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What are the benefits of a care degree?

If your relative needs care or increasing help in everyday life, it makes sense to apply for a care degree. This involves money that your relative is entitled to from the time of classification. If you have a care degree, you can claim benefits from the care insurance - as long as you have paid into the care insurance fund for at least two years during the past ten years. From care level 2, you are entitled to care allowance and/or care benefits in kind.

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What does the degree of care mean?

The care degrees provide information about how severely the independence of your relative is impaired. This ranges from care level 1 with "minor impairments" to care level 5 with "most severe impairments". The care level to which your relative is assigned depends on fixed criteria. These are assessed according to a point system that covers both physical and mental impairments. If the person in need of care is cared for at home, the classification from care level 2 onwards entitles the person to either care benefits in kind or care allowance.

Who gets how much?

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Care degree 1

If your relative is still largely independent and only needs a small amount of help, then he or she is not entitled to care benefits in kind or care allowance with care degree 1, but he or she does receive the following benefits:

  • Regular counselling
  • Relief amount
  • Nursing aids for consumption
  • Subsidy for age-appropriate design of the living space

The relief amount (125 euros per month) can be used for help in everyday life - and especially in care level 1 also for basic care assistance, such as showering or bathing. Counselling by a care expert, which can be used up to twice a year, is also important for you. Because you can be there as a caring relative. Expert guidance is very helpful if you feel responsible for your relative and want to support him or her in the best possible way. The care aids for consumption - for example, protective gloves and disinfectants - are covered by the long-term care insurance up to an amount of 40 euros per month (480 euros per year). The subsidies for age-appropriate renovations of up to 4,000 euros are granted for the installation of an age-appropriate shower, for example.

Care degree 2 to 5

In the following, you can get a quick overview of which services are covered by the long-term care insurance fund for each care degree. But be careful: You cannot simply add up all the numbers in one column. For example, there is an entitlement to care allowance or care benefits in kind - and a combination of both. The criteria for the calculation must be observed. The same also applies if, for example, you claim preventive care: In this case, the care allowance is halved for a certain period of time. Day/night care and care benefits in kind are also a combination option. Therefore: You should know the conditions more precisely, especially for the benefits that can be offset against each other. The costs for professional outpatient care services or daily living assistants are not the same everywhere. Keep this in mind when you calculate the financing specifically for care at home.

Benefits from the long-term care insurance fund for care degrees 2 to 5:

  care level 2 care level 3 care level 4 care level 5
care benefits in kind 689 euro/month 1,298 euro/month 1,612 euro/month 1,995 euro/month
care allowance 316 euro/month 545 euro/month 728 euro/month 901 euro/month
Entlastungsbetrag 125 Euro/month (also for full inpatient care) 125 Euro/month (for home care) 125 Euro/month (for home care) 125 Euro/month (for home care)
Preventive care 1,612 Euro/year 1,612 Euro/year 1,612 Euro/year 1,612 Euro/year
Short-term care 1,612 Euro/year 1,612 Euro/year 1,612 Euro/year 1,612 Euro/year
Nursing aids for consumption 40 euros/month (not for full inpatient accommodation) 40 euros/month (not for full inpatient accommodation) 40 euros/month (not for full inpatient accommodation) 40 euros/month (not for full inpatient accommodation)
Subsidy for age-appropriate housing conversion 4,000 euros per adaptation measure 4,000 euros per adaptation measure 4,000 euros per adaptation measure 4,000 euros per adaptation measure
Housing group allowance 214 Euro/month (limited to 2,500 Euro in total) 214 Euro/month (limited to 2,500 Euro in total) 214 Euro/month (limited to 2,500 Euro in total) 214 Euro/month (limited to 2,500 Euro in total)
Day and night care 689 euro/month 1,298 euro/month 1,612 euro/month 1,995 euro/month
Stationäre care 770 Euro/month 1,262 Euro/month 1,775 Euro/month 2,005 Euro/month

Upgrading or reduction of the degree of care

If your relative has been classified in a certain care level, this does not automatically apply forever. A downgrading can happen - but is rarely indicated in practice. This is only relevant if an improvement in the condition can be expected at the time of classification - for example, through a rehabilitation measure. However, the long-term care insurance fund must then prove this improvement. An increase in the care level can be applied for if the independence of the person in need of care decreases. Sometimes this happens suddenly, for example due to illness or an accident. Sometimes it happens gradually. This is when you, as a family caregiver, are in demand. Because you can recognise in which areas more help is needed in everyday life. It is helpful if you make a note of changes. This way, you can better argue when a decision is made about an upgrading.

Your relative can appeal against the classification into a certain care level.

If the classification is not to your satisfaction, your relative can appeal. A carer or a legally appointed guardian may also do this. This appeal must be made in writing within four weeks. The date of the decision is the starting point for calculating the four weeks, not the date of delivery. Seek professional advice when lodging an objection. This does not have to be a lawyer right away. Care support centres are also a good place to start in such matters. As with the application for a care degree, the following also applies to the objection: If you want to support your relative, be well prepared. Read the report carefully and make notes on the points where you disagree. Check whether all medical prescriptions and reports have been included in the report. Maybe some documents were not available at the time of the assessment? Document what you think was missed out in the final assessment.

In order to meet the deadline of four weeks, a formal objection is sufficient for the time being. With this, you inform the long-term care insurance fund that you do not agree with the decision and that you are filing an objection. You can then deal with the finer points - because the deadline has been met and this buys you some time.

Sources & Notes

[NBSP] https://www.verbraucherzentrale.de/wissen/gesundheit-pflege/pflegeantrag-und-leistungen/pflegegrad-abgelehnt-so-wehren-sie-sich-mit-widerspruch-und-klage-11547
https://www.bundesgesundheitsministerium.de/themen/pflege/online-ratgeber-pflege/leistungen-der-pflegeversicherung/leistungen-fuer-pflegebeduerftige-des-pflegegrades-1.html
[NBSP] https://www.vdk.de/deutschland/pages/themen/pflege/75419/pflegegrad_abgelehnt_wie_kann_man_einen_widerspruch_einlegen?dscc=ok

 

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