Apply for Full-Time Residential Care for Individuals Covered by Long-Term Care Insurance
As a person covered by long-term care insurance, you are entitled to care in a nursing home or another full-time residential facility if home care or partial residential care is not possible or is not an option due to the specific circumstances of your case.
In addition to the actual long-term care services, the scope of benefits also includes social support and medical treatment.
The maximum monthly amount that long-term care insurance funds pay for full-time residential care services depends on your care level (as of 2021):
- for care level 2, a maximum of EUR 770.00
- for care level 3, a maximum of EUR 1,262
- for care level 4, a maximum of EUR 1,775
- for care level 5: a maximum of EUR 2,005
In most cases, the costs of full-time inpatient care exceed the amount covered by your long-term care insurance fund. You will then be required to pay a copayment. This copayment is the same for all residents within a facility, regardless of their care level. So, for example, if you have care level 5, you pay the same copayment as someone with care level 2.
Starting in January 2022, your copayment for care-related expenses will be reduced. The long-term care insurance fund will then pay a supplement toward your copayment. The supplement depends on the duration of full-time inpatient care.
This supplement to your copayment amounts to
- 5 percent if you receive full-time inpatient care for up to and including 12 months,
- 25 percent for full-time inpatient care lasting more than 12 months,
- 45 percent for full-time inpatient care lasting more than 24 months,
- 70 percent for full-time inpatient care lasting more than 36 months.
The costs of care in a nursing home can vary significantly from one facility to another. In addition, you are responsible for:
- costs for room and board
- in some cases, costs for foreseeable investments. These are costs incurred by the nursing home, such as building rent or purchases. These costs may be allocated among the facility’s residents
- in some cases, costs for additional services. These are also referred to as “comfort services.” This includes, for example, a private room, special meals, or specific care services.
If you are unable to cover these additional costs yourself, your relatives must pay them. However, children are only required to contribute to the costs of the care facility if their annual gross income exceeds EUR 100,000. If your relatives are also unable to cover the costs, you will receive government assistance through the social services office.
If you live in a nursing home during the week and are cared for at home by family members on the weekends, you can also apply for home care benefits, such as a care allowance or assistive devices.
If you need help choosing a suitable care facility, contact your long-term care insurance provider or your nearest care support center.
- Full-Time Inpatient Care for Individuals Covered by Statutory Long-Term Care Insurance: Information
- Long-term care insurance funds contribute to the costs of care in a nursing home or other full-time residential facility through a monthly flat-rate contribution.
- The contribution varies depending on the care level. This contribution is provided to individuals with care levels 2, 3, 4, or 5. Individuals with care level 1 receive a lower contribution.
- Full-time residential care can be requested informally or through the application for social long-term care insurance benefits.
- Long-term care insurance funds provide assistance in selecting a suitable care facility.
- Information available from: Long-term care insurance funds or recognized counseling centers, such as care support centers
-
Responsible: Long-term care insurance funds
- If you already have a care level designation: if applicable, the notice from the long-term care insurance fund regarding the determination of your care level (report from the Medical Service of the Long-Term Care Insurance)
- If applicable: power of attorney, guardian ID card
- If applicable: medical records
- If applicable: Severely Disabled Person’s ID Card
Depending on the individual case, additional documents may be required. Please check with your health insurance provider for more information.
-
You have a care level of 2, 3, 4, or 5
- If you have care level 1, you can apply for the relief payment
-
You cannot receive care at home or in a semi-residential setting
You do not have to pay anything for the application.
You can submit your application for full-time residential care by mail, for example, or—with many long-term care insurance providers—in person at their office or online.
- You submit the application for full-time residential care to your long-term care insurance provider. 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 provider will commission the Medical Service or other independent assessment agencies to determine whether you require care at least to this extent.
- 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 provide you with a list of approved nursing homes where you can compare services and prices.
-
Your long-term care insurance provider settles the costs directly with the care facility you have chosen.
Processing usually takes about 2 to 6 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 decide 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 the need for long-term care or your entitlement to long-term care benefits has not yet been determined in your case, or if an application for a higher care level has been submitted, the Medical Service must be involved.
This usually extends the processing time for your request by about 3 to 4 weeks.
You will receive benefits from your long-term care insurance fund starting in the month in which you submitted the application, but no earlier than the date on which you meet the eligibility requirements. If the application is submitted later than the calendar month in which the need for long-term care arose, benefits will be granted starting from the beginning of the month in which the application was submitted. Therefore, you should submit the application in a timely manner.
If the long-term care insurance fund does not issue a written decision within 25 business days of receiving the application, or if any of the assessment deadlines specified by law are not met, the long-term care insurance fund must pay you EUR 70.00 immediately for each week the deadline is exceeded. This does not apply if the long-term care insurance fund is not responsible for the delay or if you are already receiving full-time residential care and have already been assigned at least care level 2.
- Appeal
- Lawsuit before the Social Court
- Forms: Yes
- Online application available: Many statutory long-term care insurance funds offer an online application process.
- Written submission required: No
- In-person appearance required: no
In some federal states, you can apply for a residential care allowance in addition to the benefits provided by your long-term care insurance fund.
You can change nursing homes at any time.
- Inpatient Long-Term Care for Individuals Covered by Statutory Long-Term Care Insurance: Provision of Information
Remark: Displaying Performance on the Original Portal
The text was automatically translated based on the German content.
- Full-Time Inpatient Care for Individuals Covered by Statutory Long-Term Care Insurance: Information
- Long-term care insurance funds contribute to the costs of care in a nursing home or other full-time residential facility through a monthly flat-rate contribution.
- The contribution varies depending on the care level. This contribution is provided to individuals with care levels 2, 3, 4, or 5. Individuals with care level 1 receive a lower contribution.
- Full-time residential care can be requested informally or through the application for social long-term care insurance benefits.
- Long-term care insurance funds provide assistance in selecting a suitable care facility.
- Information available from: Long-term care insurance funds or recognized counseling centers, such as care support centers
-
Responsible: Long-term care insurance funds
- If you already have a care level designation: if applicable, the notice from the long-term care insurance fund regarding the determination of your care level (report from the Medical Service of the Long-Term Care Insurance)
- If applicable: power of attorney, guardian ID card
- If applicable: medical records
- If applicable: Severely Disabled Person’s ID Card
Depending on the individual case, additional documents may be required. Please check with your health insurance provider for more information.
-
You have a care level of 2, 3, 4, or 5
- If you have care level 1, you can apply for the relief payment
-
You cannot receive care at home or in a semi-residential setting
You do not have to pay anything for the application.
You can submit your application for full-time residential care by mail, for example, or—with many long-term care insurance providers—in person at their office or online.
- You submit the application for full-time residential care to your long-term care insurance provider. 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 provider will commission the Medical Service or other independent assessment agencies to determine whether you require care at least to this extent.
- 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 provide you with a list of approved nursing homes where you can compare services and prices.
-
Your long-term care insurance provider settles the costs directly with the care facility you have chosen.
Processing usually takes about 2 to 6 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 decide 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 the need for long-term care or your entitlement to long-term care benefits has not yet been determined in your case, or if an application for a higher care level has been submitted, the Medical Service must be involved.
This usually extends the processing time for your request by about 3 to 4 weeks.
You will receive benefits from your long-term care insurance fund starting in the month in which you submitted the application, but no earlier than the date on which you meet the eligibility requirements. If the application is submitted later than the calendar month in which the need for long-term care arose, benefits will be granted starting from the beginning of the month in which the application was submitted. Therefore, you should submit the application in a timely manner.
If the long-term care insurance fund does not issue a written decision within 25 business days of receiving the application, or if any of the assessment deadlines specified by law are not met, the long-term care insurance fund must pay you EUR 70.00 immediately for each week the deadline is exceeded. This does not apply if the long-term care insurance fund is not responsible for the delay or if you are already receiving full-time residential care and have already been assigned at least care level 2.
- Appeal
- Lawsuit before the Social Court
- Forms: Yes
- Online application available: Many statutory long-term care insurance funds offer an online application process.
- Written submission required: No
- In-person appearance required: no
In some federal states, you can apply for a residential care allowance in addition to the benefits provided by your long-term care insurance fund.
You can change nursing homes at any time.
- Inpatient Long-Term Care for Individuals Covered by Statutory Long-Term Care Insurance: Provision of Information
Remark: Displaying Performance on the Original Portal
The text was automatically translated based on the German content.