Eleventh Book of the Social Code

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Basic data
Title: Social Code Book Eleventh
- Social Care Insurance -
Short title: Eleventh Book of the Social Code
Abbreviation: SGB ​​XI
Type: Federal law
Scope: Federal Republic of Germany
Legal matter: Social law
References : 860-11
Issued on: May 26, 1994
( BGBl. I p. 1014, 1015 )
Entry into force on: January 1, 1995
Last change by: Art. 5 G of 19 May 2020
( Federal Law Gazette I p. 1018, 1028 )
Effective date of the
last change: 		predominantly May 23, 2020
(Art. 18 G of May 19, 2020)
GESTA : M040
Weblink: Text of the law
Please note the note on the applicable legal version.

The Eleventh Book of the Social Code ( SGB ​​XI ) contains the provisions for social long-term care insurance in Germany and thus forms the basis for financing long-term care needs in inpatient and outpatient care . This should guarantee the basic right to self-determination and independence according to the possibilities of the person in need of care and ensures their permanent care.

After the Social Code XI awarded benefits are not limited in their duration, need no doctor's prescription and no treatment order . The legal responsibility for the implemented care activities lies entirely with the caregiver .

Application for the assumption of costs to the care insurance

1) Application for care benefits : to be submitted by the insured person to the relevant care insurance fund , the applicant can go through

get help from the outpatient nursing service or the social worker at their hospital

2) Assessment by the MDK : as a rule, the need for care is assessed by an independent assessor within four weeks

3) Classification of the level of care based on the needs ascertained by the MDK, from which the type and scope of the service result;

Objection must be submitted within four weeks

Structure of SGB XI

The SGB XI is divided into 14 chapters, some of which are again divided into sections and titles.

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  • First chapter (§§ 1 to 13): General regulations
  • Second chapter (§§ 14 to 19): Beneficiaries
  • Third chapter (§§ 20 to 27): Persons subject to compulsory insurance
  • Fourth chapter (§§ 28 to 45c): Long-term care insurance benefits
    • First section (§ 28): Overview of the services
    • Second section (§§ 29 to 35): Common regulations
    • Third section (§§ 36 to 43a): Services
      • First title (§§ 36 to 40): Home care benefits
      • Second title (§§ 41 to 42): Partial inpatient care and short-term care
      • Third title (§ 43): Full inpatient care
      • Fourth title (§ 43a): Care in fully inpatient facilities for the help of disabled people
    • Fourth section (§§ 44 to 45): Benefits for caregivers
    • Fifth section (§§ 45a to 45c): Benefits for people in need of care with a significant general need for care
  • Fifth Chapter (Articles 46 to 53a): Organization
    • First section (§§ 46 to 47): Long-term care insurance providers
    • Second section (§§ 48 to 49): Responsibility, membership
    • Third section (§§ 50 to 51): Reports
    • Fourth section (§§ 52 to 53a): Performance of the association's tasks
  • Sixth Chapter (Sections 54 to 68): Financing
    • First section (§§ 54 to 60): Contributions
    • Second section (§ 61): Contribution subsidies
    • Third section (§§ 62 to 64): Use and administration of funds
    • Fourth section (§§ 65 to 68): compensation fund, financial compensation
  • Seventh chapter (§§ 69 to 84): Relationships between the long-term care insurance funds and the service providers
    • First section (§§ 69 to 70): General principles
    • Second section (§§ 71 to 76): Relationships with care institutions
    • Third section (§§ 77 to 78): Relationships with other service providers
    • Fourth section (§§ 79 to 81): Performance audits and quality assurance
  • Eighth chapter (§§ 82 to 92a): care allowance
    • First section (§§ 82 to 83): General regulations
    • Second section (Sections 84 to 88): Remuneration for inpatient care services
    • Third section (§§ 89 to 90): Remuneration for outpatient care services
    • Fourth section (§§ 91 to 92a): Reimbursement of costs, state care committees, care home comparison
    • Fifth section (§§ 92b): Participation of long-term care insurance in integrated care
  • Ninth chapter (§§ 93 to 109): Data protection and statistics
    • First section (§§ 93 to 103): Information bases
      • First title (§§ 93 to 98): Principles of data use
      • Second title (§§ 99 to 103): Information bases of the long-term care insurance funds
    • Second section (§§ 104 to 106a): Transmission of performance data
    • Third section (sections 107 to 108): data deletion, obligation to provide information
    • Fourth section (§ 109): Statistics
  • Chapter 10 (§§ 110 to 111): Private long-term care insurance
  • Eleventh chapter (§§ 112 to 120): Quality assurance, other regulations for the protection of those in need of care
  • Chapter 12 (Sections 121 to 125): Regulation on fines
  • Chapter thirteenth (§§ 126 to 130): Subsidies for private long-term care provision
  • Fourteenth Chapter (§§ 131 to 139): Formation of a care provision fund

literature

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