Cookies facilitate the provision of our services. By using our services, you agree to our use of necessary cookies. You can refuse the use of optional cookies or only allow certain cookies. You can find further information in our privacy policy.

  • Logo eGo Saarland
Your current search term: Apply for Combined Benefits for Those Covered by Long-Term Care Insurance
Return to your search results

 

Apply for Combined Benefits for Those Covered by Long-Term Care Insurance

If you receive care at home, you are entitled to in-kind care benefits. These include physical care services, nursing care, or assistance with household chores. In addition, the long-term care insurance fund will pay you a care allowance. The maximum monthly amount for in-kind care benefits depends on your care level:

  • for care level 2, a maximum of EUR 689.00
  • for care level 3, a maximum of EUR 1,298
  • for care level 4, a maximum of EUR 1,612
  • for care level 5, a maximum of EUR 1,995

You can combine in-kind long-term care benefits with a long-term care allowance. In this case, it is referred to as a combined benefit. The costs are calculated on a pro-rata basis: The more in-kind long-term care benefits you use, the less long-term care allowance you receive. For example, if you use 80 percent of all the in-kind long-term care benefits to which you are entitled, you will no longer receive 100 percent of the maximum long-term care allowance, but rather 20 percent. Conversely, if you use only a few in-kind long-term care benefits, you will receive a correspondingly higher long-term care allowance. 

Your decision regarding the ratio of cash benefits to in-kind benefits you wish to receive is binding for 6 months.

  • Combined Benefits of Cash and In-Kind Benefits for Individuals Covered by Statutory Long-Term Care Insurance: Eligibility
  • In the case of home care, a combination of benefits is possible: in addition to care provided by family members, services from an outpatient care provider may be utilized 
  • The person in need of care continues to receive a care allowance, but only on a pro-rata basis
  • Requirements:
    • Home care
    • At least care level 2
  • The entitlement to in-kind long-term care benefits per calendar month
    • for care level 2, a maximum of EUR 689.00
    • For care level 3, a maximum of EUR 1,298
    • for care level 4, a maximum of EUR 1,612
    • for care level 5, a maximum of EUR 1,995
  • For example, if 80 percent of the in-kind long-term care benefits are utilized, the long-term care allowance is reduced to 20 percent of the rate corresponding to the long-term care level 
  • Applications are submitted informally in writing to the long-term care insurance fund 
  • The decision is binding for 6 months
  • Information is available from: long-term care insurance funds or recognized counseling centers, such as care support centers
  • Responsible: Long-term care insurance funds
     

  • If applicable: Power of attorney, guardian ID card  
  • If applicable: Notice from the long-term care insurance fund regarding the determination of the care level (report from the Medical Service of the Long-Term Care Insurance)  
  • If applicable: medical records 
  • If applicable: Severe disability ID card  

Depending on the individual case, additional documents may be required. Please check with your long-term care insurance provider for more information.
 

  • You have a care level of 2, 3, 4, or 5.
  • You receive home care.
  • You do not make full use of in-kind care benefits.
     

You do not have to pay anything for the application.

You can submit your application for combined benefits by mail, for example, or—with many long-term care insurance providers—in person at their office or online.   

  • Calculate the portion of the in-kind long-term care benefit that corresponds to the monthly maximum amount to which you are entitled based on your care level. 
    • If, for example, the monthly costs of the in-kind long-term care benefit amount to 70 percent of the maximum amount, you will still receive 30 percent of the long-term care allowance.
  • Submit the application for combined benefits to your long-term care insurance fund. If you are unable to do so yourself, you can authorize someone in writing to act on your behalf.
  • 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 determine whether you require care at a level of at least care level 2.
  • The long-term care insurance fund will evaluate the assessment, review your application, and notify you of the result.
  • Your long-term care insurance provider can give you a list of approved long-term care service providers, allowing you to compare services and prices.
  • Your long-term care insurance provider settles the payment for in-kind long-term care benefits directly with the home care service provider.
     

Processing usually takes about 2 to 3 business days.

To ensure prompt processing and a decision, your long-term care insurance provider must have all the necessary information and, if applicable, any required documents—complete and detailed. 
The long-term care insurance provider will make a decision on applications in a timely manner.

Please note that the processing time indicated is an average across all long-term care insurance funds. It may vary in individual cases.

The exact processing time also depends on the complexity of the individual case and may be extended accordingly. The same applies if documents or records are sent by mail to you or your long-term care insurance provider.
If necessary, the Medical Service must be involved. This usually extends the processing of your request by about 2 to 3 weeks.
 

If you opt for a combination benefit, you are bound by this decision for 6 months. This means you cannot change the ratio in which you combine in-kind long-term care benefits and long-term care allowance. An exception applies if your condition deteriorates significantly and you require more care.

  • Appeal
  • Lawsuit before the Social Court
     

- Forms: Yes

- Online application available: Many long-term care insurance funds offer an online application process. 

- Written submission required: no

- In-person appearance required: no
 

Redirect Service: Deep Link to the Original Portal

The text was automatically translated based on the German content.

Source: Serviceportal Saarland