Apply for help with care

As a person in need of care, you are entitled to help with care if you are unable or unable to fully cover the funds required for care through your own income and assets or through the income and assets of the non-separated spouse or partner.

First of all, it is the task of the social care insurance (SGB XI) to provide assistance to people in need of care who are dependent on solidarity support due to the severity of the need for care. However, the benefits of the social long-term care insurance are budgeted in terms of amount.

As a person in need who has health-related impairments of independence or abilities and therefore needs help from others, can be entitled to help for care according to the Twelfth Book of the Social Code (SGB XII). The reason for the need for help may be physical, cognitive or mental impairments or health-related stress or requirements that you cannot compensate for and cope with independently.

The determination of whether and to what extent there is a need for care is usually carried out by the Medical Service of the Health Insurance (MDK). The MDK is commissioned by the responsible nursing care fund if an application for benefits from the social long-term care insurance (SGB XI) is submitted. The MDK determines how independent a person still is according to a points system. The following applies: The more points the person receives, the higher the degree of care (care levels 1 to 5) and the more care and support needs there is. The degree of independence or impairments is measured according to the extent to which someone can cope with his everyday life independently and to what extent he needs support. The social assistance provider is bound by the MDK's findings on the degree of care. The social assistance institution decides on the content and scope of the benefits on its own responsibility.

Assistance for long-term care is also suitable for you if you are not insured in the social long-term care insurance or are not entitled to benefits from the social long-term care insurance. If you are not insured for long-term care and therefore have no expert opinion of the MDK and no classification in a degree of care by the nursing care fund, the social assistance provider has to determine the necessary nursing needs.

In principle, preference should be given to care in one's own home to inpatient care. If possible, home care should be carried out by relatives or other close persons (neighbourhood help). If this option is out of the question, the necessary help is ensured by professional nurses (nursing services and social stations).

The provision of services is also possible as part of a personal budget.

In the case of home care, you are entitled to basic care and domestic care as a benefit in kind for care assignments of the outpatient services and social stations (home care assistance). Alternatively, it is possible to receive a care allowance if you can use it to ensure basic care and domestic care yourself. A combination of money and benefits in kind is possible.

The scope of benefits of long-term care insurance also includes offers in the event of prevention of the caregiver (home care), day or night care (semi-inpatient care) and short-term care (temporary inpatient care).

You are entitled to care in fully inpatient care facilities if home or semi-inpatient care is not possible or is not considered due to the specific nature of the individual case.

In addition, nursing aids and technical aids, subsidies for measures to improve the individual living environment as well as nursing courses for relatives and voluntary caregivers can be granted.

Caring relatives or caring neighbours and friends may, if necessary, receive social security benefits in the form of contributions to the competent pension insurance institution.

Depending on the type of benefit, the benefits of long-term care insurance are only covered by long-term care insurance up to certain maximum limits.

In the case of fully inpatient care, the costs for accommodation and food are not covered, as these are also to be borne in the home environment.

If it is not possible for you to cover uncovered remaining costs, social assistance benefits (SGB XII) come into question in this respect.

However, social assistance as state aid only occurs if your income and assets - and, if necessary, the spouse or life partner - are not sufficient. Dependent relatives are only used if their total annual income is more than EUR 100,000 (§ 94 paragraph 1a SGB XII; §16 SGB IV, Common Rules for Social Security).

Where available, the following documents shall be submitted:

  • Valid identity documents, if necessary confirmation of registration
  • Power of attorney, supervisor's card
  • Notification of the nursing care fund on determination of the degree of care
  • Decision on the determination of a degree of disability
  • Proof of health and long-term care insurance
  • Proof of income
  • Statements of account
  • Proof of assets, e.g. capital-forming insurance, savings accounts, real estate, valuables, motor vehicle
  • Lease
  • Information on non-separated spouses or life partners
  • Contract with the care facility

The scope of the required documents, in particular proof of income and assets, depends on the special features of the individual case.
In addition, in the case of applicants with long-term care insurance, the medical report of the Medical Service of the Health Insurance (MDK) as well as the decision of the nursing care fund on the classification in a degree of care and the benefits from the long-term care insurance must be submitted.

In the case of "non-carers insured", medical reports or other medical documents should be attached; the assessment shall be initiated by the authority responsible for granting care assistance.

Form: Assistance for care begins as soon as the social assistance institution becomes aware that the conditions for the benefit are met. The application can then be informal or you can request forms, in particular from the social welfare office.

Online procedure possible: no

Written form required: yes

Personal appearance required: no

Preconditions

  • In principle, only those in need of care of care levels 2 to 5 receive the benefits of assistance for care.
  • Due to the low severity of their impairments, people in need of care level 1 are (only) entitled to care aids and measures to improve the living environment. In addition, a relief amount of currently a maximum of EUR 125.00 per month is granted.
  • There is no entitlement to assistance for care below care level 1.
  • However, care assistance is only provided if:
    • one's own resources are not sufficient,
    • the person in need of care cannot bear the expenses for care himself or herself from his or her income and assets, and
  • also does not receive the expenses from others, in particular the long-term care insurance. This may be the case if the persons in need of care are not insured in the long-term care insurance or do not yet meet the pre-insurance periods or if the benefits of the long-term care insurance are not sufficient.

Related Links

  • §§ 61 et seq. Twelfth Book of the Social Code (SGB XII)

On 01.01.2017, the new 5 degrees of care as well as an extended term of care-neediness were introduced. These changes are primarily intended to guarantee elderly people with dementia the same care services as those in need of physical care.

You can get help with care as follows:

  • As a long-term care insured person, you first contact the responsible nursing care fund to clarify which benefits you are entitled to and in what amount.
  • Only if these benefits are not sufficient or if you are not entitled to any benefits at all, you can apply for help with care from the responsible social assistance institution if you are in need.
  • In the case of persons not insured in the statutory long-term care insurance, the responsible social assistance institution shall arrange for the assessment to determine the need for care and the necessary need for assistance.
  • If the requirements are met and the income and financial circumstances make it necessary to provide assistance for care, you will receive a notification of approval.

Responsible for the content
Ministry of Social Affairs, Health, Integration and Consumer Protection

Last update or date of publication
19.10.2020