Care Allowance After a Hospital Stay: What to Do Next

When Mr. W. was discharged from the hospital after his hip surgery, his daughter was faced with a barrage of unanswered questions.

Who will help with laundry, cooking, and doctor's appointments now? Will Dad now receive care allowance? And if so—when, how much, and how do you actually apply for it?

It is precisely at times like these that people don't need lengthy legal texts. They need clear answers.

This magazin them.

What is a long-term care allowance—and why does it become so important after a hospital stay?

Long-term care allowance is a monthly cash benefit provided by the statutory long-term care insurance program. It is paid starting at Care Level 2 if care at home—that is, provided by family members, friends, or volunteers—is ensured. The money is not earmarked for a specific purpose: it recognizes the dedication of family caregivers and helps them reorganize their daily lives.

After a hospital stay, whether following a surgery, a fall, or a serious illness, care needs often change abruptly. People who previously lived independently suddenly need help getting dressed, cooking, or using the restroom. At the same time, family members are overwhelmed, bureaucratic hurdles await, and the discharge date is fast approaching.

That is exactly why long-term care benefits after a hospital stay are such an important issue. And that is exactly why it’s worth taking the right steps early on.

The New Rule: How Long Will the Care Allowance Continue to Be Paid While in the Hospital?

Anyone who already has an officially recognized care level and is admitted to the hospital doesn't need to worry, at least for a certain period of time. Starting in 2026, the so-called "eight-week rule" will apply:

The New 8-Week Rule (Effective in 2026)

Care allowance continues to be paid in full for up to eight weeks (56 days) during a full inpatient hospital stay.

The entitlement is suspended only starting on the 57th day, and it is immediately reinstated as soon as the person returns home.

This doubled the previous four-week deadline, providing significant relief for those affected and their families.

Important: The duration of a single continuous stay is the determining factor. Multiple shorter stays, each lasting fewer than 56 days and not occurring immediately one after the other, do not trigger a suspension of the long-term care allowance.

Special Note Regarding Rehabilitation: If inpatient rehabilitation begins immediately after a hospital stay, all days are counted together. If you spend even just one day at home during this period, it interrupts the count and you retain your entitlement to the nursing care allowance.

Applying for a Care Level After a Hospital Stay: The Sooner, the Better

If you don't yet have a care level but will need assistance after discharge should submit the application as early as possible, preferably while still in the hospital.

The care level is determined by the Medical Service (MD) . It doesn’t matter whether you’re having a “good day” at the time: the assessment focuses on your long-term need for assistance in daily life, not your condition on any given day. Five areas are evaluated in each category:

• Mobility (e.g., walking, climbing stairs)
• Cognitive and communicative skills
• Self-care (e.g., bathing, getting dressed, eating)
• Dealing with the demands of illness
• Everyday life and social contacts

Hospital Social Services: Your First Point of Contact

Since October 2017, hospitals have been required by law to offer discharge management services. The hospital’s social services department helps patients apply for a care level, organize short-term care or home nursing care, and prepare for discharge to home care.

“I had no idea I could apply for that while I was still in the hospital,” says the daughter of Mrs. S., 81.

After a stroke , it was clear that returning home would require support. The clinic’s social worker filed an urgent application for a care assessment that very same day and arranged a short-term care placement for the transitional period.

"That way, we were able to plan things out calmly, without Mom just being sent home."

Who is eligible for a care allowance, and how much is it?

Care allowance is available to individuals in need of care who are classified at care level 2 or higher and who:

• are covered by statutory or private long-term care insurance,
• be cared for at home by family members, friends, or volunteers,
• organize their own care (not exclusively through an outpatient care service).

The current monthly amounts are as follows:

Care Allowance and in-kind care benefits can be combined: If an outpatient care service covers part of the costs, the care allowance is reduced proportionally but not eliminated entirely. This so-called combined benefit is the most practical option for many families.

Applying for Care Allowance: Step by Step

Here's what to do if you want to apply for a nursing care allowance after a hospital stay:

1. Submit an application to the long-term care insurance fund—informally, by phone or in writing—preferably while you are still in the hospital.
2. Contact the hospital's social services department and ask for assistance.
3. Gather documents: medical reports, hospital discharge summary, and, if applicable, a rehabilitation report.
4. Preparing for the MD's assessment: Document your care needs realistically, including descriptions of your "bad days."
5. Wait for the decision and, if necessary, file an appeal if the care level does not reflect reality.

Tip: Before the assessment, keep a brief care log. Note down what the person in need of care can no longer manage on their own each day. This helps the assessor identify their actual needs.

Care Allowance and the Role of Family Members

Care allowance isn't simply "paid out and forgotten." Anyone who receives care allowance also has responsibilities:

• Care visits by an outpatient service: Starting at Care Level 2, a consultation visit is required every six months in accordance with Section 37 of SGB XI. This visit serves the purpose of quality assurance and does not cost the family providing care anything extra.
• Reporting Requirement: Hospital stays must be reported to the long-term care insurance fund to avoid having to repay benefits.
• Proof of Care: Care must be “ensured in an appropriate manner.” The long-term care insurance fund is best suited to clarify what this means in practice.

Many family caregivers overlook the fact that they, too, have rights. Anyone who cares for a close relative can take care leave (up to six months of leave) or family care leave (up to 24 months of part-time work). And: Pension contributions continue to be paid for the caregiver during the care period; this also remains in effect during the first eight weeks of a hospital stay.

The Most Common Mistakes—and How to Avoid Them

• Applying too late: The most common mistake. Submit your application while you’re still in the hospital—don’t wait until weeks after you’ve been discharged.
• Underestimating care needs: Many people downplay their symptoms during the assessment. Describe realistically what you can no longer do on a bad day.
• Failure to Report a Hospital Stay: This May Result in Recoupment. Report inpatient stays to your long-term care insurance provider.
• Do not combine benefits: Care allowance, in-kind benefits, the care relief allowance, and short-term care can often be combined effectively. Contact your long-term care insurance provider or a long-term care support center.
• Not taking advantage of counseling services: Care centers, welfare organizations, and hospital social services offer free support.

Three Real-World Examples: Here's How It Can Work

Example 1: Hip surgery, Care Level 3, return home

Ms. K., 78, is being discharged from the hospital after her hip surgery. Her husband is caring for her at home, and a home care service visits three times a week.

The family receives a combination of benefits: a pro-rata care allowance plus in-kind care benefits for the care service. They use the relief amount to pay for a housekeeper who comes twice a week.

Result: Ms. K. stays at home. Her husband has more time to himself. They can plan their daily lives again.

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Example 2: Stroke, no care level, transitional care

Mr. B., 65, suffers a stroke. This is his first hospital stay; he has not yet been assigned a care level.

While the patient is still in the hospital, Social Services files an expedited application for a care assessment and arranges a short-term care placement for the first four weeks after discharge.

Following the assessment, Care Level 2 is granted, retroactive to the date of the application. Mr. B. will now receive a care allowance and will continue to receive outpatient rehabilitation services.

Example 3: A Person Living Alone, Short-Term Care as a Bridge

Ms. M., 83, lives alone and has no relatives nearby. Following a pulmonary embolism, she is unable to return to her own home for the time being.

Through discharge planning, a spot in a short-term care facility is arranged. During this time, arrangements are made for an outpatient care service to assist with the patient’s return home.

Today, Ms. M. receives daily visits from a home care service and continues to live in her apartment.

Your Checklist: What Needs to Be Done and When?

Still in the hospital

• Contact social services and ask for help with the application process
• Submit an application for a long-term care level to the long-term care insurance fund (informal; a phone call is sufficient)
• Making Active Use of Discharge Management: Short-Term Care, Home Health Care, Assistive Devices
• Obtain the hospital report and medical records for the evaluation

 During the first 14 days after discharge

• Notify your long-term care insurance provider about your hospital stay (if you haven't already done so)
• Keep a care journal, make daily entries—support is needed
• Contact a care center for a free consultation
• Assess the living situation: assistive devices, grab bars, and, if necessary, home modifications
• Preparing for the assessment appointment: provide a realistic description; do not downplay the situation

We're here for you—when everyday life gets to be too much.

A hospital stay changes a lot of things. The bureaucracy involved doesn't have to make it any harder. Tell us about your situation, and together we'll determine what support you or your family members are entitled to.

Legal Notices

This magazin general information and is not a substitute for individual legal or social counseling. Legal regulations are subject to change. For current benefit amounts and legal information, please contact your long-term care insurance provider or a long-term care support center.

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