For people in need of care, social welfare will cover the costs associated with care under certain conditions. The costs are covered after the benefits provided by statutory long-term care insurance and are dependent on income and assets.

One of the prerequisites for the costs to be covered is that you are in need of care. 

The reason for needing care may be physical, cognitive, or psychological impairments, or health-related stresses or demands that you are unable to compensate for and cope with independently. 

The Medical Service of the Health Insurance Funds (MDK), which is commissioned by your long-term care insurance, determines whether and to what extent you are in need of care. The MDK assesses how independently you can still cope with everyday life. It determines the level of care required using a points system. Your responsible long-term care insurance fund is then responsible for covering the costs of care. However, depending on the type of service, long-term care insurance only covers costs up to certain maximum limits. If you are unable to cover the remaining costs, supplementary social assistance benefits (SGB XII) – such as care assistance – may be available. 

You can obtain more detailed information on the assessment procedure from your long-term care insurance provider. 

If you do not have long-term care insurance, the social welfare agency can commission the relevant health authority (known as the public health officer) to assess your need for care. 

Nursing care can be provided at home, in outpatient residential groups, or in a nursing facility.

The specific services you can claim are based on the list of services covered by statutory long-term care insurance. 

This provides for the following support options:

From care level 1:

• Care aids
• Measures to improve the living environment
• Digital care applications
• Additional support for the use of digital care applications
• A relief amount

From care level 2 to 5:

• Home care in the form of: care allowance, home care assistance, respite care, care aids, measures to improve the living environment, digital care applications, additional support in using digital care applications
• Partial inpatient care
• Short-term care
• Relief amount
• Inpatient care

Relatives are required to contribute to the costs if their gross annual income exceeds €100,000; see also the Act on Relief for Relatives Obligated to Pay Maintenance in Social Assistance and Integration Assistance (known as the Relatives Relief Act).

• Your health is affecting your independence or abilities, so you need help from others. This means you have physical, cognitive, or mental impairments or health-related stresses or demands that you can't handle or deal with on your own.
• The need for care must be at least as severe as that required for a legally defined care level to be granted. This means that you must have at least care level 1. However, only limited benefits are provided for people in need of care at care level 1 within the framework of care assistance. On the other hand, people in need of care at care levels 2 to 5 have full access.
• You and your spouse or partner who does not live separately do not have sufficient income or assets to cover the costs of care.

You will receive care assistance at the earliest from the point at which the responsible social welfare agency becomes aware that the requirements for benefits have been met.

• As a person with long-term care insurance, you should first contact your responsible long-term care insurance fund or your private long-term care insurance company that provides private compulsory long-term care insurance.
• The long-term care insurance fund or company will commission the Medical Service (MD) or
  other independent experts or,
  if you have private insurance, Medicproof, to prepare an expert opinion on the need for long-term care and the level of care required, and will clarify which benefits you are entitled to and in what amount.
• If these benefits are insufficient or you are not entitled to any benefits at all, you can apply for nursing care assistance. This also applies if you do not have nursing care insurance.
• Our responsible case worker will advise and inform you about your benefit requirements.
• After you submit your application, we will review the documents you have submitted and, if necessary, determine your need for care. 
• We will also check your income and assets (and those of your spouse or partner). If the person in need of care is a minor and unmarried, we will take into account the income and assets of their parents.
• If all requirements are met, you will receive a notice of approval.

Although an informal application is possible, we will need you to fill out the application form afterwards.

• Appeal within one month of notification of the administrative decision
• Action before the social court within one month of notification of the appeal decision

There are no legally prescribed deadlines. However, you should apply for care assistance before moving into a nursing home or before claiming care services for home care, or at least notify the authorities of your needs in advance. This is because social assistance benefits, including care assistance, only commence once the social assistance provider or the agencies commissioned by it become aware that the requirements for the benefit have been met.

A decision on the application will be made as quickly as possible. The processing time depends, among other things, on the completeness of the information provided and the required supporting documents.

There are no fees.