Request help for care permit
First of all, it is the task of the Social Care Insurance (SGB XI) to provide assistance to those in need of care who, because of the seriousness of the need for care, need solidarity support. However, social care insurance benefits are budgeted according to the amount. As a person in need who has health-related impairments of self-employment or skills and therefore needs help from others, may be entitled to assistance for care under the Twelfth Book of the Social Code (SGB XII). The need for help may be physical, cognitive or psychological impairments, or health-related strains or demands that you cannot independently compensate for and cope with. As a rule, the Medical Service of Health Insurance (MDK) decides whether and to what extent there is a need for care. The MDK is commissioned by the responsible nursing care fund when an application for social care insurance benefits (SGB XI) is submitted. The MDK determines how independent a person is according to a points system. The following applies: The more points the person receives, the higher the level of care (care grades 1 to 5) and the more care and care needs are available. The degree of independence or impairment is measured according to the extent to which someone can manage his daily life independently and to what extent he needs support. The social assistance institution is bound by the findings of the MDK on the degree of care. The content and scope of benefits is decided by the social assistance institution under its own responsibility. Care assistance is also eligible for you if you are not covered by social care insurance or are not entitled to social care insurance benefits. If you are not covered by care insurance and therefore have no expert opinion from the MDK and no classification in a nursing care level by the nursing fund, the social welfare provider must determine the necessary nursing needs. In principle, care in one's own home is to be given preference over inpatient care. Home care should, if possible, be carried out by relatives or other related persons (neighbourhood assistance). If this possibility is not considered, the necessary help is provided by professional nurses (care services and social wards). 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 home care in kind for care assignments of outpatient services and social wards (home care assistance). Alternatively, you can receive a care allowance if you can provide basic care and home care yourself. A combination of money and benefits in kind is possible. The range of benefits of long-term care insurance also includes offers in case of prevention of the caregiver (home care), day or night care (semi-stationary care) as well as short-term care (temporary inpatient care). You are entitled to care in full-time care facilities if home or semi-stationary care is not possible or is not considered because of the specific nature of the individual case. In addition, care aids and technical aids, grants for measures to improve the individual living environment and care courses for relatives and volunteer carers can be granted. Caring relatives or carers and friends may, if necessary, receive social security benefits in the form of contributions to the relevant pension insurance institution. Depending on the type of benefit, the long-term care insurance benefits are only covered up to certain limits. In the case of full-time care, the costs of accommodation and meals are not covered, as these are also to be borne in the home environment. If you are not able to cover uncovered residual costs, social assistance benefits (SGB XII) are eligible in this respect. However, social assistance as state aid only occurs if your income and assets - and possibly the spouse or civil partner - are not sufficient. Dependent relatives are only used if their total annual income exceeds EUR 100,000 each (Section 94 paragraph 1a SGB XII; Section 16 SGB IV, Common Social Security Regulations).
Where available, the following documents shall be submitted: Valid personnel documents, confirmation of registration if applicable Power of attorney, supervisor's card Decision of the nursing care fund on care degree assessment 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 spouses or civil partners who are not separated Contract with the nursing home The extent of the documents required, in particular proof of income and assets, depends on the specificities of the individual case. In addition, in the case of care-insured claimants, the medical opinion of the Medical Service of the Health Insurance (MDK) as well as the decision of the nursing insurance fund on the classification in a care degree and the benefits from the long-term care insurance must be submitted. In the case of 'non-care-insured persons', medical reports or other medical documents should be attached; the assessment shall be initiated by the authority responsible for granting assistance for care.
Form: Care assistance 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 ask for forms, in particular from the social welfare office. Online procedure possible: no Written form required: yes Personal appearance necessary: no
In principle, only patients in care grades 2 to 5 receive the benefits of care assistance. Care grade 1 patients are (only) entitled to care aids and measures to improve the living environment due to the low level of impairment. In addition, a relief amount of currently a maximum of EUR 125.00 per month will be granted. There is no entitlement to care assistance below grade 1. However, care assistance is only provided if: do not sufficient resources, which or the person in need of care cannot bear the expenses for care himself 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 if they do not yet meet the pre-insurance periods or if the benefits of the long-term care insurance are not sufficient.
As of January 1, 2017, the new 5 levels of care and an extended concept of care neediness were introduced. These changes are intended to guarantee the same care services for the elderly with dementia as those in need of physical care.
You can get help with care as follows: As a care-insured person, you first contact the responsible care fund to clarify which benefits you are entitled to and how much. Only if these benefits are insufficient or you are not entitled to any benefits at all, you can apply for assistance with the responsible social assistance provider if you are in need. The responsible social welfare institution arranges the assessment for persons not insured in the statutory long-term care insurance to determine the need for care and the necessary need for assistance. If the conditions are met and the income and wealth conditions make it necessary to provide assistance for care, you will receive an authorisation notice.