Care in kind
The care benefit in kind is a benefit provided by long-term care insurance in Germany in accordance with Section 36, Book 11 of the Social Code . It includes home care provided by professional caregivers in the form of basic and domestic care. Treatment care is not part of the care benefit in kind.
The term benefit in kind is meant in the sense of a benefit in kind (care): The insured person receives the prescribed benefit from an outpatient care service or a single carer who has to be approved by the care insurance fund by means of a care contract. The scope of care benefits in kind is limited by the fact that the long-term care insurance funds, as the long-term care insurance provider, only finance the benefits up to certain monthly maximum amounts, which are based on the degree of care needs ( degree of care ).
Instead of the care benefit in kind, the insured person can also claim care allowance or choose the mixed form of combination benefit.
Eligibility requirements
The prerequisite for entitlement to care in kind is a need for care from care level 2.
Another prerequisite is that the care recipient is cared for on an outpatient basis in his home environment. This can be in your own household, but also in the household of relatives, in assisted living , in old people's homes or dormitories for the disabled. In contrast, those in need of care who are fully inpatient do not receive any care benefits in kind.
Amount of care in kind
With the Care Strengthening Act 2, which came into force on January 1, 2017, care levels were replaced by care levels. Depending on the level of care determined, care benefits in kind can be claimed up to the maximum monthly value listed in the table below:
| Care level 1 | Care level 2 | Care level 3 | Care level 4 | Care level 5 | |
|---|---|---|---|---|---|
| Outpatient benefits in kind | 0 € | € 689 | 1298 € | 1612 € | 1995 € |
Performance complexes
Nursing care is provided by outpatient nursing services or individual nurses - the so-called service providers - who have concluded a supply contract with the relevant regional association of long-term care insurance. The Medical Service of the Health Insurance (MDK) and the Association of Private Health Insurance e. V. at the state level with the associations of the carriers of the outpatient or inpatient care facilities in the state jointly and uniformly according to § 75 SGB XI framework agreements . Every service provider must ensure that he can provide the required services himself or with suitable staff effectively and economically. The quality of the service provision can be checked by the MDK.
The amount of the remuneration for outpatient care services is based on a remuneration agreement concluded between the payers and the service providers ( Section 89 SGB XI). The individual nursing activities are assigned to different service complexes. The service complexes summarize those activities that arise in a care situation according to the knowledge of the care sector. The person in need of care can choose from the service complexes those that meet his or her need for help and are to be provided by the care service.
Examples of service complexes
Basic care:
- Great care / full bath - full body washing in bed, showering or bathing
- Small care - partial washing, including required dressing and undressing
- Transfer / dressing and undressing - transferring from bed to bed
- Help with excretions - urinary and fecal incontinence care , including catheter care
- Simple help with excretions - accompaniment when using the toilet, simple incontinence care
- Special storage
- Mobilization - also includes the movement of individual limbs ( prophylaxis )
- Simple help with food intake - e.g. setting the table, providing drinks, clearing away
- Extensive help with food intake
- Administering tube feeding
- Help with leaving / going to the apartment
Domestic supply:
- Shopping and errands (every ¼ h or part thereof)
- Washing, ironing
- Cleaning of the apartment (maintenance, if necessary basic cleaning), garbage disposal
- completely removing and moving the bed
- Heating the apartment
- Prepare a simple (cold) meal
- Prepare a warm meal
Web links
- Services for home care. www.bundesgesundheitsministerium.de
- Examples of service complexes and their remuneration; As of January 1, 2018
literature
- Manfred Stradinger: Long-term care insurance . Rudolf Haufe Verlag, 2008, ISBN 3-448-09121-9
- Paul Braasch: The health system in Germany: structure, services, further development . 4th edition, Deutscher Ärzteverlag, 2007, ISBN 3-7691-3220-3 , Chapter 6.6: Long-term care insurance benefits
Individual evidence
- ↑ Manfred Stradinger: Pflegeversicherung , Rudolf Haufe Verlag, 2008, ISBN 3-448-09121-9 , pp. 44–52
- ↑ http://www.buzer.de/gesetz/4851/al0-6489.htm