Costs

Sponsors of the ambulatory care


An important factor for using ambulatory care services is the issue of reimbursing the costs. The most important and the most often used sponsors are the competent medical insurance centers and the caretaking insurance centers.

In the field of basic care (SGB XI) the service provider is the caretaking insurance center and in the field of medical care, it is the medical / health insurance center (SGB V). In case the care is performed in stages, the value of the reimbursement depends on each stage of caretaking.

Moreover, there is the possibility to ask for support from the social assistance centers.

Try using your computer in order to calculate the costs for caretaking!!

We are an official partner of all the caretaking insurance centers and the social assistance centers
Caretaking insurance

Like everybody, the persons who need care want to continue living in their own home. As long as the hospitalization is not necessary, this is the best solution. This is why there are 3 options for ambulatory care:

  • •specialized nursing: the specialized personnel in an ambulatory care unit or in a social service department comes regularly at the home of the person who needs care. There they take over the necessary tasks.
  • •Financial support for care: the family members, friends or neighbours take over the care services. The caretaking insurance grants the nursed person a financial support for nursing. .
  • •Combination between specialized care and financial support for nursing.

The ambulatory care does not have to take place exclusively in the home of the nursed person. It may happen also in another home.

Specialized care

The caretaking insurance takes over the costs for the ambulatory caretaking services. However, there are maximum limits for which the caretaking insurance center takes over the costs:

  • •stage 0 in caretaking – up to 231.00 Euro every month
  • •stage I in caretaking – up to 468.00 Euro every month
  • •stage II in caretaking – up to 1 144.00 Euro every month
  • •stage III in caretaking – up to 1 612.00 Euro every month
  • •stage III in caretaking for difficult cases – up to 1 955.00 Euro every month € im Monat

Two conditions must be fulfilled for these costs to be covered:

  • •the first condition is the existence of a contract between the nursed person and the ambulatory care unit. This contract will establish for example various services and periods. If you are unhappy after the first intervention, you can terminate the contract within 24 hours. In order to do so, you don’t need to mention your reasons. The contract will be terminated instantly.

  • •Beside this, the ambulatory care unit must be accepted by your caretaking insurance center or by the associations working for your caretaking insurance center

Financial support for caretaking

If the respective person is nursed by a private person, that is the family, neighbours or friends, the insurance grants financial support for caretaking. This amount of money will be given every month to the person being nursed. The amount of the financial support will depend on the stage of caretaking:

  • •stage 0 in caretaking – up to 123.00 Euro every month
  • •stage I in caretaking – up to 244.00 Euro every month
  • •stage II in caretaking – up to 458.00 Euro every month
  • •stage III in caretaking – up to 1 612.00 Euro every month
  • •stage III in caretaking– up to 728.00 Euro every month

The following conditions are valid for the financial support for caretaking:

  • •The care takers must make sure they perform the basic caretaking and also the household supplies.

  • •If the caretakers work only a few days a month, the financial support is granted depending on the worked period. There is an exception however: if the nursed person must go to the hospital, the financial support is granted for four more weeks

  • •The caretaking insurance center checks if the services are appropriate. In order to do that, the caretakers must ask for assistance from an authorized caretaking institution. This institution may advise the caretakers and report the success of the caretaking activity to the Caretaking Insurance Center. The costs for this are taken over by the Caretaking Insurance Center.
Health insurance center

If by using caretaking services, we can avoid or shorten a hospitalization period or if the hospitalization is not possible for certain reasons, then the competent medical insurance centers take over the costs for a period of maximum four weeks depending on the illness case – in exceptional well justified cases, the period may be extended. The ambulatory care normally includes basic care and medical nursing (for example changing the bandage) as well as housekeeping.

Ambulatory care may also be performed as treatment if it is necessary in order to meet the requirements of the medical treatment. The health insurance center may determine the caretaking to be provided and the housekeeping, establishing the period and volume of work for it. However, these additional services will not be taken over by the health insurance center, as they are subject to the caretaking insurance center. The condition is that there should not be people living in the respective house, who can take over the care completely.
Social assistance directorate

If the caretaking costs are higher than the services offered by the caretaking insurance center, you have the right, if you have smaller incomes, to ask the social assistance directorate to take over part of the costs. The respective rights are checked by the social assistance directorate. We can assist you in filing your application. The contract we have with the social assistance directorate enables direct and unbureaucratic reimbursement for the offered services. You do not have to deal with anything.

Other sponsors

    Beside the sponsors mentioned above, there are also other sponsors who are not so often met. Among them:

  • • War victims’ assistance center
  • • Professional association
  • • Pension office
  • • Integration office
  • • Assistance Directorate

We can offer you counseling during a private discussion regarding the options that amost suitable for you.
Private financing

If the care taking is not performed in stages, the caretaking insurance does not take over the costs for ambulatory care.

wever, our clients still have the possibility to benefit from our services. But these must be with private financing. If the existing financial means do not cover the necessary services, one may file a request at the social assistance directorate so that they might take over the expenses – „social assistance directorate”.