Take advantage of your care level

from | Sep 2, 2022

Home care is a special affair of the heart for many relatives. But this requires more and more certain care aids for consumption; for example, disposable gloves, bed protection pads or hand and surface disinfectants. If a care degree is available, the statutory health insurance funds cover the costs up to €40. 

What are care aids?

Nursing aids for consumption are products that can generally only be used once due to their material or for hygienic reasons. These are expressly not suitable for reuse. Long-term care insurance covers products that are used for basic care at home. These include, for example, absorbent bed protection pads (both disposable and washable bed protection pads), disinfectants for hands and surfaces, protective gloves, and disposable protective aprons or mouth guards. These products are included in the list of aids of the GKV and are listed there. You will also find other aids under category 54. To apply for suitable nursing aids, click here: Order nursing aids.

Your legal entitlement

Care aids can only be obtained free of charge from the long-term care insurance fund by persons who receive outpatient care, i.e. who live, for example, in their own apartment, an assisted living facility or an outpatient assisted living care community. In addition, there must be a recognized nursing degree. If care is provided in a nursing home, the nursing home or the health insurance fund is responsible for providing aids. 

If the following criteria are met, you can apply for free nursing aids for consumption worth up to 40 euros per month in accordance with § 78 Para. 1 in conjunction with § 40 Para. 2 SGB XI:

- There is a recognized degree of care (class 1 to 5).

- The person in need of care lives at home, in a shared apartment or a

  Assisted Living Facility and is cared for from there.

- Care at home takes place with the support of private individuals (relatives, neighbors, etc.).

For privately insured persons, an invoice is sent directly to the person in need of care together with the delivery of the care aids. The invoice is then simply submitted to the long-term care insurance fund by the insured person.

The application

To receive care aids for consumption worth 40 euros, an application must be submitted. To ensure that everything is approved quickly and easily by the long-term care insurance fund, it is advisable to have this done by a provider of aids. After you have entered your data, the application runs automatically. You can find out more about this directly here.

Provider change

If you already have a contract with a service provider, you can change it at any time. Here, too, you will be supported by your new provider. The care insurance companies require a so-called service provider change form. You can find a change form here, for example. 

It is also possible to exchange individual products. It is important that the products are adapted to the individual care needs.

Where can nursing aids be obtained from?

If the nursing care insurance company has approved your requested aids, you have various options for receiving the products. The most convenient way is a monthly delivery directly to your home.

This eliminates the often arduous walk to a supplier. All products you order are always delivered to you free of charge.

You can also find more information about care aids here

Duration until approval

Once the application has been submitted, a decision is usually made on the application within one to two weeks. This is regulated in § 13 para. 3a SGB V and means:

  • a decision on the application must be available after 3 weeks at the latest
  • If the MDK (Medical Service of the Health Insurance Fund) is consulted, the deadline is extended to 5 weeks.
  • If the deadline of 3 or max. 5 weeks is not met, the Fund is obliged to explain the reasons in writing.
  • the MDK has a period of 3 weeks for a statement
  • after the expiry of all deadlines or extensions of deadlines without any reaction from the Fund, the application is considered approved
  • The person in need of care should now set another deadline for the health insurance company and point out that after the set deadline has expired, the aid will be procured by the company itself
  • by law, the health insurance companies are obliged to reimburse the costs if all the necessary conditions are met

Apply for care degree

If there is not yet a care degree, a call to the care insurance company is usually sufficient. It is even better to write an informal letter. The long-term care insurance fund will then send you all the necessary forms directly. In this case, the applicant is always the person in need of care. He or she must fill out the forms or at least sign them. If there is an advance power of attorney or a care directive, the trusted persons named therein can also submit the applications. The long-term care insurance fund must inform the applicant in writing within five weeks (25 working days) of the application being submitted whether or not a long-term care degree will be recognized. If they miss this deadline, the applicant is entitled to compensation of 70 euros for each week it takes longer. If the long-term care insurance fund rejects the application, you can file an appeal within one month.