Home Age & Care Care levels (formerly: care levels)

Care levels (formerly: care levels)

by Josephine Andrews
Published: Last Updated on 406 views

The degree of care (formerly: care level) decides which benefits a person in need of care is entitled to. The classification is usually based on an expert opinion from the medical service. Find out more about the degrees of care and their benefits here!

Care grades replace care levels

The previously applicable three levels of care were replaced by the five levels of care in January 2017. They provide a more accurate and comprehensive assessment of a patient’s abilities and impairments. Depending on the degree of care, a person in need of care receives different levels of support from the care insurance.

The classification is usually based on an expert opinion from the medical service of the statutory ( MD ) or private health insurance companies ( Medicproof ). The abilities and degree of independence of a patient are assessed: The expert assesses the extent to which the person concerned can still take care of themselves and how much help they need in everyday life. Not only physical impairments (as before) are taken into account, but also mental and/or mental ones to the same extent.

Anyone who was previously in a care level is automatically classified in a care level. No one is classified worse than before, so there is no need to fear a loss of performance. In fact, most people in need of care will receive even higher benefits in the future.

Classification: What is assessed?

The appraiser will come to the patient’s home or care facility by prior appointment. At this appointment, the relatives, carers and all other people who support the person in need of care should also be present. They can give the appraiser valuable information about the self-reliance and the abilities of the person concerned.

Specifically, the assessors assess the following six areas of life (“modules”) when classifying the degree of care:

  • Mobility (physical mobility): getting up in the morning, moving around the apartment, climbing stairs, etc.
  • Mental and communication skills : Orientation about place and time, grasping facts, recognizing risks, understanding what others are saying, etc.
  • Behavior and psychological problems : restlessness at night, fears, aggression, resistance to care measures, etc.
  • Self-sufficiency : wash and dress independently, eat and drink, go to the toilet alone, etc.
  • Dealing independently with the demands and stresses caused by illness or therapy and coping with them: Ability to take medication alone, measure blood pressure or go to the doctor, etc.
  • Organization of everyday life and social contacts : ability to organize everyday life yourself, to make direct contact with other people, etc.

In these areas, the assessors determine the degree of independence of the (potential) person in need of care using a point value between 0 (the person concerned can carry out the activity without a helping person or with aids) and 3 (the person cannot carry out the activity, either). in pieces). The total number of points resulting from the evaluation of the six modules determines the level of care a patient is assigned to.

The five levels of care

Care level 1 (total points: 12.5 to under 27)
Those in need of care in care grade 1 receive, among other things, care advice, advice in their own home, supply of aids and grants to improve the living environment (such as stair lifts or age-appropriate showers).

In addition, there is a relief amount (outpatient) of up to 125 euros per month. It is earmarked and can be used, for example, for day or night care or short-term care.

Anyone who is cared for as a full in-patient can receive a subsidy of up to 125 euros per month.

Care level 2 (total points: from 27 to under 47.5)
With care level 2, there are significant impairments of independence and skills.

Those affected who are cared for at home are entitled to a monthly cash benefit (care allowance) of EUR 316 or outpatient care benefits in kind of EUR 724 per month. The earmarked relief amount (outpatient) amounts to up to 125 euros per month.

The benefit amount for inpatient care is 770 euros per month.

Care level 3 (total points: from 47.5 to under 70)
At care level 3, there are severe impairments of independence and skills.

For this level of care, a cash benefit of 545 euros per month or a benefit in kind of 1,363 euros is provided for outpatient care. The earmarked relief amount (outpatient) is up to 125 euros per month.

Anyone receiving inpatient care is entitled to a benefit amount of EUR 1,262 per month.

Care level 4 (total points: from 70 to under 90)
Patients with care level 4 have severe impairments of independence and skills.

In the case of outpatient care, a cash benefit of EUR 728 or a benefit in kind of EUR 1,693 is provided. Up to 125 euros per month can be granted as earmarked relief (outpatient).

Inpatients are entitled to a benefit amount of 1,775 euros per month.

Care level 5 (total points: from 90 to 100)
Care level 5 also has severe impairments of independence and skills, but there are also special requirements for nursing care.

The monthly cash benefit (outpatient) is 901 euros, the benefit in kind (outpatient) 2,095 euros and the earmarked relief amount (outpatient) up to 125 euros. The benefit amount for inpatient care is 2,005 euros per month.

Outpatient care benefits in kind can also be combined with the care allowance.

In addition to these main benefit amounts, other benefits can be applied for, such as respite care, short-term care, subsidies for nursing aids or barrier-free apartment conversions.

Subsidy for nursing home expenses

In order to relieve the financial burden on people in need of care, care grades 2 to 5 have received a so-called “performance surcharge” since January 2022. You will receive the money in addition to the care allowance and regardless of the degree of care. The amount of the subsidy depends on the period in which the care services are received.

Residents with care levels 2 to 5 receive:

  • 5 percent of the personal contribution to the care costs within the first year in the care facility.
  • 25 percent of your own share of the care costs if you are cared for as an inpatient for more than one year.
  • 45 percent of your own share of the care costs if you live in the home for more than two years.
  • 70 percent of your own share of the care costs if you are cared for in a care home for longer than 36 months.

Respite and respite care

In the case of short -term care, a person in need of care who is otherwise cared for on an outpatient basis is temporarily cared for as a full inpatient. This may be necessary, for example, to deal with a crisis situation in home care or after a stay in hospital. For short-term care, patients in care grades 2 to 5 can receive 1,774 euros per year for the costs of short-term care for up to eight weeks per calendar year. Those assigned to care level 1 can use the monthly relief amount of up to 125 euros to pay for short-term care.

If a family member caring for you falls ill or wants to go on vacation, the long-term care insurance pays for replacement care. This so-called preventive care can, for example, be taken over by an outpatient care service, voluntary caregivers or close relatives. The long-term care insurance covers the costs of replacement care for a maximum of six weeks per calendar year and up to an amount of 1,774 euros.

Transitional care in the hospital

Transitional care has been in place since January 2022. It is intended to help patients who cannot be adequately cared for after a stay in hospital: There may not be an immediate place available in short-term care or a rehabilitation facility. Or relatives cannot adequately care for the person concerned at home.

Transitional care is usually provided in the hospital where treatment took place. It is limited to ten days. The application for interim care is made via the social services department of the hospital or directly to the health insurance company.

Partial inpatient care (day/night care)

Some people in need of care who are otherwise cared for at home can spend part of their time in an appropriate facility – either at night (night care) or during the day (day care). In this way, home care is to be supplemented or strengthened.

With care level 1, the monthly relief amount of up to 125 euros can be used to finance this part-time inpatient care. Monthly benefits of up to EUR 724 (level of care 2), EUR 1,363 (level of care 3), EUR 1,693 (level of care 4) or EUR 2,095 (level of care 5) can be requested for the other levels of care.

Aids and home remodeling

The long-term care insurance partly covers the costs for nursing aids . Technical aids such as care beds or wheelchairs are usually provided on loan or for an additional fee. For consumable products such as disposable gloves or bed pads, the long-term care insurance company can grant a monthly subsidy of up to 40 euros, regardless of the level of care.

The long-term care insurance can also contribute up to EUR 4,000 per measure to the costs of converting the apartment , such as installing a stair lift.

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