Internal Medicine

Care level 2

definition

Care level 2 is assigned to people who are significantly impaired in their independence. The impairment can be on a physical, psychological or cognitive level. In the old care level system, this corresponded to care level 0 or 1. These are also automatically classified as care level 2 in the new system.

What are the requirements for care level 2?

As already described above, the person concerned must have a physical, psychological or cognitive impairment that restricts the person's independence.
The assessment of the independence of a person in need of care takes place with the help of the “New Assessment Assessment (NBA)”. This is carried out after the application has been submitted by an expert from the health insurance's medical service. It can also be done in a retirement or nursing home. A number of points between 27 and 47.5 points must be achieved in this test in order to be classified in care level 2.
Six different areas of life are assessed in the assessment:

In the assessment, independence plays the most important role. Mainly the resources and skills of a person should be assessed and not, as in the old care classification procedure, the need for help. For example, the extent to which the person concerned can still wash himself is assessed.
Two other important subject areas are, on the one hand, how patients deal with their limitations and illnesses and, on the other hand, shaping everyday life and maintaining social contacts.
Of course, mobility is also included in the overall assessment, albeit not so heavily weighted.
What is new in the current assessment is that cognitive and communication skills are also taken into account. This is especially important for people with dementia. They are often not physically restricted, but still need a lot of support in everyday life.
Last but not least, it is also taken into account whether the appraised person needs support in coping with psychological problems, such as anxious behavior.

The final assessment of the individual sub-areas by the expert is relatively complex. However, care level calculators are available online with which the care level of the person in need of care can be roughly estimated. It is also advisable to prepare for the reviewer's visit. It is helpful to consider in advance in which areas of life the person concerned needs help and which activities can be carried out themselves. In addition, it is good to have the person with you who is mainly responsible for the care during the assessment. It is also useful to have a doctor's letter and medication plan ready.

You can find detailed information on other levels of care under: Care levels and care levels

What benefits do you get with care level 2?

Insured persons with care level 2 are entitled to both care allowance and care benefits in kind.

The care allowance of € 316 is paid out for care by relatives or friends.
The care benefits in kind, which also include outpatient care, are remunerated with up to € 689.
In addition, there are support and relief services of up to € 125. These include cleaning and household help, as well as everyday companions. But also care groups, in which the cared for are mentally and physically activated, are financed with this money.
In cases in which caregiving relatives are not able to take over care due to illness, time off or other appointments, there is an entitlement to prevention allowance. This amounts to a maximum of 1612 € for 4 weeks. In addition, half of the care allowance is paid out during this period. The prevention allowance does not have to be applied for in advance from the health insurance company.
Day and night care fall under outpatient benefits in kind. In addition, there may be a right to care and medical aids. This includes e.g. a home emergency call system. A detailed list of the aids with the corresponding financial assumption can be found in the aids catalog.
In addition, there is a one-time financial support from the health insurances for a disabled-friendly living space adjustment. The maximum coverage by the health insurance company is € 4,000. Claim can be e.g. arise when installing a stairlift. Residential groups are also entitled to funding of up to € 4,000 for age-appropriate living space adjustments. There can be a maximum of 4 insured persons with care level 2 in this residential group. In addition, the members of a residential group can receive a one-off grant of € 2,500 each when they are set up. The monthly support is € 214.
There are also free offers for caring relatives, such as advice on optimizing care and a care course that can also be attended by volunteer caregivers. In the case of inpatient care for the person concerned, e.g. In a nursing home, the co-payment to be paid is € 580, as in all other care levels. However, the actual costs may vary from house to house. In addition, there may be additional costs for accommodation, meals and investments in the house.
In the case of inpatient care for a person with care level 2, the care fund pays € 770 per month.

What is short-term care?

Short-term care is often used after a person in need of care has been hospitalized. This takes place, for example, in a nursing home. The long-term care insurance funds pay a maximum of € 1,612 per year for short-term care for a maximum of 28 days. If no preventive care has been taken in the current year, short-term care for up to 8 weeks can be subsidized with € 3,224. During the short-term care, those affected also receive half of the monthly care allowance for relatives.

Our next topic might also be of interest to you: Domestic care

Care allowance during and after the hospital stay

During a hospital stay of up to 28 days, you are still entitled to the care allowance. Payment will only be stopped from the 29th day.
If care allowance has been suspended due to long hospitalization, payment will start again immediately upon discharge to a home setting. In the event that rehabilitation begins immediately after discharge, the care allowance is only paid out again after it has ended. If there are a few days between hospitalization and the rehabilitation measure, you are again entitled to care allowance. The care allowance payments are also discontinued from the 29th day in the event of rehabilitation. If a short-term care placement is desired after the hospital, subsidies are paid by the care fund.

What remuneration do you get if you take on care as a relative?

If you look after your relatives or friends in need of care at home with care level 2, you are entitled to a monthly care allowance of € 316. While in the old care level system, the level of remuneration was influenced by the presence of dementia, now everyone with care level 2 receives the same amount of € 316. This is around € 70 higher than the old care level system with an equivalent level of care.

If the care of the relatives is also partly taken over by an outpatient care service, a combination of care allowance and care benefit in kind is possible. In this case, however, the care allowance is no longer paid in full. In addition, caregivers can take part in care courses free of charge and take advantage of advice on optimizing care. If you are unable to attend due to illness or vacation, preventive care can also be used.

You might also be interested in our next article: Levels of care in dementia

How do I apply?

Before the application is made, it is useful to keep a care diary. This should record how much help the person concerned needs in everyday life. The documentation should be detailed and specified in time. It can later serve as a basis for the assessment by the expert and serves as a support that nothing is forgotten. The application can then be made to the care insurance fund.

The application can be made by telephone, informal letter or by visiting a care center. The application only needs to state that long-term care insurance benefits are being applied for. You will then receive a form which has to be filled out and signed by the person concerned or his authorized representative. This form does not have to and should not contain any precise information on the care situation.

An appointment is then made with the care insurance fund to assess the care situation, at which the specific care situation is then described. After a maximum of five weeks, the long-term care insurance fund should classify you in a care level, otherwise you will be entitled to compensation payments from the long-term care insurance fund. If there is good justification, the care classification can be contradicted.

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 must be submitted to the relevant long-term care insurance fund. The long-term care insurance is an independent authority, but is affiliated with the statutory health insurance. This means that every statutory health insurance company also has a long-term care insurance and every member of the statutory health insurance is automatically a member of the corresponding long-term care insurance. The same principle generally applies to private health insurers. The application can be made by phone, informally by letter or by visiting a care center. If additional long-term care insurance has been taken out, this must also be informed.