Apply for full inpatient home care for those with long-term care insurance Unfortunately this specification of service has not yet been completely translated.
If you can no longer manage independently at home due to your need for care and cannot be cared for at home, care in a nursing home is necessary. Your long-term care insurance will pay part of the costs upon application.
As a person insured for long-term care, you are entitled to care in a nursing home or another fully inpatient facility if home care or partial inpatient care is not possible or cannot be considered due to the special nature of your case.
In addition to the actual care services, the scope of benefits also includes social care and medical treatment care.
The maximum monthly amount that long-term care insurance funds pay for fully inpatient care services depends on your care level (as of 2021):
- for care degree 2, a maximum of EUR 770.00
- for care degree 3 a maximum of EUR 1,262
- for care level 4 a maximum of EUR 1,775
- for care degree 5 a maximum of EUR 2,005
In most cases, the costs of full inpatient care are higher than the amount covered by your long-term care insurance. You then pay a co-payment. This is the same for all residents within a facility, regardless of their care level. So if you have care level 5, for example, you pay the same amount as someone with care level 2.
From January 2022, your own contribution to care-related expenses will be reduced. The long-term care insurance fund will then pay a supplement to your own share. The supplement depends on the duration of the full inpatient care.
This supplement to your own contribution amounts to
- 5 percent if you receive full inpatient care for up to and including 12 months,
- 25 percent if you receive full inpatient care for more than 12 months,
- 45 percent if you receive full inpatient care for more than 24 months,
- 70 percent if full inpatient care is provided for more than 36 months.
The cost of care in a nursing home can vary greatly between facilities. In addition, you bear yourself:
- Costs for room and board
- under certain circumstances, costs for calculable investments. These are costs that the nursing home has, for example, for building rent or purchases. These costs can be passed on to the residents of the facility
- Under certain circumstances, costs for additional services. These are also referred to as "comfort services". This refers, for example, to a single room, special meals or special care services.
If you cannot bear the additional costs yourself, your relatives must pay for them. However, children do not have to contribute to the costs of the nursing facility until their annual gross income exceeds EUR 100,000. If your relatives cannot cover the costs either, you will receive state support via the social welfare office.
If you live in a nursing home during the week and are cared for by relatives at home on weekends, you can apply for additional benefits for home care, for example care allowance or care aids.
If you need help choosing a suitable care facility, contact your care insurance fund or your nearest care support center.
- If you already have a nursing degree: if applicable, notification from the nursing care insurance fund about the determination of the nursing degree (expert opinion of the Medical Service of the Nursing Care Insurance)
- if necessary: power of attorney, guardian's identity card
- 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 health insurance company for more information.
- Forms: yes
- Online procedure possible: Many statutory long-term care insurance companies offer an online procedure.
- Written form required: no
- Personal appearance required: no
Zum Antrag auf vollstationäre Heimbetreuung über den Kassen-Navigator des GKV-Spitzenverbands
You have care degree 2, 3, 4 or 5
- If you have care degree 1, you can apply for the relief amount
You cannot be cared for at home or in a partial inpatient setting
In some federal states, you can apply for a nursing home allowance in addition to the benefits provided by your nursing care insurance fund.
You can change nursing homes at any time.
§ 43 Elftes Buch Sozialgesetzbuch (SGB XI)
Informationen zur Pflege im Heim 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 submit the application for full inpatient home care by mail, for example, as well as - for many long-term care insurance companies - in person at the office or submit it online.
- You submit the application for full inpatient care to your care insurance fund. If you are unable to do this yourself, you can authorize someone in writing.
- If you have not yet been assigned 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 need at least this level of care.
- 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 homes where you can compare services and prices.
Your nursing care insurance fund will bill the service directly to the nursing care facility you have chosen.
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