The path to the right level of care

There are calculators on the Internet, for example from some long-term care insurance companies, which assess the need for care. If it becomes increasingly clear to you that inpatient care is the only option, apply to the care insurance fund for a so-called care degree in order to receive financial support. This works particularly smoothly if you agree a power of attorney for care and a living will with the person in need of care, so that you can not only be the contact person for the care insurance companies, but can also regulate the actions of doctors in an emergency and other medical treatments in the future.

Prepare the appraisal well

After you have submitted the application, an expert from the Medical Service of the Health Insurance Funds (MDK), or a Medicproof employee in the case of privately insured persons, will assess the care requirements on site. According to Julia Rieder from Finanztip, good preparation is crucial: "Before the appointment, gather together all the documents that give an impression of the state of health and limitations of the person in need of care. This includes doctor's letters, for example, but also an overview of all the medication the person is taking. A certificate of severe disability or documents from the care service can also be helpful. Make a note of the situations in which you notice restrictions, where the person in need of care needs help and what problems they have in everyday life and with care. Care advisors from the health insurance company or from local authority-financed care support centers can go through all the points that are important for the assessment with you in advance and prepare the appointment together with you." Talk to your relative about the appointment in advance. They should describe their condition as realistically as possible, not make themselves look better, but also not dramatize anything.

The assessor is guided by eight modules with a total of 64 test points. They will interview your relative in need of care and test their motor and communication skills. While people with care level 1 are only slightly in need of help because they only need help with shopping or cleaning, for example, the restrictions for care levels 2 to 5 are considerably higher. Here, the person in need of care is entitled to care in inpatient facilities.

Lodge an objection in the event of rejection

The care insurance fund must decide on the application within 25 working days. If it has recognized a care degree, you will receive financial support retroactively from the date of application. If the need is not recognized or the level of care is too low, you can lodge an appeal within one month. "It's best to get help with the reasons for the appeal. This is available from care advice centers or social associations, for example. You should always bring the care assessment with you to a consultation. The long-term care insurance fund must send this to you. The long-term care insurance company will decide on the objection on the basis of the files or send a second expert. If your objection is rejected, you can take legal action in the social court," says Julia Rieder.