When everyday life suddenly becomes too difficult, everything changes. An accident, a serious illness, or the period following surgery raises questions that go far beyond mere practical arrangements. In these moments, one thing matters above all else: the certainty that you can remain in your familiar surroundings.
Medical treatment care is the cornerstone of this approach; it is a central component of in-home nursing care and is prescribed by a doctor to ensure care is provided in the patient’s own home. It ensures that professional help comes to your home so that your own four walls remain a place of recovery. For people who are particularly in need of care, medical treatment care makes it possible for them to continue receiving care and medical attention in their familiar home environment.
In this article, you'll learn everything about the services, costs, and legal framework of long-term care under SGB V.
What Is Therapeutic Care? A Definition
The definition of therapeutic care is closely linked to the goal of medical recovery. In contrast to general care or household assistance , it encompasses medical interventions that are directly intended to cure an illness or various diseases, prevent their worsening, or alleviate symptoms.
Therapeutic Care Under SGB V: The Legal Framework
The legal basis for this is found in the Fifth Social Code (SGB V). It stipulates that home health care is a benefit covered by statutory health insurance. The goal is clearly defined: Supportive care is intended to ensure the success of medical treatment or to prevent or shorten a hospital stay.
The Key Difference from Basic Care
There is often confusion regarding the distinction from basic care. While basic care (SGB XI) includes activities such as bathing, dressing and undressing, or feeding, and is covered by the long-term care insurance fund if a care level , therapeutic care focuses exclusively on medical treatment, certain aspects of which may only be performed by specially trained professionals, among others.
- Basic Care: Assistance with Daily Living, Personal Hygiene, Mobility.
- Therapeutic care: Medical care provided by licensed nursing professionals under a doctor's orders.
Services and Responsibilities: What Do They Entail?
Imagine that Ms. K. returns home from the hospital after a fall. The doctor has prescribed rest, but the daily wound care and the need to take her medication exactly as prescribed are too much for her to handle. This is exactly where the home care service comes in.
Typical Tasks in Medical Treatment Care
The list of services is extensive and requires a high level of expertise. The most common services include:
- Wound Care: Professional dressing changes for chronic or surgical wounds.
- Medication Management: The preparation and administration of medications.
- Injections & Infusions: Administering insulin or pain medication, as well as monitoring infusions.
- Vital signs: Regular blood pressure and blood sugar checks.
- Specialized Care: Catheter care, suctioning, or ostomy care.
The professional execution and careful documentation of these activities are a central component of nursing practice, which holistically reflects the entire nursing process within the framework of therapeutic care as prescribed by a physician.
Who is responsible for implementing these measures?
The safety of the insured person is the top priority. Therefore, medical care may only be provided by trained professionals who have completed a three-year training program (e.g., registered nurses). Nursing assistants or care aides may only perform these tasks if they have completed specific continuing education and have at least two years of professional experience.
The Path to Care: Prescription and Approval
No one has to go through this alone. There is a clear process for getting help.
The Doctor's Prescription
A doctor's prescription is absolutely necessary for the home care service to provide care. This is often referred to as a "prescription for care."
- Initial prescription: Generally valid for up to 14 days.
- Follow-up prescription: The duration of validity depends on the individual's health status.
As soon as the prescription is issued, it is submitted to the health insurance provider. The provider reviews the eligibility and grants approval.
It’s important to know: As an insured person, you have the right to adequate care if it is medically necessary; it is not a “luxury” that you have to earn. Accept help when you need it.
Costs and Financing: What Do You Need to Know?
Costs are a common cause for concern. However, the health insurance system provides strong protection in this regard.
Coverage by Health Insurance Companies
As a rule, health insurance companies cover the full cost of nursing care. However, there is a legal provision regarding copayments for adults (ages 18 and older):
- A flat fee of 10 euros per prescription.
- 10 percent of the costs for up to 28 days per calendar year.
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Observe load limits
To ensure that the financial burden does not become too high, there is a cap. This cap is set at one percent of gross income (for those with chronic illnesses) or two percent for everyone else. If this limit is reached, an application for exemption from copayments may be submitted.
Why Professional Care Makes a Difference
It’s about more than just changing a bandage. It’s about the people. An experienced caregiver recognizes signs of a worsening condition early on and responds immediately. This aspect of care requires not only technical skill but also empathy for the patient’ssituation.
Support for relatives
It is often family caregivers who feel overwhelmed. Assistance from a professional care service takes a massive burden off the family. It restores the peace of mind that comes from knowing medical care is in the best hands, while allowing you to refocus on your role as a daughter, son, or spouse.
Frequently asked questions (FAQ)
Can you apply for medical care even without a care level designation?
Yes! Since treatment-related care is a benefit covered by health insurance (SGB V), it is not dependent on a care level. The only determining factor is the medical necessity, as determined by a doctor.
Can basic care and therapeutic care be provided at the same time?
Absolutely. Many people need both: help with bathing (basic care) and medical injections or blood sugar testing. In this case, health insurance and long-term care insurance work hand in hand.
