How the state helps relatives of people in need of long-term care

How the state helps relatives of people in need of long-term care

Finally time to relax and take a vacation: Many people who care for a relative at home are at the end of their tether and need some time off. Few know: There is money for their relief under certain conditions, and now even retroactively – up to 2496 euros for the years 2015 and 2016.

The nursing care insurance companies grant this so-called relief amount to all those in need of care from care level 1. Retroactively for the two previous years it is about 104 euros per month in which a claim to the relief amount existed. To the 1. January of this year, the legislature has increased the amount to 125 euros per month. The money is available exclusively to finance inpatient short-term, day or night care services or also certain services provided by an outpatient care service.

Funds are "saved"

The fact that almost 2,500 euros are thus available retroactively to caregivers is something that even experts only notice when they read the new care law, which came into force at the beginning of January. It says, mutatis mutandis: Insofar as insured persons in the period from 1. January 2015 to 31. December 2016 eligibility requirements, but they have not used the entitlement or have not used it in full, they will be given the opportunity to continue to use these benefit amounts until 31. December 2018 to be retrieved. In addition, unclaimed funds would not expire, but would be considered saved funds that can be used until the end of 2017. The law on the Internet: https://tinyurl.com/zw7eoow and https://tinyurl.com/jkk87fu.

"We fear that some care insurance companies do not sufficiently inform those in need of care about this change in the law, because unfortunately this has not always worked in the past," says Meret Lobenstein, care expert at the consumer center Rhineland-Palatinate. It advises people in need of care not to let the amounts to which they were already entitled in 2015 and 2016 lapse and to use them in addition to the 125 euros per month for the period starting January 2017. 'No one needs to feel bad about it'. The legislator provides the money specifically so that caregivers can take a break and recharge their batteries," says Lobenstein.

Reimbursement for those in need of care

Example: a man in need of care with care level 3 goes to a nursing home for short-term care in June of this year, as his care-giving relative is traveling for two weeks. In 2015 and 2016, he never used the respite care benefit, although he would have been entitled to it the entire time. For the two weeks in the nursing home are now available: 2496 euros retroactively for the two previous years plus 750 euros relief amount for the first six months of this year (six times 125 euros). In addition, the nursing care insurance fund pays half of the nursing care allowance, i.e. 272.50 euros instead of 545 euros in nursing care level 3.

The person in need of care receives the relief amount in the form of a reimbursement of costs. This means: He must submit to the nursing care insurance fund the receipts for costs for which he has made advance payments. The money is used to cover all or part of the personal contributions for accommodation, meals and investment costs charged by the home. According to the law, the nursing care insurance funds are obliged to provide unclaimed amounts for the years 2015 and 2016 even this year or next year on request.

Care grades 2 to 5 excluded from reimbursement

Even those who already took advantage of short-term care services in 2015 or 2016, for example, without using the relief amount, can invoke the new regulation. "The law expressly provides that then eligible persons can subsequently apply for reimbursement," explains consumer advocate Lobenstein.

Together with evidence of the personal expenses borne in the two previous years, the application must be submitted to the long-term care insurance fund by the end of 2018. Instead of short-term care, people in need of care can use the relief amount for inpatient day or night care and for certain services provided by an outpatient care service. Excluded from a cost refund are according to legal regulations in the care degrees 2 to 5 ambulatory offers within the range of the self supply.

Further support

It is important to know: These relief amounts are available in addition to the money for the so-called prevention care of up to 1612 euros per year. This prevention care (often called "substitute care") takes effect when the actual caregiver is temporarily absent and another person (except close relatives) or an outpatient care service steps in.

This can be for vacation and sick leave, but also for individual hours of absence, such as for a visit to the doctor or hairdresser, a meeting with friends or an evening at the theater. "This entitlement is in addition to the entitlement to respite care and the respite amount," said expert Lobenstein. A retroactive payment of the prevention care allowance for the years 2015 and 2016, however, is – unlike the relief amount – not possible.