Care levels (formerly: care levels)
Martina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.
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Care levels replace care levels
The previous three levels of care will be replaced by the five levels of care from January 2017. They provide a more accurate and comprehensive assessment of a patient's abilities and impairments. Depending on the level of care, a person in need of care receives different amounts of support from long-term care insurance.
The classification is usually based on an opinion from the Medical Service of Health Insurance (MDK). The skills and degree of independence of a patient are assessed: The expert assesses the extent to which the person concerned can still take care of himself and how much help he needs in everyday life. Not only physical impairments (as before) are taken into account, but also emotional and / or spiritual ones to the same extent.
Anyone who has previously been in a care level is automatically classified in a care level. Nobody is rated worse than before, so there is no need to fear any loss of performance. Rather, most people in need of care will receive even higher benefits in the future.
Classification: What is being assessed?
The expert comes to the patient's apartment or nursing home after an appointment has been made in advance. 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 assessor valuable information about independence and the abilities of the person concerned. Specifically, the experts assess the following six areas of life (called "modules") in the care level classification:
- Mobility (physical agility): getting up in the morning, moving around the apartment, climbing stairs, etc.
- Cognitive and communicative skills: orientation about time and place, understanding facts, recognizing risks, understanding what others are saying, etc.
- Behaviors and psychological problems: restlessness at night, fears, aggression, defense against care measures, etc.
- Self-sufficiency: washing and dressing yourself, eating and drinking, going to the toilet alone, etc.
- Coping with and independently dealing with demands and stresses caused by illness or therapy: ability to take medication alone, measure blood pressure or go to the doctor, etc.
- Design of everyday life and social contacts: Ability to shape everyday life yourself, make direct contact with other people, etc.
The total number of points resulting from the evaluation of the six modules determines the level of care a patient is classified into.
The five levels of care
| Care level 1 (total points: 12.5 to under 27) |
People in need of care in care level 1 receive, among other things, care advice, advice in their own home, provision of aids and grants to improve the living environment (such as a stair lift or age-appropriate shower).
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. Those who receive full inpatient care can receive a monthly allowance of up to 125 euros. |
| Care level 2 (total points: from 27 to under 47.5) |
With care level 2 there are considerable impairments of independence and abilities. 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 689 per month. The earmarked relief amount (outpatient) is up to 125 euros per month. The amount of benefits for inpatient care is 770 euros per month. |
| Care level 3 (total points: from 47.5 to under 70) |
With care level 3, there are severe impairments of independence and abilities. For this level of care, a monthly cash benefit of 545 euros or a benefit in kind of 1,298 euros are provided for outpatient care. The earmarked relief amount (outpatient) is up to 125 euros per month. Those who receive inpatient care are entitled to a monthly benefit amount of 1,262 euros. |
| Care level 4 (total points: from 70 to under 90) |
Patients with care level 4 show the most severe impairments of independence and abilities. In the case of outpatient care, a cash benefit of 728 euros or a benefit in kind of 1,612 euros are provided. Up to 125 euros per month can be granted as an earmarked relief amount (outpatient).
In-patient care is 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 the most severe impairments of independence and skills, but there are also special requirements for care. The monthly cash benefit (outpatient) is 901 euros, the benefit in kind (outpatient) 1,995 euros and the earmarked relief amount (outpatient) up to 125 euros. The amount of benefits for inpatient care is EUR 2,005 per month. |
Outpatient care benefits in kind can also be combined with the care allowance.
In addition to these main benefits, additional benefits can be requested, such as preventive care, short-term care, subsidies for care aids or for barrier-free home renovations.
Short-term and preventive care
With short-term care, a person in need of care who is otherwise cared for on an outpatient basis is temporarily cared for on an inpatient basis. This can be necessary, for example, to cope with a crisis situation with home care or after a stay in hospital. For short-term care, patients in care levels 2 to 5 can receive 1,612 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 caregiver 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, volunteer caregivers or close relatives. 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 1,612 euros.
Partial inpatient care (day / night care)
Some people in need of care who are otherwise cared for at home can spend part of the time in a corresponding facility - either the night (night care) or 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 day-care care. For the other care levels, monthly benefits of up to 689 euros (care level 2), 1,298 euros (care level 3), 1,612 euros (care level 4) or 1,995 euros (care level 5) can be requested.
Tools and home remodeling
Long-term care insurance partially covers the costs of care 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 inserts, the long-term care insurance can grant a monthly allowance of up to 40 euros, regardless of the level of care required.
The long-term care insurance can also contribute up to 4,000 euros per measure to the costs of the home renovation, such as the installation of a stairlift.
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