After having been assessed by the MDK (Medical Service of the Health Insurance Funds), persons in need of nursing care I to III and persons who are in need of basic care and home care but do not yet meet the requirements of Care Level I are entitled to additional childcare. This applies, among other things, to people who suffer from dementia, mental disability or mental illness, which severely restricts their ability to carry out daily tasks.

For the assessment, whether the restriction of the everyday competence in the long term is substantial, the following damages and ability disturbances are decisive:

uncontrolled leaving the living area (tendency to run away)

To misunderstand or cause hazardous situations

improper handling of dangerous objects or potentially hazardous substances

verbally or verbally aggressive behavior in misjudging the situation

inappropriate behavior in the situational context

Inability to perceive one's own physical and emotional feelings or needs

Inability to cooperate in therapeutic or protective measures as a result of therapy-resistant depression or anxiety disorder

Disorders of higher brain functions (impaired memory, reduced judgment), which have led to problems in coping with everyday social services

Disruption of the day / night rhythm

Inability to independently plan and structure the daily routine

Misunderstanding of everyday situations and inadequate reactions in everyday situations

pronounced labile or uncontrolled emotional behavior

predominantly depression, despondency, helplessness or hopelessness due to therapy-resistant depression

Everyday competence is considerably limited if the assessor of the medical service or the appraiser commissioned by the nursing care insurance determine long-term and regular damage or impairments of ability in at least two areas of which at least once from one of the areas 1 to 9

The law of long-term care insurance has newly regulated the entitlement to the so-called additional care benefits with the entry into force of the Long-term Care Nursing Act from 1 July 2008. These care services have been created for people in need of care with and without care, who are considerably limited in their everyday skills.

Insured persons who fulfill the requirements of § 45a may, depending on the extent of the considerable general need for care, make use of additional care and relief services. The costs for this will be covered, but not more than 104 euros per month (basic amount) or 208 euros per month (increased amount). The amount of the respective claim is determined by the care fund on the recommendation of the Medical Service of the Health Insurance in individual cases and communicated to the insured. The amount is earmarked for quality-assured services of care or relief. It serves the reimbursement of expenses incurred by the insured in connection with the use of benefits of the nursing service.

from 01.01.2015 People in need of care who do not fulfill the requirements of § 45a can also claim additional care and support services. The costs for this are taken up to an amount of 104 euros per month.

New as of 01/01/2017 The so-called relief amount for additional care services amounting to 104,00 Euro or 208,00 Euro will be standardized and from 2017 onwards a flat rate of 125,00 Euro. If the person in need of care does not receive the same benefits at least in total after the transfer of care levels 2016 into care levels 2017, the grandfathering takes effect: The care fund then pays the difference.

In addition to basic care and home care services, the beneficiaries receive an additional care allowance of € 1,500 up to € 2,496 per year for care services. The required benefit is provided in 2 stages (level 1: € 1,500, level 2: € 2,496) according to the amount of care that has been identified. This usually coincides with the levels of care, as the severity of the disease increases the need for additional services. The benefit can be claimed within the respective calendar year; If the service is not used up in one calendar year, the unused amount can be transferred to the following calendar year. This expires however on 30.06. of a calendar year.