Pflegehilfsmittel Bewilligung

If you are in need of care and are being cared for at home, you can be provided with care aids.

If you are cared for at home by relatives, acquaintances or a nursing service, you are entitled to nursing aids. These are intended to facilitate care at home, help alleviate your symptoms or enable you to lead a more independent life. You do not need a doctor's prescription for care aids, but you do need a recognized care degree and an application to your care insurance fund. Your long-term care insurance fund is affiliated with your statutory health insurance fund. You can therefore use the same contact details.

Nursing aids such as disposable gloves, disinfectants or absorbent bed pads are needed daily and can only be used once. For such products your nursing care insurance pays a lump sum of up to EUR 40.00 per month.

Reusable technical care aids such as care beds, shower trolleys or home emergency call systems are normally provided by your care insurance fund on loan and free of charge. For new purchases, you pay an own contribution of 10 percent, up to a maximum of EUR 25.

In practice, you often do not have to make the initial application for care aids yourself. The medical service, which prepares an expert opinion on your need for care, usually also informs your care insurance fund whether and which care aids are required. If you agree, this is also considered an application.
Furthermore, care specialists can make specific recommendations on the provision of aids and care aids as part of the provision of care benefits in kind, in the case of home nursing, in the case of out-of-hospital intensive care, as well as during the counseling sessions in the home of the person in need of care. These recommendations also count as an application. Many mail-order companies and medical supply stores specializing in nursing aids will also take care of the application process for you.

If you or an authorized person submits the application, please state which care aids you require on a monthly basis. Subsequent changes are possible with regard to the type and quantity of products. As a rule, you only have to apply for reimbursement once. However, some nursing care insurance companies only approve nursing care aids for a limited period of time, for example for 1 year.

You can find out which products are considered nursing aids and are therefore eligible for reimbursement or a loan in the nursing aids directory of the GKV-Spitzenverband, the central lobby group of the statutory health and nursing care insurance funds in Germany.

• Notification from the nursing care insurance company about the degree of nursing care (expert opinion from the medical service of the nursing care insurance company)
• if necessary: power of attorney, guardian's identity card
• if applicable: medical documents
• if applicable: severely disabled person's card
• Proof of health and long-term care insurance

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

• You have a care degree
• You are cared for in the home environment
  
  

You do not have to pay anything for the application.

If the medical service, a nursing specialist, a medical supply store, a specialized dealer or an expert does not submit the application for care aids for you, you can obtain the application form for care aids from your care insurance fund.

• You can submit the application for long-term care aids by mail, for example, and - for many long-term care insurance funds - in person at the office or online.
• The long-term care insurance fund will review your application and inform you of the result.
• The nursing care insurance fund
  • takes over the contract prices agreed in each case
  • transfers the flat rate for nursing aids to you each month,
  • pays the costs for the technical care aid, less your own contribution, or
  • lends you the technical nursing aid.
• In the event of subsequent changes to the type and quantity of nursing aids, you submit a new application.
  
  

Processing usually takes about 2 to 6 working days.
For a quick processing and decision, your long-term care insurance fund must have the necessary information as well as any required documents complete and meaningful.
The long-term care insurance fund decides on applications promptly.
Please note that the processing time given is an average value for all care insurance funds. It may vary in individual cases.
The exact processing time also depends on the complexity of the individual case and may be longer accordingly. The same applies if documents or records are sent to you or your care insurance fund by mail.
If necessary, the Medical Service may have to be involved. This usually extends the processing of your request by about 3 to 4 weeks.

In principle, the long-term care insurance fund must make its decision no later than 3 weeks after receipt of the application. If it obtains an opinion from the medical service, it must inform the insured person of this and decide within 5 weeks of receipt of the application. If the long-term care insurance fund is unable to meet these deadlines, it will inform the insured person of this in good time in writing or electronically, stating the reasons. If no notification of a sufficient reason is made, the benefit is considered approved after the deadline.

• Objection
• Action before the social court

• Approval of nursing aids
• People with long-term care insurance are entitled to care aids, for example hygiene products, care beds and home emergency call systems.
• Requirements:
  • home care
  • at least care level 1
• Application for care aids must be made to both care insurance companies of the person in need of care.
• often the medical service, care specialists or care aid providers take over the application process
• depending on the type of nursing aid, the nursing care insurance fund will cover
  • the respective contractually agreed prices minus any co-payment to be made
  • a monthly lump sum
  • or provides a loaner device
• a new application must be submitted for changes in product type and quantity
• Information provided by: Care insurance companies or recognized advice centers, such as care support points.
• responsible: Nursing care insurance funds
  
  

- Forms: yes

- Online procedure possible: many long-term care insurance companies offer an online procedure.

- Written form required: no

- Personal appearance required: no