An important step for those in need of care and their relatives is applying for a care level according to § 40 SGB XI. This care level determines the type and extent of support and financial relief that those in need of care can receive. But how exactly does one apply for a care level, and what steps need to be considered? In this guide, we provide you with an overview.
1. Gather Information and Assess Needs
Before submitting the application, it is important to clarify the care needs of the individual concerned. What limitations exist in daily life? What assistance is needed? Here, care advisors, doctors, or outpatient care services can provide valuable support.
2. Application to the Nursing Care Fund
The application for a care level is submitted to the responsible nursing care fund. This can be the health insurance company or a private nursing care insurance. The application can be made in writing, by phone, or online. It is advisable to submit the application as early as possible to avoid delays.
3. Assessment by the Medical Service of the Health Insurance (MDK)
After receiving the application, an MDK assessor will conduct a home visit to assess the care needs of the applicant. Various criteria such as mobility, cognitive and psychological abilities, as well as independence in daily life, will be evaluated.
4. Receipt of Notification and Right to Appeal
After the assessment, you will receive a notification regarding the determined care level. If you disagree with the decision, you have the opportunity to lodge an appeal within a period of four weeks. It may be helpful to seek expert assistance in a timely manner.
5. Utilization of Services
After determining the care level, the corresponding services can be utilized. These include, among others, financial subsidies, outpatient care services, day and night care, or the provision of care aids.
