Increasing demand due to the ageing of society?the subject of care has become increasingly important in recent decades. One often hears in this connection of an overageing of the society, which is not so completely correct, because beside the increase in humans, who reach a higher age, simply too few young humans follow (low birth rate), whereby the equilibrium was lost (further information for this at the Berlin institute for population and development: Ageing of the population).
In addition to regular aging with the physical ailments, health impairments and everyday restrictions that are usually inevitably associated with it, we have the feeling that dementia is spreading more and more. There is hardly anyone who has not already come into contact with this disease through relatives or acquaintances. Dementia does not always only affect people of advanced age, but can also completely throw the lives of younger people off track.
If a close person is permanently dependent on care by third parties due to age, dementia or any other illness or physical restriction, the question of how this task can be mastered usually arises relatively soon. Many relatives decide in this connection to take over the care themselves, so that no removal is necessary into a nursing facility.
Financing care at home
What does home care cost and how is home care financed? Home care is always associated with costs, so that questions such as “Who pays for home care?”, “Home care, who pays?” or “Who pays for home care?” are often asked. In addition, the question often arises as to how high the costs of care at home actually are. In our section on financing home care, we get to the bottom of these questions and try to find answers.
Care services from the care insurance fund
If a nursing case occurs, it is not the case that a payment from the nursing insurance is made automatically. In order for the nursing insurance fund to pay, it is first necessary to submit a request for nursing services to the responsible nursing insurance fund.
Since the nursing insurance funds are always affiliated with the statutory health insurance fund (see box above), you can contact your health insurance fund if you are dealing with nursing services and do not have direct contact information for a contact person at the nursing insurance fund. A phone call is sufficient for an initial application. In order to be on the safe side, one should write down the name of the person with whom one spoke on the telephone as well as the date and if necessary the time of the call. In this way, you can check afterwards whether the nursing care insurance actually pays from the day of the initial telephone application.
In addition to the “application by telephone”, you should also make a written application to the nursing care insurance for security reasons. This can be done informally.
The nursing care insurance will then send you a corresponding application form. Many care insurance funds also offer the possibility of downloading the application form online from their website.
Application and further procedure
The basic data of the insured person, including name, residential address and health insurance number, are queried in the application form of the nursing insurance fund. This information is required by the nursing insurance fund so that it can process the application. The nursing insurance fund can also use this data to check, among other things, whether the applicant is entitled to benefits from nursing insurance (see the notes in the following box).
Notes on care benefits in kind
The care benefits in kind can be purchased by the insured person in need of care from an authorised care service. In this case, no money will be transferred from the nursing insurance fund to the insured person, as the latter bills the nursing service directly. An agreement is made between the person in need of nursing care and the nursing service that certain areas of nursing care, such as personal hygiene, are carried out by professional nursing staff of the service.
It is also possible that part of the benefits in kind may be used for support services in everyday life. This is particularly important for people in need of care who are dependent on a great deal of care. In this case, the relief amount (125 euros) is topped up by benefits in kind. There is a limit of 40% – a maximum of 40% of the benefits in kind can therefore be used for offers of support in everyday life. This includes, for example, the assignment of domestic help, care companions or (voluntary) care staff.
Information on combination benefits (care allowance and care benefits in kind)
Within the framework of the combined benefit, nursing allowance and benefits in kind may be combined. In this case, a nursing service is commissioned to carry out certain nursing activities. The proportionate remaining amount is paid out as nursing allowance.
The insured person in need of nursing care can decide for himself how the benefits in connection with the combined benefit are to be distributed. If, for example, he or she claims 70% of the benefits in kind, he or she still receives 30% of the care allowance.
Here the nursing care insurance funds usually proceed very pragmatically: An examination takes place as many per cent of the care material achievements of the insured one were called up and afterwards a transfer of the proportionate remainder as care money takes place.