Daily care allowance insurance

from Wikipedia, the free encyclopedia

The daily care allowance insurance is private coverage of the care risk . Upon proof of the need for care , an agreed fixed amount of money is paid for each day of care. The daily allowance is transferred regardless of the actual burden of care.

Tariff variants

Daily care allowance insurance can be divided into three types:

Static, tiered tariffs of the conventional kind

Here the insured can only freely determine the amount of the daily allowance in level III. That is the base value of 100%. In its service promise, the provider specifies a fixed ratio of the daily care allowance to be paid in care level II and I, which are graduated in descending order from care level III.

  • Most often z. B. the distribution ratio 100% / 60% / 30% is offered. I.e. starting from the base value of 100% in level III, 60% of the base value of level III is paid in level II and 30% in level I.
  • The following distribution ratios can still be found among the various companies: Care level III / II / I: 100% / 60% / 40% or 100% / 70% / 30% or 100% / 50% / 25%.
  • There are also tariffs that do not provide for Level I or II benefits. Depending on the provider, a daily care allowance of up to € 150 per day can be agreed. Some tariffs only provide for a graduation for home care. In the case of inpatient care, 100% is always paid. These tariffs are useful for a group of people who later do not want to be cared for at home but in the home.

Modular, flexible tariffs

Here, the insured himself determines the daily care allowance to be agreed in the individual care levels. Any combination is conceivable, but the daily allowance of the higher level may not be agreed to be lower than the daily allowance of the next lower level. All levels can also be insured at the same level - 100%.

These tariffs can be tailored to the respective customer needs. Those who do not attach great importance to the coverage of care level III do not have to overinsure themselves in level III in order to be sufficiently insured in level I. These tariffs are recommended for people for whom the highest possible level of protection is important. Many of these flexible tariffs also allow care level 0 to be insured with a daily care allowance.

State-sponsored supplementary long-term care insurance (Pflege-Bahr)

On June 29, 2012, with the passing of the Care Reorientation Act (PNG), the Federal Government decided to financially support private insurance against the care risk based on the model of the Riester pension contracts . The term “Pflege-Bahr” has become natural for the state-subsidized daily care allowance insurance due to the decisive initiative by Health Minister Daniel Bahr ( FDP ). Until the end of 2012, the term “Pflege Riester” was also in use. Since 2013, daily care allowance insurance can be subsidized by the state with five euros per month. Prerequisite: the insured person pays a minimum monthly contribution of ten euros. In addition, the daily care allowance policy is linked to certain minimum benefits.

In the May issue (05/2013), the Pflege-Bahr was heavily criticized by Stiftung Warentest . The state-sponsored long-term care insurance therefore offers insufficient benefits to cover the gap in care in the case of long-term care. The PKV Association rejected the criticism, however: The Pflege-Bahr offers full coverage, especially if you start early.

As of May 31, 2013, more than 125,000 contracts had been signed. According to PKV chairman Reinhold Schulte, around 1,000 new contracts are added every day.

Care levels (PG)

With the  Care Support Act 2  on January 1, 2017, the conversion of  levels of care  to the  nursing degree .

  • Care level 1: Low impairment of independence (was not taken into account until December 31, 2016)
  • Care level 2: Significant impairment of independence (up to December 31, 2016: care level 0 and care level 1)
  • Care level 3: severe impairment of independence (up to December 31, 2016: care level 1 with limited everyday skills and care level 2)
  • Care level 4: most severe impairment of independence (until December 31, 2016: care level 2 with limited everyday skills and care level 3)
  • Care level 5: most severe impairment of independence (until December 31, 2016: care level 3 with limited everyday skills and care level 3 with hardship)

The amount of the daily care allowance varies depending on the degree of need for care and, for some tariffs, depending on whether the care is outpatient or inpatient. The maximum benefits of the five care levels (PG) are limited. The Federal Ministry of Health has put together the most important information about the innovations in care in a brochure.

Tariff calculation

The following parameters are relevant for the rewards:

  • Amount of the daily allowance: Depending on the provider, a daily allowance of up to 150 euros / day can be agreed.
  • Age at entry: Younger insured persons pay significantly less

Until the introduction of the unisex tariffs , women paid significantly higher premiums due to the higher care risk.

Demarcation

The daily care allowance insurance is a voluntary private insurance that increases the benefits from the statutory long-term care insurance . The calculation is funded according to the guidelines for private health insurance.

The benefit is often based exclusively on the care level (depending on the insurance conditions), i.e. it is independent of whether the care services are organized in the form of inpatient, semi-inpatient care, in the form of home care assistance by approved care services or yourself.

The statutory long-term care insurance will continue to bear only part of the costs in the event of long-term care. That is why the Germans should make private provisions. Since January 2013, the state has been paying a monthly allowance of 5 euros if someone takes out private daily care allowance insurance that meets certain state requirements. A study by Stiftung Warentest in May 2013 showed that these policies are nowhere near enough to cover the need for money in the case of care.

Individual evidence

  1. ↑ Information from the Federal Ministry of Health on subsidized long-term care
  2. ↑ a b Care insurance - daily care allowance tariffs in the test of the Stiftung Warentest In: Finanztest 5/2013, pages 70-77 and test.de from April 16, 2013, accessed on November 20, 2014.
  3. ^ Statement of the PKV-Verband on the financial test article
  4. ↑ Handelsblatt from June 19, 2013
  5. ↑ Overview of the maximum benefits of the five care levels (PG) per month (valid from: 01.01.2017). Retrieved October 25, 2017 .
  6. ↑ The Nursing Strengthening Acts: An overview of the most important things. Retrieved October 25, 2017 .

Web links