Leistungen der Pflegeversicherung

If someone is no longer able to care for themselves on their own, it is generally possible to claim benefits from long-term care insurance if the prerequisites for this are met. Persons in need of care in the sense of the law are those who have health-related impairments of independence or abilities and therefore require help from others. The prerequisite is the presence of physical, cognitive or mental impairments or health-related burdens that cannot be compensated or managed independently. The need for care must be permanent, i.e. expected for at least 6 months. The benefits provided by the long-term care insurance funds are graded according to the degree of need for care (care grade), which depends on the severity of the impairment of independence or abilities. This is determined by the Medical Service of the Health Insurance (MDK) or other independent experts. An assessment tool based on the individual care situation is used to assess the need for care and assign a care level. It is based on questions such as: What can the person in need of care do on his or her own in everyday life? What abilities are still available? How independent is the patient? What does he or she need help with? On the basis of the report and the recommendation for classification, the long-term care insurance fund issues an assessment notice.

Five degrees of care make it possible to determine the type and severity of the respective impairments, regardless of whether they are physical, mental or psychological. The five degrees of care are graduated: from minor impairments of independence or abilities (care degree 1) to the most severe impairments of independence or abilities, which are accompanied by special requirements for nursing care (care degree 5).

Long-term care insurance provides the following benefits, among others:

1. Care benefit in kind,
2. Care allowance for self-procured care aids,
3. combination of cash benefit and benefit in kind,
4. home care if the caregiver is prevented from attending,
5. care aids and measures to improve the living environment,
6. Day care and night care,
7. short-term care,
8. full inpatient care,
9. Care in fully inpatient facilities for disabled persons,
10. social security benefits for caregivers,
11. additional benefits for caregiver leave,
12. care courses for relatives and voluntary caregivers,
13. additional care services,
14. Personal budget benefits,
15. Social security benefits for caregivers
16. Additional benefits for those in need of care in outpatient assisted living groups.
17. Offers for support in everyday life

In addition, there are entitlements to care consulting and start-up financing for the establishment of outpatient assisted living groups.

For all questions regarding entitlement to benefits, the necessary prerequisites and the application procedure, please contact the staff of the long-term care insurance fund responsible for you.