What do I do to get help

Have your health insurance fund pay for home care and domestic help

You have statutory health insurance and can be hospitalized because of an illness, after an operation or other treatment temporarily not take care of yourself? Then you are entitled to household help on prescription. The prerequisite for this is that you have no one at home to help you with body care, eat and do the housework or to look after the children. You can decide for yourself whether you want to be helped by a professional or by asking relatives or friends for help.

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

tasks

The extent to which health insurances pay for domestic help depends on what you can still do yourself or with the support of others. If a fairy godmother is approved for her own household, she will take care of the necessary things: washing clothes, cleaning the apartment, preparing meals, doing shopping and running errands, and looking after and supervising the children.

Request

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

  • from when the help is necessary
  • for how long and
  • to what extent the aid should be given.

In order for the care to work smoothly, it is best to submit your application during your hospital stay.

Duration

If primarily children under the age of twelve are to be cared for during a hospital stay 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 available four weeks at most limited per episode of illness. If there are children to be looked after, the health insurance company will provide help for a maximum of 26 weeks. Parents or single parents should inquire at their health insurance fund whether they will also voluntarily pay for care services for older children.

Freedom of choice

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

It is also possible to entrust a trusted person with the housekeeping.

costs

The health insurers pay for a self-organized replacement worker in 2021 10.25 euros per hour. In principle, all costs of domestic help that arise from the use of services can be reimbursed by the health insurance companies. However, the reimbursement is limited to a certain amount and number of hours. An 8-hour deployment per day is generally considered appropriate. For an 8-hour day, this means 82 euros.

What is to be assessed as an "appropriate number of hours" must be taken into account in the context of the circumstances of an individual case. For example, it must be taken into account how many children have to be looked after in the household, as well as the age of the children / child or whether one is a single parent. In addition, the circumstances can also mean that a daily operating time of more than eight hours is required. The health insurance company can explain these circumstances on a case-by-case basis.

For neighbors or friends, the hourly wage is a small recognition of their active commitment. Close relatives or spouses will only receive the cash injection from the health insurance company if they can provide evidence of loss of earnings or travel expenses.

However, it is also possible that the health insurance company as part of its Statutory service assumes the cost of domestic help beyond the legal framework. It is best to ask your health insurance company beforehand.

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