Internal Medicine

Care level 5 - you should know that

definition

Care level 5 is the highest of the 5 care levels. This expresses the greatest severity of the need for care that a person in need of care can be classified into. He has the highest claim to care benefits, which are paid out by the long-term care insurance to the individual insured in the event of a need for care. It occurs when there are severe impairments in independence and / or skills with special requirements for nursing care.

Requirement for care level 5

The first prerequisite for being able to be classified in a care level at all is the minimum insurance period of the care insurance, which determines from when care allowance can be applied for and paid out. Every person in need of care is only entitled to care allowance if they have paid into the same statutory long-term care insurance for two years in the ten years prior to submitting the application. An application can then be made to determine the degree of care.

A point system determines the number of points from which the respective level of care is achieved. The system consists of 100 points. From 90 points, the requirement for care level 5 is met. These prerequisites include impairments from a total of 6 modules, which represent different areas of life. These are restrictions in mobility, cognitive and communicative abilities, behavior and psyche, self-sufficiency, coping with and independent handling of illness and therapy-related requirements, the organization of everyday life and social contacts.

If there is a particularly serious need that makes it difficult or impossible to cope with the tasks and skills independently and / or there is a complete loss of function of the legs and / or arms, a level of care of 5 can be awarded even if the 90 points are not reached. Since the 90 points are made up of the sum of the restrictions from the different modules and different degrees of severity, the exact prerequisites are decided individually in each individual case.

You might also be interested in this topic: Care level 4

What benefits do you get with care level 5?

The services depend on the restrictions and wishes of the person in need of care. First and foremost, the benefits depend on whether a person wants to be cared for at home or in a home. If the person concerned would like to be cared for by a relative, this is basically possible. It must then be clarified whether the relatives can also do this in full or whether a trained nurse has to be hired to provide support and assistance. Therefore, the services are based on the individual needs of the person being cared for.

In principle, the higher the need, the higher the benefit claim. With care level 5, around 900 euros per month are paid out to those affected if they are cared for by a private person. If only a care service is used, monthly maximum amounts for care benefits in kind are reimbursed up to 2000 euros per month. The caregivers decide for themselves how they want to use this amount, i.e. whether for care measures, household help and / or care. These include help with the preparation of meals and ingestion, personal hygiene and hygiene measures, cleaning laundry and household, playing, reading aloud, accompanying visits to friends and relatives. For visiting services and shopping aids, an additional amount of 215 euros per month can be drawn for support and relief services.

If you do not use the benefits, you can take them with you into the following year until June 30th and use them

Remuneration for caring relatives

The relative receives the care allowance to which the person in need of care is entitled from their care insurance. The person to be cared for passes it on, so to speak, to their carer, who in this case is the relative. If the person to be cared for is classified at care level 5, you will receive around 900 euros per month. Lower levels of care are paid less than the prevailing level of care. Relatives who take care of people in need of care with care level 3 receive around 500 euros a month. More detailed information can be obtained from the care insurance companies.

Read more about care by relatives on the following page: domestic care

How do I apply?

Applications can be made by post or by phone to the long-term care insurance. Depending on the insurance and the agreements made in the long-term care insurance contract between the insurer and the insured person when joining the long-term care insurance, an application can also be made on request in an email. A request for an application is sufficient. This means that the informal request that the person concerned asks for an application. The insured person or a person authorized by him or her can submit the application.

You may also be interested in applying for a power of attorney. Read more about this at: Health care proxy - everything to do with the topic!

Where do you apply?

The application is submitted to the care insurance of the person to be cared for. Long-term care insurance and health insurance are usually identical. The postal address, email address or telephone number for the application are on the long-term care insurance contract, which the insured person should have. Otherwise, all statutory long-term care funds can now also be found on the Internet with their contact information.

After the hospital stay

If a person in need of care who has already been classified in a care level and receives care allowance enters hospitalization, short-term care can be connected to it. Care is then based on the needs of the person being cared for and can last a maximum of 4 weeks per year.

If a person is normally not in need of care, but only in need of care for a limited period, due to special circumstances, a temporary care can be applied for. Transitional care is congruent with short-term care, so to speak, short-term care without a degree of care. Here, a person to be cared for can take up to four weeks of help in an inpatient care facility after a hospital stay or receive financial support up to around 1,600 euros per month.

Short term care

Short-term care guarantees a full inpatient stay for a person requiring care. Either additionally after a hospital stay or to relieve a relative or a private person who cares for the person in need of care at home. In special cases, short-term care can also be used if home care cannot yet be fully guaranteed. The short-term care comprises a total of four full weeks, which, however, do not necessarily have to be used in one go. However, these four weeks refer to a calendar year. Further weeks are only possible in the following year.

Further information on the topic of care levels can be found at: