What are my rights?
Many of those who are in need of care prefer to be cared for at home instead of moving into a nursing home or retirement residence. Living at home means you can be looked after by relatives or a nursing service (or both) and stay in your familiar environment. Caring for someone at home is called "outpatient care" ("Ambulante Pflege") or "home care" ("häusliche Pflege").
The so-called long-term care insurance ("Pflegekasse") partly bears the costs of home care, provided that you are covered by one, and they have determined your need for long-term care. You can read more about the issue in our chapter "Nursing Care System".
Here, we explain your rights as a patient who wants to be cared for at home. Furthermore, if you are a caregiver, keep reading to learn what rights you have as the provider of care for a loved one.
What do I need to know?
Yes. You do not necessarily need a professional nursing service. If relatives or acquaintances want to take over the care at home, you can use their help if you prefer so. In this case, you will monthly receive a so-called "care allowance" ("Pflegegeld"), which is at your free disposal. The amount of the care allowance depends on the level of care ("Pflegegrad") required according to the initial assessment. Currently, the amount of long-term care allowance is between €332 (care level 2) and €946 (care level 5) per month (as of 07/2021). Please note that you will not receive a care allowance for care level 1.
If you are cared for by family members or acquaintances, you will be visited twice a year by qualified care professionals who will give you and your family members tips and advice. Please note: If you do not cooperate to make such visits possible, your care allowance may be cut.
In this case, you can use the service of an outpatient nursing firm. An outpatient nursing service employs trained nurses who visit you several times a week (or day, if necessary).
The nurses can undertake different tasks, including:
- helping with body care and food intake
- shopping and cooking as well as cleaning the flat
- providing medical care, e.g. administering injections, medication or changing bandages,
- or helping you in your social activities, such as going for walks or inviting friends to visit.
The costs of nursing services are at least partly taken over by long-term care insurance. Such support is called "benefit-in-kind" or "Pflegesachleistung". For care level 2, up to €723 and for care level 5, up to €2095 is taken over (as of 07/2021). People in care level 1 are not entitled to "benefit-in-kind" or "Pflegesachleistung”. The long-term care insurance pays the nursing service firm directly, so you do not need to pay in advance and wait to be reimbursed later. However, if the cost of the nursing service is higher than the amount agreed upon by your insurance, then you have to pay the difference yourself.
With the AOK-Pflegenavigator, you can search for care services in your area. Furthermore, on pflegelotse.de, you can search for nursing services and counselling centres. The checklist for selecting a care service can also help you with the choice. On top of all these options, you can ask your health insurance company to provide you with a selection of high-grade nursing services.
Compare and check the offers and seek detailed advice before making any choices. You should get to know the nursing service before you decide and sign a contract. If you ended up being dissatisfied despite prior research, of course, you can also change the nursing service later.
Many people prefer outpatient care services which specialise in caring for patients with different cultural and religious backgrounds. These so-called intercultural care services ("Interkulturellen Pflegedienste") recognise and respect cultural practices, traditions and beliefs of people with whom they deal. The caregivers at these services also often speak different languages. Seek advice from your health insurance or an Adult's Migration Counselling Centre about intercultural care services in your area. You can find an Adults' Migration Counselling Centre in your area on bamf.de.
Yes. You can conveniently be cared for by both relatives and a nursing care firm if you prefer so. Opting for such an option may be the right solution, for instance, when your caretaker does not have time around the clock. If you combine care from relatives and professional care but only use a portion of the "benefit in kind" to which you are entitled (i.e. the costs to be paid to the nursing care firm by your insurance company), you will receive the remnants in the form of care allowance ("Pflegegeld").
The following example can clarify the issue: A person in need of nursing care in care grade 3 is entitled to €572 care allowance ("Pflegegeld") or 1.363 nursing benefits-in-kind ("Pflegesachleistung"). She obtains a nursing service, which helps her with washing and dressing in the morning and costs about €310 per month. The cost of the service corresponds to 22.74% of €1.363, which means from the "benefits-in-kind" she is entitled to, 77.26% is left unused. The remaining amount is paid to her as care allowance, meaning that in addition to the assistance provided by the nursing service, the person also receives 77,26%% of the maximum care allowance to which she is entitled - that is €441.93. The long-term care allowance will be paid proportionally- as a result, the total value of the benefits (service + cash) she receives, i.e., €751.93 (€310 + €441.93) will be higher compared to what she would have received if she opted for the long-term care allowance only.
People in need of care who live at home (rather than in care facilities) can receive €125 per month as financial aid. This money is called the "Entlastungsbeitrag" (roughly "relief contribution"), and it is available for all levels of care, including people with care grade 1. You can use this money to finance, e.g., daily care services, care support measures, help with housekeeping, etc. However, you do not receive the funds transferred directly - instead, you will be reimbursed after you have paid for and acquired the relevant items or services yourself. You then submit the invoice to your long-term care insurance and get the money back - up to an amount of €125 per month. If you can't provide an invoice for an item every month, you do not need to worry: the money you don't use will be available for you to claim until June of the following year. This means, for example, if you cannot submit an invoice from January to November, you can submit an invoice for €1,500 (€12 × €125) in December. You can find more information about this form of aid (in German) at verbraucherzentrale.de.
Many people in need of care use the help of devices such as wheelchairs, specially fitted stairs, showers or toilets to meet their needs in everyday life. Nowadays, a variety of such auxiliary materials are available to facilitate almost all areas of everyday life, from dressing in the morning to preparing for bedtime in the evening. However, the costs of these materials could sometimes be enormous.
People in need of care can have the costs of such technical aids partially reimbursed or subsidised. If you need such assistance, discuss it with your doctor. The insurance will require a prescription before providing you with such support.
For daily requirements such as disinfectants, gloves and alike, the long-term care insurance will provide you with a financial subsidy of about €40 per month. You do not need to hand in any receipts for such support - applying to your long-term care insurance suffices.
If you have health insurance, then your health insurance is the right point of contact. In addition to health insurance contributions, each insured person automatically pays a certain amount to the so-called long-term care insurance fund, which supports people in need of care. Your long-term care insurance carrier is the same as your health insurance company. Health insurance companies have independent nursing experts who can give you detailed advice free of charge. If necessary, the consultants can also come to your home. In addition to German, some centres also offer advice in other languages. You can find a care centre nearby at zgp.de. You can also ask your health insurance company to suggest a counselling centre nearby.
Alternatively, you can first seek advice from a migration counselling centre for adults (MBE). Their advice is also free of charge- and their staff speak different languages. You can find one of their branch offices in your area at bamf.de.
Taking care of a relative is a great responsibility- one should not underestimate the effects such a responsibility can have on one's own life. When you take care of a loved one, in particular, single-handedly and for a long time, you may overload yourself physically and mentally.
There are various types of support available to assist and prepare you for this challenging task:
- Long-term care insurance employs independent care advisors who can provide you with detailed advice free of charge. You can also seek advice from them in the comfort of home. Sometimes it is even possible to consult them in foreign languages. Care advisors often work in so-called care centres ("Pflegestützpunkten"). Contact your health insurance or check the bdb.zgp.de database to find a care centre nearby.
- You can attend free courses which will prepare you for the task. Here, you will learn everything you need to know as a caregiver. Insurance companies offer these classes. Ask a care advisor for more information in this regard.
- Self-help groups are also a great way to seek advice and support. If you feel left alone, it helps to meet people who are in a similar situation. Your care advisor can give you the address of a self-help group in your area.
- If you are ever tied up with something, for instance, in case you get sick or go on holiday, you can claim a so-called "Verhinderungspflege", i.e. each year, you can take up to six weeks off and transfer your responsibilities to a nursing care service. The long-term care insurance will then take over part of the costs of service provided during your absence.
- If you take care of a person with a nursing degree of (at least) 2 and spend a minimum of 10 hours (spread over at least two days) per week for his/her care, the nursing care insurance makes pension and unemployment insurance contributions for you. In addition, you are insured against accidents during nursing activity and your commute.
If you work and take care of a loved one at the same time, you have the right to be exempted from work for specific periods. You may not be dismissed during these times, but you will not receive any wages from your employer.
There are several schemes within which you can get exempted from work for more extended periods to care for a loved one:
- Nursing Time ("Pflegezeit"): If you apply to your employer for nursing time, you can take up to six months of full or part-time leave. To do so, you must submit a written application to your employer at least ten days in advance, stating the duration and the starting date of the care.
- Family Care Time ("Familienpflegezeit"): The family care allows you to take time off work for up to 24 months. However, you still have to work at least 15 hours a week. To benefit from this scheme, you must submit a request to your employer at least eight weeks in advance.
- Short-term loss of working capacity ("kurzzeitige Arbeitsverhinderung"): In a case of emergency, you can apply to your employer for a so-called "short-term loss of working capacity" for up to 10 days of leave - this is particularly useful when a loved one is suddenly in need of care. Your employer will not compensate you for these ten days, but you can apply for a so-called "Pflegeunterstützungsgeld" (roughly: "Nursing support allowance") at the long-term care insurance company. You must apply for such allowance immediately at the time the need for care occurs.
If your caregiver treats you poorly, e.g. If you are neglected or subjected to violence, you can call the Crisis Helpline in your area. On zqp.de, you can also search for a counselling centre on site. Another option is to contact a care centre ("Pflegestützpunkt") nearby.