Have home care and household help paid for by health insurance

 Help on prescription: People with statutory health insurance can apply for home nursing or household help.

The essentials in brief:

• The entitlement exists in the event of a serious illness and in particular after treatment in hospital.
• The prerequisite is that you do not have anyone living in your household who can look after you or run the household.
• Assistance is usually provided for a maximum of four weeks per episode of illness and statutory co-payments are payable.

Do you have statutory health insurance and are temporarily unable to take care of yourself because of an illness, after an operation or other treatment in the hospital ? Then you are entitled to household help on prescription. The prerequisite for this is that you do not have anyone at home who can help you with personal hygiene, with food or around the house or who can take care of the children. You can decide for yourself whether you want help from a professional or ask relatives or friends for help.

Our tips for a successful application to the health insurance company:

tasks

The extent to which health insurance companies pay for domestic help depends on what you can still do yourself or with the help of others. If a good fairy is approved for your own household, it will take care of the necessary things that arise: washing clothes, cleaning the apartment, preparing meals, doing shopping and running errands as well as looking after and supervising the children.

application

You can apply in writing to your health insurance company for a service person to help you around the house. A certificate of necessity from the doctor treating you must be submitted with the completed form, in which the diagnosis and the resulting impairments are listed. In addition, the doctor must also state it

• when help is needed
• for how long and
• how much help should be given.

To ensure that care runs smoothly, it is best to start your application while you are in hospital.

duration

If children under the age of twelve are primarily cared for during a stay in hospital or rehabilitation, the health insurance company will cover the costs while they remain in the clinic. After returning to your own home environment, support from a domestic help is limited to a maximum of four weeks per episode of illness. If children have to be cared for, the health insurance company will provide help for a maximum of 26 weeks. Parents or single parents should ask their insurance company whether they also voluntarily pay for care services for older children.

freedom of choice

You can freely choose a suitable household worker from a welfare association, nursing service or local service provider. The health insurance companies are obliged to provide advice when applying for household help. It makes sense to ask the health insurance company for suitable providers and their contact details when you apply. In addition, the health insurance company will also make an initial contact upon request and inquire about free capacities in advance.

It is also possible to entrust a trusted person with household chores.

Cost

In 2022 , health insurance companies will pay 10.25 euros per hour for a self-organized replacement worker . In principle, all costs of household help that arise from the use of services can be reimbursed by the health insurance companies. However, reimbursement is limited to a certain amount and number of hours. As a rule, an 8-hour assignment per day is considered appropriate. For an 8-hour day, this means 82 euros.

What counts as a "reasonable number of hours" must be considered within the context of the circumstances of an individual case. It is important to consider, for example, how many children have to be cared for in the household, as well as the age of the children/the child or whether you are a single parent. In addition, the circumstances can also mean that a daily deployment time of more than eight hours is required. The health insurance company can explain these circumstances in individual cases.

For neighbors or friends, the hourly wage is a small acknowledgment of their hard work. Close relatives or spouses only receive the cash injection from the health insurance company if they can prove that they have lost earnings or travel expenses.

However, it is also possible for the health insurance company to cover the costs of domestic help as part of its statutory benefits beyond the legal framework. It is best to ask your health insurance company beforehand.

If you rely on a professional household help, it is important that the health insurance company always concludes a contract directly with the specialist. In this case, the replacement worker or facility settles the costs directly with the responsible health insurance company. In this way you can avoid being left with a significant part of the costs. Nevertheless, you also have to contribute something, namely ten percent of the costs. Converted to a minimum of five and a maximum of ten euros. If care at home is already ensured by the benefits of long-term care insurance , there is no additional household help.

However, a personal contribution (additional payment) of 10 percent of the costs is obligatory, but at least 5 and at most 10 euros per day. This only applies to pregnancy or childbirth.

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