Care assistants: who receives them, who has to pay?

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Written By Kampretz Bianca

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Nursing Care Fund Decision Deadlines

There are legally regulated deadlines for the nursing care insurance fund as to when it must make a decision on the application. In principle, the nursing care fund must be paid out by the end of 3 weeks after receipt of application decide. If you obtain an opinion from the medical service, you must inform the insured within a maximum period of time 5 weeks after receipt of application decide.

If the fund is unable to meet these deadlines, it will notify the fund in writing or electronically in a timely manner, stating the reasons. If it does not receive a message with the reason, the service will be considered approved after the deadline has expired.

A warning: If a nursing professional has recommended nursing assistance, it is assumed that the person who needs care also needs it. In this case, there is usually no examination by the medical service, so the deadline remains at 3 weeks.

Provision of nursing assistants

If the nursing care insurance company has approved the requested assistance, it will provide the assistance to the insured. The health insurance fund can purchase the nursing assistance for the insured and cover the costs, but it can also make the assistance available on loan. The loan is often the case for very expensive assistance, such as patient lifts, or assistance that does not need to be adapted to the insured, such as nursing beds.

The nursing care insurance company will tell you how and through which provider, such as which medical supply store, you will receive care. If in doubt, ask the nursing care insurance company.

The claim against the health insurance fund is not limited to the equipment itself with the aid itself. The care also includes individual adjustment, repair, maintenance and replacement, training in the use of the aid and operating costs (e.g. electricity costs).

Care aids for consumption

Consumable care aids are products that, due to their material or for hygiene reasons, are generally only used once and cannot be reused. These include, for example, disposable gloves, hand and surface disinfectants, face masks, protective aprons or disposable bed protectors.

Nursing care insurance companies can provide these benefits or reimburse the costs. 40 euros per month will be reimbursed for care benefits intended for consumption. An informal application is sufficient if the need for care has been established. Many nursing care funds also offer prepared forms for this purpose.

Payments and additional costs

Adult insured persons must pay 10 percent of the nursing allowance, up to a maximum of 25 euros per nursing allowance. Exemption from additional payments is possible. The regulations apply Exemption from additional payments for statutory health insurance. You don’t have to pay anything extra for the use of nursing supplies.

If people in need of care decide to equip the nursing assistant with something beyond what is necessary, they will have to bear the additional costs themselves.

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