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Apply for care assistance


Do you have impairments in your independence or abilities that exist for health reasons and are therefore dependent on help from others? Then, under certain circumstances, you are entitled to assistance with care.

If you have long-term care insurance, your responsible long-term care insurance fund or your private long-term care insurance company, which carries out private compulsory long-term care insurance, is first responsible for covering the costs of long-term care. However, depending on the type of benefit, the costs are only covered by long-term care insurance up to certain maximum limits.

If it is not possible for you to cover the remaining costs, social assistance benefits, such as help with care, are eligible.

However, you may also be entitled to care assistance if you do not have any claims against long-term care insurance, for example if you are not insured for long-term care or if the need for care is expected to last less than 6 months.

The reason for the need for care can be physical, cognitive or psychological impairments or health-related burdens or demands that you cannot compensate for or cope with independently.

You submit the application for assistance with care to your responsible social assistance institution.

  • If your long-term care insurance fund has already decided on your level of care, the social assistance institution is bound by this decision. The prerequisite for this is that it is based on facts that must be taken into account in both decisions.
  • If no decision has been made by the long-term care insurance fund about your level of care, the social assistance institution can take action itself if there is a need for urgency. For this purpose, the social assistance institution may commission other experts or the medical service to assist in its decision.

You will only receive care assistance if your income and assets and those of your spouse or partner are not sufficient to cover the uncovered costs of care yourself, after covering your living expenses and other general living needs. Dependent children and parents will only be reimbursed if their gross annual income exceeds EUR 100,000.

You are entitled to the following benefits as part of the care assistance:

In care level 1:

  • Care aids
  • Measures to improve the living environment
  • digital care applications
  • Supplementary support for the use of digital care applications
  • Relief amount

In care levels 2 to 5:

  • home care in the form of:
    • Care allowance
    • home care assistance
    • Preventative care
    • Care aids
    • Measures to improve the living environment
    • other services
    • digital care applications
    • Complementary support for the use of digital care applications
  • Semi-inpatient care, i.e. temporary care during the day or at night in a day care facility or night care facility
  • Short-term care, i.e. temporary, full-time inpatient care, if the care generally takes place at home
  • Relief amount
  • inpatient care, i.e. permanent full inpatient care

The competent authority will check your documents. If the appropriate conditions are met, you will be granted care assistance.

Process flow

You will receive care assistance at the earliest from the point in time when the responsible social assistance institution becomes aware that the conditions for the benefits are met.

  • As a person with long-term care insurance, you should first contact your responsible long-term care insurance fund or your private long-term care insurance company, which carries out the private compulsory long-term care insurance.
  • The long-term care insurance fund or the long-term care insurance company instructs the
    • Medical Service (MD) or
    • other independent reviewers or,
    • if you are privately insured, Medicproof to prepare an expert opinion on the existence of the need for long-term care and the degree of care, and clarifies which benefits you are entitled to and in what amount.
  • If these benefits are not sufficient or if you are not entitled to any benefits at all, apply for care assistance from your competent social assistance institution. This also applies if you do not have long-term care insurance.
  • There you will be advised and can inform the social welfare institution about your need for benefits.
  • The social assistance institution will check the documents you have submitted and your income and financial circumstances and, if applicable, those of your spouse or partner. In the case of minors and unmarried persons in need of care, the income and assets of their parents are taken into account.
  • If all requirements are met, you will receive a notification of approval.

Requirements

  • For health reasons, you are impaired in your independence or abilities, so that you need help from others. This means that you have physical, cognitive or psychological impairments or health-related burdens or demands that you cannot compensate for or cope with independently.
  • The need for long-term care must be at least as severe as that at which a legally defined level of care is awarded. This means that you must have at least care level 1. However, only limited benefits are provided for those in need of care at care level 1 within the framework of assistance for care. On the other hand, people in need of care in care levels 2 to 5 have full access.
  • You and your non-separated spouse or partner do not have sufficient income or assets to cover the costs of care.

What are the fees?

There are no fees.

Fee: free of charge

What deadlines do I have to pay attention to?

There are no statutory deadlines. However, you should apply for care assistance before moving into a nursing home or before using home care services, or at least let them know your needs in advance. This is because the benefits of social assistance, i.e. also assistance for long-term care, do not start until the social assistance institution or the bodies commissioned by it become aware that the conditions for the benefit are met.

Processing duration

A decision on the application will be made as soon as possible. The processing time depends, among other things, on the completeness of the information and the required evidence.

Appeal

  • Objection within one month of notification of the administrative act
  • Appeal to the Social Court within one month of notification of the notice of objection

Professionally released on

21.03.2022

Author

The text was automatically translated based on the German content.

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