Applying for residential care for people with nursing care insurance with disabilities

Please note in particular our information under:

  • Performance specification

    Do you live as a person with a disability in a residential home or another fully inpatient facility that enables you to participate socially and supports you in integrating into working life? Then your care insurance fund will cover 15 per cent of the costs under certain conditions.

    However, the care insurance fund pays a maximum of EUR 266.00 per month. You bear the remaining costs yourself. If your income is not sufficient for this, you are entitled to basic security benefits in old age and in the event of reduced earning capacity or housing benefit. To do this, you must submit an application to the social welfare organisation. This is usually the social welfare office in your place of residence.

    This also applies to special forms of housing such as a residential home or a residential group for people with disabilities. This must

    • The focus is on communal living and integration into society,
    • the Housing and Care Act applies and
    • the scope of care largely corresponds to the care provided in a fully inpatient facility.

    If you are at home with your relatives at the weekend or on holiday, you are entitled to the following benefits for this time:

    • Care services in kind: This refers to the services of an outpatient care service. Your entitlement to care benefits in kind is reduced by the amount that the care insurance fund pays for accommodation in a residential home or boarding school in that month. For example, if you are at home 10 days a month, the amount paid by your care insurance fund for the 20 days you spent in a residential home or boarding school will be deducted from the amount you are entitled to in kind each month.
    • Carer's allowance: If you are supported at home by relatives or volunteers, you can receive carer's allowance. For each day you spend at home, you will receive 1/30 of the monthly care allowance. The day of arrival and departure counts as a full day at home. You will also receive care allowance even if you receive care services in kind at the same time. This does not reduce your care allowance.
       

  • Process flow

    You can submit the application for cost coverage for care in a fully inpatient facility for people with disabilities by post, for example, or - in the case of many long-term care insurance companies - in person at the office or online.

    • Submit the application for full inpatient care in facilities for people with disabilities to your care insurance fund. If you are unable to do this yourself, you can authorise someone in writing.
    • The long-term care insurance fund will check your application and inform you of the result.
    • Once your application has been processed, your care insurance fund will transfer the monthly benefit contribution directly to your facility.
    • Your care insurance fund can also provide you with a list of authorised facilities for the disabled where you can compare services and prices.

  • Requirements

    • You have care level 2, 3, 4 or 5.
    • You live in a
      • full inpatient facility for people with disabilities or
      • comparable form of housing.

  • Which documents are required?

    • If applicable: power of attorney, carer's pass
    • Notification from the long-term care insurance fund about the determination of the degree of care (expert opinion from the medical service of the long-term care insurance)
    • if applicable: medical documents
    • If applicable: Severely disabled person's pass
    • Proof of health and long-term care insurance

    Depending on the individual case, further documents may be required. Please contact your care insurance fund for more information.
     

  • What are the fees?

    You do not have to pay anything for the application.

  • What deadlines do I have to observe?

    You will only receive the benefit from your long-term care insurance fund from the month in which you submit the application, but at the earliest from the date on which the conditions for entitlement are met. If the application is not submitted in the calendar month in which the need for care arose, but later, the benefits will be paid from the beginning of the month in which the application was submitted.

  • Processing time

    Processing normally takes around 2 to 6 working days.

    Your long-term care insurance fund must have the necessary information and any required documents in a complete and meaningful form in order to process and decide quickly.

    The long-term care insurance fund decides on applications promptly.
    Please note that the processing time indicated is an average value for all long-term care insurance funds. It may vary in individual cases.

    The exact processing time also depends on the complexity of the individual case and may take longer. The same applies if documents or records are sent to you or your long-term care insurance fund by post.

    If the need for care or the entitlement to care services has not yet been established in your case or if an application is made to upgrade the level of care, the Medical Service must be involved. This usually extends the processing of your application by around 3 to 4 weeks.
     

  • Legal basis

  • What else should I know?

    Special information for - District of Waldeck-Frankenberg

    What can I do if the care facility cannot be paid for out of my own income or assets?

    Under certain conditions, the competent social welfare office grants "help for care".

  • Comments

    Further information can be found in the advice and information portal: "Pflege in Hessen" (Care in Hesse)

    • Care in Hesse

      (Hessian Ministry for Social Affairs and Integration)


Who do I need to contact?

Special information for - District of Waldeck-Frankenberg

Advice on choosing the right care facility is available from the social welfare office of your district or independent city as well as from the care support centres.

However, information is also available from your long-term care insurance fund. According to § 7a SGB XI, it is obliged to provide comprehensive care counselling within 2 weeks.

You can find out about the care support point in your area via the following link: www.pflege-in-hessen.de.

Responsible departments

Responsible staff