What levels of care are available?
The degrees of care have been in effect since 01. 01. 2017 through the second Care Strengthening Act (PSG II) and make it easier for people in need of help to actually be classified as in need of care in order to receive benefits from the care insurance fund.
The change from 3 levels of care to 5 levels of nursing care was primarily aimed at attributing a need for care to people suffering from dementia, mental illness or mental disability and who have limited everyday competence. There are levels of care from 1 to 5, and the new assessment assessment (NBA) is used to determine which level of care is received. The more points you receive in it, the higher the level of care you receive.
Care level 1 applies to people with a slight impairment of independence. If the impairment is significant, care level 2 applies. People with a severe impairment of independence are assigned to care level 3 and people with the most severe impairment are assigned to care level 4.
Care level 5 provides assistance to people who suffer from a severe impairment in everyday life and who have special requirements in terms of nursing care. The new care level 1 has existed since January 01, 2017 and is assigned to people in need of care who previously had no care level. Since the former care level 1 was transferred to care level 2, care level 1 is completely new.
Consequently, no care level corresponds to it. It is primarily used to help patients with dementia. In order to receive the nursing level 1 by the MDK assessors, the affected persons must receive a score of 12.5 to <27 in the new assessment.
This calculates the score using various modules such as Care Level 1 corresponds to a slight impairment of independence, whether physical or mental. People with care level 1 do not receive a care allowance for care at home, neither care benefits in kind nor outpatient cash benefits. What they receive is an “earmarked ambulatory discharge amount” of 125€ monthly.
This amount serves above all the financing of care, supervision and guidance of the care-needy persons to day-structuring measures.
- Mobility
- Cognitive and communication skills
- Behaviours
- Psychological difficulties
- Self-catering
- Coping with disease- or therapy-related stress
- Shaping everyday life and social life.
Affected persons in need of long-term care with a “significant impairment of independence” and people who were previously assigned to care level 1 are assigned care level 2. The evaluators are given a score of 27 to 47.5 in the new assessment.
The persons in need of care receive monthly care allowance of 316€ for home care by relatives. In addition there are care benefits in kind of monthly 689€, which are accounted for by ambulatory care services directly with the care insurance companies themselves. This means that those affected, with or without dementia, receive significantly more care allowance and benefits in kind than in the former care level system.
In addition, there is the new uniform “relief contribution” of 125€ per month, with which those in need of care can pay, for example, a home help, an everyday companion, shopping assistance or a care group. If short-term care (e.g. in a nursing home) is needed after a stay in hospital, the nursing care insurance funds pay subsidies for up to four weeks up to a maximum of €1,612 per year. Insured persons with a “severe impairment of independence” and dementia patients with previous care level 1 and people with care level 2 are awarded care level 3.
In the NBA of the MDK, the score to be achieved for care level 3 is between 47.5 and 70 points. The severely care-needy persons receive a monthly care allowance of 545€ with a home care by relatives as well as care benefits in kind by an ambulant care service of 1. 298€ per month.
In addition there is the mentioned relief contribution of 125€ monthly for domestic help, purchasing assistance or similar. Receive more detailed information about the requirements and grants of the care grade 3. The care grade 4 describes a “severe impairment of independence” of affected persons in need of care.
The requirement is a score between 70 and 90 points in the NBA of the MDK. In addition, all patients who have been assigned to care level 3 or care level 2 with limited everyday competence are automatically transferred to care level 4.The concerning receive a monthly care money of 728€ with domestic care by relatives and care achievements in kind by an ambulatory care service of 1. 612€ monthly.
In addition, there is the relief contribution of 125€ monthly for a care group, everyday support, domestic help or similar. The care level 5 is the highest care level with the most extensive benefits of the care insurance. It helps people with “most severe impairment of independence” and a particularly high need for care.
To receive this level of care, 90 to 100 points are required in the NBA. This corresponds to people who previously received care level 3 with limited everyday competence, the colloquial “hardship cases”. Affected persons with care level 5 receive 901€ per month for home care by relatives or friends as well as care benefits in kind of 1. 995€ for care by an outpatient care service. In addition, they receive the monthly relief contribution of 125€ for domestic help, everyday care or similar.
