Apply for combination benefit for long-term care insurants Unfortunately this specification of service has not yet been completely translated.

If you are cared for at home by relatives, you can receive care allowance and use the services of an outpatient care service at the same time in a combination solution.

If you are cared for at home, you are entitled to care benefits in kind. These include physical care services, nursing care measures or help with household management. In addition, the nursing care insurance fund will pay you a nursing allowance. The maximum monthly amount for care benefits in kind depends on your care degree:

  • for care level 2 a maximum of EUR 689.00
  • for care degree 3 a maximum of EUR 1,298
  • for care degree 4 a maximum of EUR 1.612
  • for care level 5 a maximum of EUR 1,995

You can combine care benefits in kind and care allowance. In this case, the benefit is referred to as a combination benefit. The costs are calculated on a pro rata basis: The more care benefits in kind you use, the less care allowance you receive. For example, if you claim 80 percent of all the care benefits in kind to which you are entitled, you will no longer receive 100 percent of the maximum care allowance, but 20 percent. If, on the other hand, you use only a few care benefits in kind, you will receive correspondingly more care allowance.

Your decision as to the ratio of cash benefits to benefits in kind is binding for 6 months.

  • If applicable: power of attorney, guardian's identity card
  • If applicable: notice from the long-term care insurance fund on the determination of the degree of long-term care (expert opinion of the Medical Service of the Long-Term Care Insurance)
  • if applicable: medical documents
  • if applicable: severely disabled person's ID card

Depending on the individual case, further documents may be required. Please contact your nursing care insurance fund for more information.



- Forms: yes

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

- Written form required: no

- Personal appearance required: no



Related Links

  • Zum Antrag auf Kombinationsleistung über den Kassen-Navigator des GKV-Spitzenverbands

Preconditions

  • You have care degree 2, 3, 4 or 5.
  • You are cared for at home.
  • You do not make full use of care benefits in kind.



Related Links

  • § 38 Elftes Buch Sozialgesetzbuch (SGB XI)
  • § 7a Sozialgesetzbuch Elftes Buch (SGB XI)

Related Links

  • Informationen zur häuslichen Pflege auf der Internetseite des Bundesgesundheitsministeriums
  • Pflegeleistungs-Helfer auf der Internetseite des Bundesgesundheitsministeriums
  • Suche des nächstgelegenen Pflegestützpunktes vom "Zentrum für Qualität in der Pflege"

You can apply for a combination benefit by mail, for example, and - in the case of many long-term care insurance companies - you can hand it in personally at the office or submit it online.

  • Calculate the share of the care benefit in kind in the maximum monthly amount to which you are entitled for care benefits in kind according to your care level.
    • For example, if the monthly costs of the care benefit amount to 70 percent of the maximum amount, you will still receive 30 percent of the care allowance.
  • Submit the application for combined benefits to your long-term care insurance fund. If you are unable to do this yourself, you can authorize someone in writing.
  • If you have not yet been assessed for a care level of at least 2, the long-term care insurance fund will commission the Medical Service or other independent assessment services to check whether you are in need of care to at least care level 2.
  • The long-term care insurance fund evaluates the expert opinion, examines your application and informs you of the result.
  • Your nursing care insurance fund can give you a list of approved nursing care services where you can compare services and prices.
  • Your long-term care insurance fund settles the care benefits directly with the outpatient care service.



Responsible for the content
Federal Ministry of Health

Last update or date of publication
22.11.2021