Many people with ADHD are unaware that they may be eligible for home help through their health insurance, which is covered in full or at least in part. Yet this kind of household support is often not a matter of convenience, but a medical necessity. ADHD is recognized as a condition whose symptoms—such as difficulty concentrating, impulsivity, and organizational challenges—can vary greatly in severity among adults and children. Anyone who struggles daily with executive dysfunction, sensory overload, and mental exhaustion needs real relief, not well-meaning advice. This magazin when coverage is possible, which agencies are responsible, and how to apply.
The table of contents below provides an overview of all the topics covered in this article, allowing you to navigate directly to the information that is relevant to you.
Introduction to ADHD
Attention-Deficit/Hyperactivity Disorder (ADHD) Attention-Deficit/Hyperactivity Disorder (ADHD) is a neuropsychiatric disorder that usually appears in childhood and significantly impacts the lives of affected families. Typical symptoms include inattention, hyperactivity, and impulsivity. These behaviors often make daily life and the care of children and adolescents with ADHD—as well as their parents—a challenge. Especially when it comes to household chores and daily care, these children need special support to experience structure and security. Parents face the task of not only helping their children in daily life but also organizing the appropriate assistance and services. Long-term care insurance offers families with children who have ADHD targeted support and relief so that daily life can be better managed despite the symptoms and limitations.
The Role of Parents
Parents of children with ADHD bear a heavy responsibility, as they are not only responsible for their children’s daily care and support but also for organizing the necessary assistance. The care burden can be significant depending on the severity of ADHD symptoms and can affect the daily life of the entire family. To make the actual effort involved in care and support transparent, it is recommended to keep a care diary in which care services and the associated effort are documented. This makes it all the more important for parents to inform themselves about their entitlements and seek targeted assistance—whether through a housekeeper who provides relief with household chores or by applying for a care level that enables access to additional benefits. Parents should not hesitate to seek professional support to reduce the burden of care and experience greater relief in their daily lives. This leaves more time and energy for the individual care and support of their own child.
Support and advice
There are numerous options available to parents of children with ADHD for obtaining support and guidance. Long-term care insurance not only provides financial benefits but also offers counseling services to help parents apply for care benefits and organize their daily routines. Specialized counseling centers, support groups, and online communities are also available to offer valuable assistance. It is important that parents do not withdraw but actively seek help to manage the demands of caregiving and ensure the best possible support for their child. Professional counseling can help them keep track of the various services available and find individualized solutions to the challenges of daily life.
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Support groups and networks
Support groups and networks are important for many parents of children and adolescents with ADHD and are always worth a try. Here, they can connect with others facing similar challenges, share experiences, and get practical tips for daily life. Interacting in these groups helps people feel understood and develop new strategies for dealing with the challenges of ADHD. Online communities and forums also make it easy to connect with others and find support. Participating in support groups can help you better manage the demands of caregiving and find relief in daily life. Parents should actively look for suitable groups to benefit from the experiences and knowledge of others and to support one another. In Germany, there is a wide range of support groups available, tailored to your preferences and individual support needs.
When does health insurance cover a home care aide for ADHD?
The legal basis is found in Section 38 of Book V of the Social Code (domestic help) as well as in supplementary provisions of long-term care insurance (Book XI of the Social Code). Both options are generally available to people with ADHD—but under different conditions.
One of the requirements is that the household includes a child under the age of 12 or a child with a disability, and that no one else is able to take on these responsibilities. In addition, the type of ADHD—that is, the severity and nature of the symptoms—can affect eligibility requirements and the extent of your need for support.
Medical necessity must be demonstrated. A doctor’s prescription is required to establish the necessity of the domestic help .
The Entitlement to domestic help can last up to 26 weeks if a child or young person lives in the household. The statutory health insurance covers the costs of a household helper if the person managing the household is temporarily unable to continue doing so due to a serious illness.
Guidelines for obtaining ADHD support tailored to your needs
Option 1: Home care assistance under Section 38 of the German Social Code, Book V (health insurance)
Health insurance covers a home health aide if:
- You are unable to manage the household due to illness
- There is a child or young person under the age of 12 (or with a disability) living in the household
- No one else in the household who can take on these tasks
ADHD alone is generally not sufficient grounds—what matters is a proven impairment in daily functioning. If there is an ADHD-related crisis, a hospital stay, or a comorbid condition (e.g., depression, burnout), the chances increase significantly.
“ADHD is a neurobiological disorder—not a personality trait. If executive functions are so impaired that the patient can no longer manage household tasks, hiring a housekeeper is clearly medically indicated,” explains Dr. Ulrike Baumann, a specialist in psychiatry and psychotherapy.
A home care aide can help create more calm and structure in the daily lives of children with ADHD, which helps alleviate symptoms. They play a vital role in developing healthy strategies for managing daily life with ADHD over the long term—both for those affected and for their caregivers.
Option 2: Respite care services through long-term care insurance (Section 45b of Book XI of the Social Code)
Anyone with a care level of 1 or higher is entitled to up to 131 EUR per month for approved respite services—including household help. This respite allowance can be used to pay for household help, is granted on a monthly basis, and cannot be saved up.
The level of care required by children with ADHD is determined by the extent to which their independence and abilities are impaired compared to typically developing peers. Many children with ADHD require an unusually high level of guidance and supervision even during childhood, which significantly increases the burden of care in everyday family life. This is a clear sign that support is needed.
In severe cases of ADHD, nearly constant supervision around the clock is necessary to protect the child from harming themselves or others. During the evaluation by the Medical Service (MD) , individual care needs, support requirements, and the level of care required in various areas of daily life are assessed. These include, in particular, cognitive and communicative abilities, the organization of daily life, skills in daily living and social interactions, as well as behavioral patterns and psychological issues. Requirements related to illness or therapy are also taken into account to determine determine the need for care and the appropriate care level (formerly care level)—such as care level 2—to be determined. Children with ADHD, in particular, demonstrate a significant need for support in several areas of life, which can influence their classification into a higher care level.
From Care Level 2 , up to €1,612 per year can be used for respite care if the primary caregiver is unable to provide care. In addition, starting at care level 2, a care allowance is available that can be used to hire private caregivers. Since July 1, 2025, there has been a combined annual amount for respite and short-term care; a total of €3,539 per year is available, which can be flexibly allocated to both services. Learn more about cost coverage with a clear overview of your financial support entitlements!
Option 3: Integration Assistance (SGB IX)
For people with a recognized disability (GdB) , integration assistance may also be an option. It is aimed at promoting social participation and may include assistance with daily living—the specifics of which vary by state. This also includes accompaniment to doctor’s appointments and government agency visits, as well as in daily life, to promote social participation.
Respite Care: Relief for Families with ADHD
The Respite care is a valuable form of support for families with children who have ADHD and require increased care. Parents and relatives who provide daily care and support often reach their breaking point. Through respite care, long-term care insurance offers targeted relief: If the primary caregiver—such as a parent—is temporarily unavailable due to illness, vacation, or other reasons, long-term care insurance covers the costs of substitute care.
Families with children who have ADHD are eligible for this benefit as long as a care level has been assigned. Respite care can be used for up to four weeks per calendar year and allows parents to take a much-needed break, recharge their batteries, or attend important appointments without having to worry about their child’s care. Respite care can be provided by professional caregivers, as well as by close relatives or friends, depending on the individual situation and needs.
Especially in cases of ADHD, it is important that the caregiver is familiar with the child’s specific needs and behaviors. Therefore, it is advisable to choose a substitute caregiver carefully and to prepare thoroughly for the handover. Respite care is a vital component in ensuring long-term care and protecting parents’ health. Check with your long-term care insurance provider to learn about the exact requirements and options—this way, you can ensure that you and your family receive the necessary relief in your daily lives. Learn more about ADHD and burnout: What really helps you and how to get relief in daily life and household tasks!
Step by step: How to apply for coverage
1. Obtain a doctor's note
Instructions: How to Obtain a Doctor's Note
- Make an appointment with your doctor or psychiatrist.
- Explain that you need a medical certificate to apply for home care assistance from your health insurance provider due to ADHD.
- Please request a detailed written confirmation that includes all relevant information (see below).
- Please check the medical certificate to ensure that all required information is complete and clear.
- Submit the medical certificate along with your application to your health insurance provider.
The first step is always to obtain a written confirmation from your doctor or psychiatrist. The medical certificate should include:
- Diagnosis (ADHD, comorbid conditions if applicable)
- Specific limitations in daily life
- Medical justification for domestic help
2. Submit an application to your health insurance provider
Submit your application before the domestic help begins—retroactive approvals are rarely granted. When submitting your application, be sure to include all required documents, such as the doctor’s note, and describe your situation as clearly as possible. Many health insurance companies have application forms on their websites. Attach the doctor’s note and describe your situation in detail.
3. Apply for a care level (if you haven't already)
If you do not yet have a care level, it is worth submitting a separate application to your long-term care insurance fund (which is usually part of your health insurance provider). In the past, the term “care level” was used for this; today, the term “care grade” is used. The medical director will then conduct an assessment—either in person or via video call.
Tip: Keep a daily journal for 1–2 weeks beforehand. Note down which tasks you’re unable to complete and why. This information will be invaluable during your consultation with the doctor.
4. Choose a provider and clarify coverage
Not all home care providers are covered by all health insurance plans. Check with your health insurance provider beforehand to find out which providers are approved—or choose a provider that handles billing directly with your health insurance plan.
Key considerations in MD assessment
The assessment by the Medical Service (MD) is a crucial step toward determining the appropriate care level for children with ADHD. To ensure that the actual care needs and daily challenges are accurately assessed, parents should prepare thoroughly. A key tool is the care diary: Over the course of at least one to two weeks, record all the care tasks you perform for your child—from helping with daily routines and supporting social interactions to assisting with impulsive behavior or concentration problems.
It is important that, when speaking with the evaluator, you openly and honestly describe how your child’s attention-deficit/hyperactivity disorder (ADHD) affects daily life and the level of care required. Describe specific situations in which your child needs special guidance, supervision, or support. You should also address any difficulties your child may have with communication, managing daily routines, or interacting with others.
Be sure to have all relevant documents—such as medical reports, therapy certificates, and the care log—ready for the assessment. It may be helpful to speak with the long-term care insurance provider or a care advisor in advance to clarify any questions and address any uncertainties. The better prepared you are, the more accurately the assessor can determine your child’s individual care needs and assign the appropriate care level. This ensures you receive the support you and your child truly need in everyday life.
What do I have to pay out of pocket—and what does my insurance cover?
|
Cost center |
Performance |
Co-payment |
|---|---|---|
| Statutory Health Insurance (Section 38 of Book V of the Social Code) | Household help during a hospital stay or crisis | Up to €10 per day |
| Long-Term Care Insurance Fund (Section 45b) | Relief benefits of up to €131 per month | None (if a care level has been assigned) |
| Rehabilitation assistance | Daily living assistance as needed | Income-based |
Common reasons for rejection – and how to address them
- “No care level assigned” → Apply for a care level separately, file an appeal
- “No dependent children in the household” → indicate any comorbid conditions and the severity of ADHD
- “Another person in the household could help” → Explain specifically why that is not possible (e.g., partner works, own ADHD)
It's worth appealing: According to the Consumer Advice Center, many initial rejections of applications for domestic help are ultimately approved after an appeal!
Frequently Asked Questions About ADHD and Health Insurance
1. Can I receive home care assistance for ADHD even if I don’t have a care level designation?
Yes, under Section 38 of the German Social Code, Book V (SGB V), if you are temporarily unable to manage your household due to illness and there are children under the age of 12 living in your household. Eligibility depends on the individual case.
2. How long can health insurance cover the cost of a home health aide?
If benefits are granted under Section 38 of the German Social Code, Book V (SGB V), they are generally limited to the duration of the illness. Respite care benefits provided through the long-term care insurance fund (Section 45b) are permanent—as long as a care level is assigned.
3. What should I do if my application is denied?
File a written appeal within one month. Seek advice from your health insurance provider, the VdK, or a social welfare organization. A detailed medical report significantly increases your chances of success.
In addition to the benefits provided by long-term care insurance, there are other support services available, such as care counseling and caregiving courses for family members, which are often free of charge. Parents of children with ADHD can also participate in free webinars led by care professionals that address typical challenges in everyday family life.
4. Are people with ADHD eligible for a health retreat?
Yes, people with ADHD can generally receive medical treatment or rehabilitation in Germany—both children and adults—provided there is a medical need and a doctor certifies it.
General Information: ADHD as an Indication for Rehabilitation or Spa Treatment
- ADHD is recognized as a mental disorder—more specifically, a specific learning disability—and may warrant rehabilitation or spa treatment, for example, at psychosomatic rehabilitation clinics.
- The key factor is that ADHD (often accompanied by conditions such as depression, anxiety, or burnout) significantly impairs or jeopardizes a person’s health or ability to work, and inpatient treatment is likely to be beneficial.
Types of Treatment and Rehabilitation for ADHD
- Psychosomatic medical rehabilitation (adults): Inpatient rehabilitation at a psychosomatic clinic, often covered by the German Pension Insurance or health insurance; ADHD is explicitly listed as an indication there.
- Mother/Father-Child Therapy Program with a Focus on ADHD (if a child is affected): There are specialized clinics offering therapy programs focused on ADHD for parents and their children; the program typically lasts 3 weeks and is covered by statutory health insurance (with a small copayment).
- Rehabilitation for Children and Adolescents with ADHD: Specialized rehabilitation programs for children and adolescents with ADHD that can be requested through health insurance, often combined with parental support.
Overview: Common Options
| Action Type | Target group | Cost centers typically | Duration (approximate) | Distinctive feature |
|---|---|---|---|---|
| Psychosomatic Rehabilitation | Adults with ADHD and related issues | German Pension Insurance or Health Insurance | about 3–5 weeks | Focus on work capacity and daily functioning |
| Mother-and-Child Health Retreat | Parents, who are often under a great deal of stress; children who may have ADHD | Public health insurance provider, e.g., AOK, Barmer, Techniker, etc. | approx. 3 weeks | Parent-Child Setting, Support & Training |
| ADHD Rehabilitation for Children and Adolescents | Children and adolescents with ADHD | Health insurance, and pension insurance if applicable | about 3–5 weeks | Multimodal ADHD therapy, including parent counseling |
Everyday requirements
- Medical prescription: A general practitioner, pediatrician, or specialist (psychiatrist, child and adolescent psychiatrist, or psychotherapist) must certify the medical necessity, including the diagnosis and an explanation of why outpatient treatment is insufficient.
- To qualify for rehabilitation through the German Pension Insurance: Your ability to work must be at risk or impaired, and certain insurance requirements (e.g., 6 months of mandatory contributions in the past 2 years) must be met
- For mother/father-child treatment programs: The parent must have a health risk or an existing condition (e.g., exhaustion, psychological stress), often in connection with the stress caused by ADHD within the family.
Proposal: How to proceed in practice
- Talk to your doctor: Describe your symptoms, ADHD diagnosis, and any additional challenges; the doctor will fill out the application forms for the insurance provider (health insurance or pension insurance).
- Use the insurance provider’s forms: Health insurance companies and the German Pension Insurance provide their own application forms for rehabilitation and spa treatments.
- Specify your preferred clinic: You have the right to choose, e.g., a clinic specializing in ADHD for families or adults; many clinics will assist you with the application.
