurance fund can pay sickness benefit:
- You are close relatives or close relatives within the meaning of the Care Leave Act or a person from the closest personal environment;
- They do not provide integration assistance services to the accompanied person for remuneration.
You apply for sickness benefit as an accompanying person to your statutory health insurance fund.
You will receive sickness benefit for the entire duration of your inpatient admission. An all-day accompaniment is also equivalent to the inclusion. A full-day accompaniment exists if the time of your presence in the hospital together with the times of your arrival and departure is at least 8 hours.
Employees: As a rule, the statutory health insurance fund reimburses you as an accompanying person 70 percent of your gross salary, but a maximum of 90 percent of your net salary.
Full-time self-employed: The amount of your sick pay is 70 percent of your earned income of the past 12 months.
Process flow
You can apply for sickness benefit as an accompanying person by post and hand in personally at the office or submit it online to many statutory health insurance companies. Many statutory health insurance companies offer forms. Please contact your health insurance company for more information.
- Obtain medical proof of the medical necessity of the accompaniment.
- Have the times of the inpatient admission or the all-day accompaniment certified.
- Submit the medical certificate and the certificate of your attendance times together with the other necessary documents to the statutory health insurance fund. Your health insurance company is responsible.
- Inform your employer of your absence.
- The statutory health insurance company will examine your application and the documents and will contact you if you have any questions.
- The health insurance company pays you the sickness benefit. For employees: Your health insurance fund pays your sick pay only after your employer has provided the health insurance fund with the necessary information about your salary.
Requirements
- You and the person with a disability you accompany have statutory health insurance.
- The person to be accompanied is treated as an inpatient in the hospital.
- Inpatient admission as an accompanying person is medically necessary. A full-day accompaniment is equivalent, i.e. the time of your presence in the hospital together with your arrival and departure time is at least 8 hours.
- You have a loss of earnings.
- You are a close relative or part of the closest environment.
- The person to be accompanied receives integration assistance benefits. You will not receive sick pay from the health insurance company if, for example, you accompany the person with a disability as a personal assistant and receive remuneration for it. If you accompany the person with disabilities as part of the integration assistance, the costs are covered by the integration assistance providers.
Which documents are required?
- Medical certificate of the medical necessity of inpatient admission
- Confirmation from the hospital about the times of admission or all-day accompaniment
- If applicable, proof of earnings or proof of loss of earnings (For employees, the employer regularly reports the required salary data.)
What are the fees?
There are no costs.
What deadlines do I have to pay attention to?
There is no deadline.
Legal basis
Applications / forms
Forms available: No
Written form required: No
Informal application possible: Yes
Personal appearance required: No
Online services available: Yes
Technically approved by
Federal Ministry of Health
Professionally released on
07.04.2022
Author
The text was automatically translated based on the German content.
