Assistance for people in need of longterm care

If you are classified as being in need of long-term care under the provisions of the Long-Term Care Insurance Act (Pflegeversicherungsgesetz), the costs of the services rendered by a home care service are partly assumed by the long-term care insurance fund. An application must be submitted to your health insurance or long-term care insurance fund in order to determine a need for long-term care. The respective fund then commissions the German Health Insurance Medical Service (MDK) to assess the extent of your need for long-term care.

Under the Second Act to Strengthen Long-Term Care (Zweites Pflegestärkungsgesetz), the assessment to determine the extent of the need for long-term care looks equally at physical impairments and restrictions on account of mental illness or psychosomatic disorders.

The existing system of long-term care categories and the additional determination of considerable restrictions in everyday abilities and skills (especially where dementia is concerned) have been replaced with a system comprising five specific grades of care (Care Grades/Pflegegrad 1 to 5).

The appropriate care grade for your situation is determined on the basis of a meeting with a representative from the MDK and the results of a visit to your home.

Different benefits can be claimed relative to the grade of care concerned. For a home care service, the long-term care insurance fund grants the following amount of long-term care benefit each month:

Care allowance (Pflegegeld)

  • in care grade 2 up to €316
  • in care grade 3 up to €545
  • in care grade 4 up to €728
  • in care grade 5 up to €901

Care benefits in kind (Pflegesachleistung)

  • in care grade 2 up to €724
  • in care grade 3 up to €1,363
  • in care grade 4 up to €1,693
  • in care grade 5 up to €2,095

Support allowance (Entlastungsbetrag)

  • in each care grade up to €125

(Status: Third Act to Strengthen Long-Term Care, January 2017)

Instead of receiving care benefits in kind (Pflegesachleistung), people in need of long-term care can claim a care allowance (Pflegegeld) or opt for a combination of the two. They can decide for themselves how to use their care allowance and regularly pass it on as a token of appreciation to recognise the services of those who provide them with care and support.

The amount of the care allowance is likewise graduated, ranging from €316 to €901 per month, depending on the care grade (Pflegegrad) concerned. In addition to the direct long-term care benefits provided, there are special benefits available for people in need of long-term care:

  • For aids such as walking frames, people in need of long-term care need no longer submit a separate application if their MDK care grade assessment recommends that these be supplied.
  • As a general rule, all people in need of long-term care automatically receive a copy of their MDK assessment report.

Tip:

Further information is available from the Federal Ministry of Health at +49 (0)30 34060-6602

or online at www.bundesgesundheitsministerium.de/themen/pflege/pflegeversicherung-zahlen-und-fakten.html

Benefits provided by the long-term care insurance fund are generally designed as non-comprehensive insurance

Costs that cannot be covered by the long-term care insurance fund must be personally borne as a deductible by those in need of long-term care. Should this not be sufficient to finance the long-term care benefits and services needed, it may under certain circumstances be possible to apply for assistance from the local Social Services Office (Sozialamt).