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Fully inpatient care for information provided by statutory long-term care insurance

If you can no longer cope independently at home because of your need for care and are not cared for at home, care in a nursing home is necessary. Upon request, your long-term care insurance will bear part of the costs.

Your responsible authority

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  • Forms

    - Forms: yes

    - Online procedure possible: Many statutory care funds offer an online procedure.

    - Written form required: no

    - Personal appearance required: no
     

  • Detailed description

    As a person with long-term care insurance, you are entitled to care in a nursing home or other fully inpatient facility if home or semi-inpatient care is not possible or is not considered because of the specificity of your case.

    In addition to the actual care services, the scope of services also includes social care and medical treatment care.

    The maximum monthly amount paid by nursing care funds for fully inpatient care services depends on your level of care (as of 2021):

    • for care level 2, maximum EUR 770.00
    • for care level 3 not more than EUR 1,262
    • for care level 4 not more than EUR 1,775
    • for care level 5, maximum EUR 2,005

    In most cases, the costs of fully inpatient care are higher than the amount that your nursing care fund covers. You then pay your own contribution. This is the same for all residents within an institution, regardless of the degree of care. So, for example, if you have care level 5, you pay the same amount as someone with care level 2.

     
    From January 2022, your own contribution to the care-related expenses will be reduced. The nursing care fund then pays a supplement to your own contribution. The surcharge depends on the duration of the fully inpatient care.
    This supplement to your own contribution is

    • 5 percent for a benefit of fully inpatient care of up to and including 12 months,
    • 25 percent for a benefit of fully inpatient care of more than 12 months,
    • 45 percent for a benefit of fully inpatient care of more than 24 months,
    • 70 percent for a benefit of fully inpatient care of more than 36 months.

    The cost of care in a nursing home can vary greatly between institutions. In addition, you will wear yourself:

    • Costs for accommodation and meals
    • possibly costs for predictable investments. These are costs that the nursing home has, for example for building rent or purchases. These costs can be passed on to the residents of the facility
    • under certain circumstances, costs for additional services. These are also referred to as "comfort services". This means, for example, a single room, special meals or special care services.

    If you cannot bear the additional costs yourself, your relatives will have to pay for it. However, children only have to contribute to the costs of the care facility from an annual gross income of more than EUR 100,000. If your relatives are also unable to cover the costs, you will receive state support from the social welfare office.

    If you live in a nursing home during the week and are cared for by relatives at home on weekends, you can also apply for home care benefits, such as care allowance or care aids.

    If you need help choosing a suitable care facility, contact your nursing care fund or your nearest care center.
     

  • Requirements
    • You have care level 2, 3, 4 or 5
      • If you have care level 1, you can apply for the relief amount
    • You cannot be cared for at home or semi-inpatient
       
  • Documents
    • If you already have a degree of care: if necessary, notification of the nursing care fund on determination of the degree of care (expert opinion of the medical service of the long-term care insurance)
    • if applicable: power of attorney, supervisor card
    • if applicable: medical documents
    • if applicable: Severely disabled person's pass

    Depending on the individual case, further documents may be required. Please contact your health insurance company for more information.
     

  • Fees

    You do not have to pay anything for the application.

  • Process

    For example, you can submit the application for fully inpatient home care by post and – with many nursing care funds – hand it in personally at the office or submit it online.  

    • You submit the application for full inpatient care to your nursing care fund. If you are unable to do so yourself, you can authorize someone in writing.
    • If you have not yet been diagnosed with a degree of care of at least 2, the nursing care fund commissions the Medical Service or other independent expert services to check whether there is a need for care to at least this extent.
    • The nursing care fund evaluates the expert opinion, examines your application and informs you of the result.
    • Your care fund can give you a list of approved nursing homes where you can compare services and prices.
    • Your nursing care fund bills the service directly with the care facility you have chosen.
       
  • Duration

    Processing usually takes about 2 to 6 working days.
    For a quick processing and decision, your nursing care fund must have the necessary information and, if necessary, necessary documents completely and meaningfully.
    The nursing care fund decides on applications promptly.
    Please note that the specified processing time is an average value of all nursing care funds. It may vary in individual cases.
    The exact processing time also depends on the complexity of the individual case and can be extended accordingly. The same applies if documents or documents are sent by post to you or your nursing care fund.
    If the need for care or the entitlement to care benefits has not yet been determined in your case or if an application for an upgrade with regard to the degree of care is submitted, the medical service must be involved.
    The processing of your request is usually extended by about 3 to 4 weeks.
     

  • Deadline

    You will only receive the benefit from your care fund from the month in which you submitted the application, but at the earliest from the time when the eligibility requirements are met. If the application is not made in the calendar month in which the need for care occurred, but later, the benefits are granted from the beginning of the month of the application. Therefore, you should submit the application in good time.
    If the nursing care fund does not issue the written notification within 25 working days of receipt of the application or if one of the assessment deadlines specified in the law is not complied with, the nursing care fund must pay you EUR 70.00 immediately after the deadline has expired for each week of exceeding the deadline. This does not apply if the nursing care fund is not responsible for the delay or if you are already in full inpatient care and at least the care level 2 has already been determined.
     

  • Responsible authority

    The responsibility lies with the respective nursing care fund.

  • Legal basis
  • Pointer

    In some federal states, you can apply for long-term care housing benefit in addition to the benefits of your nursing care fund.
    You can change the nursing home at any time.
     

  • More informationen
  • Approved

    Federal Ministry of Health

  • Approved date
    22.11.2021