Advice on nursing insurance

When you or a relative requires care, there are many organizational details that affect you. We answer the most important questions about long-term care insurance.

Where is one insured?

Most people with health insurance also have long-term care insurance with their health insurer. The nursing care application must therefore be submitted to the nursing care insurance fund of the policyholder's own health insurance company. The situation is different if the insured has taken out private long-term care insurance. In this case, the application must be made there.

Who is considered to be in need of care?

Persons in need of long-term care are those who have health-related impairments in their independence or abilities and therefore require the help of others. These are people who cannot independently compensate for or cope with physical, cognitive or psychological impairments or health-related stresses or demands. The need for care must be expected to last for at least 6 months and must be of a specified severity.

Decisive for the determination of the need for care are the following 6 modules:

  • Mobility
  • cognitive and communication skills
  • Behavioral and psychological problems
  • Self-supply
  • Coping with and independently dealing with demands and stresses caused by illness or therapy
  • Shaping everyday life and social contacts

The new definition of the need for care should now determine the degree of independence and no longer take into account the time required.

How to make the application?

The application for long-term care insurance benefits can be made informally and even by telephone.

Subsequently, the long-term care insurance company or the private long-term care insurance company sends an application form.

How to assess the need for care?

The medical service of the health insurance companies (MDK) comes about three to five weeks after application to the affected person at home, in the hospital or in the nursing home and prepares an expert opinion. For cost reasons, only legally defined services of daily life are taken into account in the appraisal. Caring relatives and affected persons should prepare well for the visit of the expert and, if necessary, keep a care diary. It is necessary to record how much time must be spent on which services each day. If the assessment takes place in the nursing home, our nursing staff will be present during the assessment and provide access to the documentation.