In this guide, you can find out whether you are entitled to long-term care benefits in kind, how much you are entitled to, how you can apply for them and which services and support in everyday life can be financed by long-term care benefits in kind.
Who is entitled to long-term care benefits in kind?
All people whose care and nursing is provided at home, i.e. not in a nursing home, are entitled to care benefits in kind. You are entitled to care benefits in kind, regardless of whether the care is provided by a care service, a home help provider or a family carer, if you have a care degree of 2-5. The subsidy for care benefits in kind is regulated by law in SGB XI and the application must be submitted manually to the responsible care insurance company. The amount of the subsidy for care benefits in kind depends on the individual care degree classification.
Definition of long-term care benefits in kind
According to Section 36 SGB XI, a care benefit in kind is professional home care assistance that provides physical care as well as support and household services. In addition, care services include the provision of professional care guidance for the caregiver and the person in need of care.
People with a care level 2 or higher who are cared for in their own home are entitled to care benefits in kind. The care insurance fund covers the costs up to the maximum amount of the respective care degree.
Care services are provided by care services that have a care contract with the responsible care insurance fund. Individuals can also be recognized by the care insurance fund. The prerequisite for this is that there is no close relationship with the person in need of care.
Examples of care benefits in kind
The term care benefit in kind can be misleading at first, as a benefit in kind implies a material benefit, such as an object. However, these are outpatient services in the form of basic care. Care benefits in kind are therefore intended to support the person in need of care in maintaining their independence.
The following services can be claimed as part of care benefits in kind:
Body-related care
- Personal hygiene (in bed and bath)
- Help with getting up, repositioning
- Help with dressing and undressing
- Promote mobility
- Support with food intake
Nursing care measures
- Support in coping with psychosocial problems
- Shaping everyday life
- Support with communication
- Maintaining social contacts
- cognitive activation
Support in the household
- Shopping
- Preparation of meals
- Ironing and washing laundry
- Cleaning work
Nursing instructions
- Practical care techniques
- Tips on benefit entitlements
Nursing care and care in kind
Nursing care, which includes tasks such as administering medication, changing dressings and injections, is not part of the tasks of care services. They are prescribed by a doctor and are therefore part of home nursing care, so the costs are not covered by the long-term care insurance fund, but by the health insurance.
Both care services and nursing care may be provided by the same person if the expenses are clearly differentiated in the invoice.
Difference between care allowance and care benefits in kind
Both the care allowance and the care benefit in kind can be applied for by people who have been assigned at least the official care level 2 and are cared for in a home environment. However, the two benefits differ in their purpose, amount and method of payment.
- Care benefits in kind: Long-term care benefits in kind are intended to finance services provided by professional caregivers. Compared to the care allowance, the care benefit in kind is relatively generous. The benefit is a so-called benefit in kind and is therefore linked to services. The amount is only paid if costs have actually been incurred.
- Care allowance: Compared to the care benefit in kind, the care allowance is rather low. It is paid directly to the person in need of care and is therefore freely available to them and is an allowance for daily living from the care insurance funds as long as the care takes place in a home environment.
Amount and benefits of care services depending on the care level
The amount of care benefits in kind depends on the respective care level. It is important to note that the amounts stated are the maximum allowance. The care insurance fund only pays the benefits in kind that are actually incurred in the respective month.
- Care level 1: 0 euros per month
- Care level 2: 796 euros per month
- Care level 3: 1,497 euros per month
- Care level 4: 1,859 euros per month
- Care level 5: 2,299 euros per month
If you notice over time that the need for care continues to increase and the independence of the person in need of care continues to decrease, an application for an upgrade of the care degree should be made in good time. This is because the entitlement to benefits from the long-term care insurance fund only increases once the care level has been officially determined.
Long-term care benefits in kind for care level 1
If you have been awarded the care level 1, you are not entitled to care benefits in kind from an outpatient care service. However, there is a special regulation for the use of respite services in the amount of 131 euros per month.
This is because you are free to use the respite services for self-care measures. This includes tasks such as personal hygiene and providing food and drink. From care level 2-5, the relief benefits of 131 euros can be used exclusively for care and relief measures.
Long-term care benefits in kind for care level 2
If your need for care is classified as care level 2 you are entitled to care benefits in kind amounting to 796 euros per month. This means that the long-term care insurance will finance costs incurred for care and nursing services up to a value of 796 euros.
Long-term care benefits in kind for care level 3
People in need of care with care level 3 are entitled to care benefits in kind amounting to €1,497 per month. Care services and support services worth EUR 1,497 can be claimed.
Long-term care benefits in kind for care level 4
If the need for care was classified as care level 4 you can claim care and support services amounting to 1,859 euros per month. The care insurance funds will cover the costs incurred up to this amount.
Long-term care benefits in kind for care level 5
People with care level 5 are entitled to care benefits in kind worth 2,299 euros per month. Care and nursing services up to this amount are financed by the insurance company.
Increase in long-term care benefits in kind 2024
The Care Support and Relief Act, which will come into force at the turn of the year 2023/2024, will increase care benefits in kind by 5%. The aim is to gradually ease the burden on people in need of care and their relatives by 2028.
Entitlement to care benefits in kind
All insured persons from care level 2 for whom care is provided at home are entitled to care benefits in kind from the care insurance fund.
The home environment includes not only the home of the person in need of care, but also, for example, the home of a family member providing care.
If you receive care support from a professional caregiver, you can apply for care benefits in kind from the care insurance fund. Unlike the care allowance, this benefit is not paid directly to the person in need of care, but the service provider settles the costs with the responsible care insurance fund.
If the costs of the caregiver exceed those of the benefits in kind, the surplus must be paid. However, if they do not use up the entire budget, the remaining amount can be used elsewhere through the combination benefits or the conversion entitlement.
The combined benefit: proportionate care benefits in kind and care allowance
The remaining amount of care benefits in kind that remains unused can be converted into care allowance. You will then receive the so-called combination benefit.
The combined benefit is calculated as follows: The monthly care allowance to which you are entitled is reduced by the percentage of the benefits in kind used.
The conversion claim: converting care benefits in kind
Up to 40% of unused long-term care benefits in kind can be converted and used for certain care and respite services. You have a so-called conversion entitlement.
If the service provider is recognized under the law of your federal state, you can use the money to pay for household help or hourly care, for example, by converting the care benefits in kind.
Apply for care benefits in kind
You can apply for long-term care benefits in kind from the relevant long-term care insurance fund. To find out the exact contact details, you can contact your health insurance company.
The first step is an informal application, which can be made by e-mail, an informal letter or a phone call. Your care insurance fund will then contact you and send you a form, which you should fill out carefully.
The date of the initial application is decisive, as you are entitled to benefits retroactively from that date. You should therefore have the initial application confirmed by the long-term care insurance fund.
If you are still unsure whether you want to apply for care benefits in kind or care allowance, you can benefit from the combination benefit. This allows you to remain flexible and continue to receive the care allowance until you apply for long-term care benefits in kind.
Who can bill for care services?
In order to be able to bill for care services, it is important that the care service or the specialist staff have a care contract with the care insurance fund in accordance with § 72SGB XI 1 [mfn]§ 72 SGB XI 1[/mfn].
This has two advantages:
- The quality of care services is assured as care providers and care staff are regularly monitored.
- The nursing staff receive fair remuneration.
There are more than 14,000 outpatient care services throughout Germany, so you should make sure that they have a contract with the relevant care insurance fund. If this is not the case, you must contact the responsible care insurance fund to find out to what extent billing can take place. If you choose a recognized care service from the outset, you will be spared this. It is also possible to request a list of recognized care services from the insurance company.
Long-term care benefits in kind during hospitalization
The care benefits in kind do not apply if you spend time as an inpatient in hospital, as you do not need a care service there. If you have applied for the combined benefit from the care insurance, you will continue to receive the pro rata care allowance for four weeks.
When do long-term care benefits in kind expire?
Care services are covered by the care insurance fund. You have a monthly budget available for this. If this is not used, it expires at the end of the month. The full budget will then be available to you again from the 1st of the new month.
Who pays for technical care aids?
The costs of technical aids are only covered by care insurance under certain conditions.
The following conditions must be met:
- the technical aids alleviate the symptoms
- they make care easier
- the independence of the person in need of care
- The health insurance company cannot be held responsible for covering the costs
Entitlement to care aids intended for consumption
There is a wide range of support available for people in need of care. A person in need of care from care level 1 is entitled to certain care aids worth 40 euros per month from the care insurance. These include, for example, bed protection pads, disinfectants, gloves and face masks.
