Apply for outpatient or inpatient hospice care from the statutory health insurance fund Unfortunately this specification of service has not yet been completely translated.
People who are suffering from a serious, incurable and far-advanced disease and have only a short life expectancy left can, under certain conditions, make use of outpatient or inpatient hospice services.
Palliative care is about the comprehensive care of people with incurable, progressive and far-advanced diseases with a limited life expectancy at the same time.
Hospice and palliative care is usually associated with many questions. In addition to the choice of possible services, the selection of suitable outpatient or inpatient services is of great importance in order to live as self-determined a life as possible until the end. If you have statutory health insurance, you are entitled to individual advice and assistance on hospice and palliative care services.
An inpatient hospice is a facility where people receive medical and nursing care until death. To allow for a quiet environment, small facilities with no more than 16 seats are necessary.
You can only be admitted to a hospice based on a physician's justification. This must include a diagnosis and the need for hospice care. Forms for the application procedure are available from your health insurance company.
If approved, the health insurance companies pay a subsidy for inpatient hospice care amounting to 95 percent of the daily requirement rate agreed with the respective hospice. 5 percent of the costs are covered by donations. There is no personal contribution.
Before admission to the hospice can take place, the declaration of cost coverage by the health insurance company should already be available in writing. Since time is usually of the essence here, the statutory health insurers strive to keep the processing time as short as possible so that admission to an inpatient hospice can take place quickly.
- A transfer from a nursing home to a hospice can only take place if the person in need of care can no longer be adequately cared for.
Outpatient hospice services
Outpatient hospice services support and accompany people in the last phase of life in their homes, in inpatient care facilities, in facilities providing integration assistance for the disabled, and in facilities providing assistance for children and young people. However, they do not provide nursing or medical care. The services are free of charge.
- Outpatient hospice services are not "service providers" in the health care system, such as nursing services, nursing homes or clinics. They rely on donations. A large part of the services is provided on a voluntary basis. Health insurance funds support outpatient hospice services upon application: In addition to personnel costs, the funding for outpatient hospice services also takes into account material costs, such as travel expenses for volunteers.
Medical certificate to determine the need for
- full inpatient hospice care
- Forms: yes
- Online procedure possible: Many statutory health insurers offer an online procedure.
- Written form required: no
- Personal appearance required: no
Zum Antrag auf Antrag auf stationäre Palliativversorgung über den Kassen-Navigator des GKV-Spitzenverbands
The need for inpatient hospice care must be confirmed in writing by a physician and must be submitted to the health plan for review and approval before it can be used.
- There is a non-curable, progressive and advanced illness with a life expectancy that is limited to days, weeks or months according to the prescribing physician's assessment.
The present complaints are so pronounced that the previous care in the family, a full inpatient care facility or a full inpatient facility of the integration assistance is not sufficient.
§ 39a Fünftes Buch Sozialgesetzbuch (SGB V)
§ 8 Zweites Gesetz über die Krankenversicherung der Landwirte (KVLG 1989)
Informationen zum Hospiz- und Palliativgesetz auf der Internetseite des Bundesgesundheitsministeriums
Fragen und Antworten zum Hospiz- und Palliativgesetz auf der Internetseite des Bundesgesundheitsministeriums
Informationen zur Hospizsuche im "Wegweiser Hospiz- und Palliativversorgung"
In general, there is no individual application procedure for outpatient hospice services. Support by an outpatient hospice service can be claimed without approval by the health insurance company.
You can submit an application for coverage of the costs of an inpatient hospice service by mail as well as - in the case of many statutory health insurers - in person at the office or submit it online.
- After an application is submitted, the health insurance company's medical service reviews the application.
- If approved: The health insurance company confirms cost coverage in writing.
The initial application is usually valid for 28 days. If the period is not sufficient, a follow-up application can be submitted.
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Federal Ministry of Health
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