In January 1995, the government of Helmut Kohl introduced the Social Act XI 1, German long term care insurance . This is an independent part of social security in Germany, at Sozialgesetzbuch and provides financial terms for the risk of treatment needs. Long term care insurance is introduced as the fifth pillar of social insurance after health insurance, industrial injury, pensions and unemployment insurance. The fifth pillar is funded by a maintenance fund, which is built for all individual health insurance.
Insurance is also provided for people in need of care because of the severity of their long-term care. Parents and sick people no longer depend on social security if they need care. Mandatory care insurance covers part of the cost of home and residential care if an increased need for care or housekeeping assistance of at least six months is required. this will help my patients to live an independent and self-determined life..
Video Long-term care insurance in Germany
The insured
Insured and voluntary insured persons from public health insurance are required to be insured in social insurance. People who are voluntarily insured have the possibility of switching to private care insurance, which also includes people fully insured from private health insurance. Couples and children of social care insurance members are entitled to premium family insurance. With this system, cover for the entire population was introduced.
Maps Long-term care insurance in Germany
Benefits
Treatment level
This treatment requires people who receive insurance benefits in three stages. These stages are referred to as the level of care and serve the classification of claims from everyone who depends on the treatment. Decisions for classification in nursing care are made with substantial consideration of nursing reports. This is made by medical insurance medical services, where the insured is checked in his living room. The level of treatment is set as follows:
- Treatment Level I : needs at least 90 minutes of assistance per day with basic maintenance needs of at least 45 minutes per day.
- Second level treatment : the need for assistance should be at least 180 minutes per day with basic maintenance needs of at least 120 minutes per day.
- Nursing level III : the need for assistance is required at least 300 minutes per day with basic maintenance needs of at least 240 minutes per day.
- Cases of adversity : care funds can provide more services in line with the benefits of inpatient care and care.
If there is a need for personal care below the required threshold of at least 90 minutes per day, there is no benefit. All services except for technical assistance and maintenance courses are budgeted. This is to prevent care insurance is changed to full insurance. Thus, contributions will remain stable and development spending can be controlled.
Home care
Like the level of care, the service is also categorized. On the one hand there is home treatment and on the other side there is inpatient care. Home care can be divided into four categories:
The first group is the so-called maintenance allowances, monthly cash benefits for privately-organized caregivers, such as family members who are currently not working. The amount of cash in EUR235 in category I, EUR440 in category II and EUR700 in category III. In this scheme, there is no difficulty setting case.
The second option is the benefit of care in the form of goods. Outpatient care services for subsidized home care, selected by the patient. This benefit has a maximum amount per month. In the treatment level, I amount to EUR450; at care level II, EUR1100; and at level III, EUR1,550. In cases of special difficulties, maintenance funds may include operations with a total value of up to EUR1,918.
In addition, a combination of care funds and care benefits is possible. In this case, the benefits of nursing care for home care can be subject to material costs. In addition, the current portion of the maximum amount can be claimed as a cash benefit for the caregiver.
Partially inpatient care is a temporary support during the day at an institution. The benefits are identical to the treatment.
Inpatient
Inpatient care includes accommodation at home. This means that the service is provided during the lifetime. The need for inpatient care is assumed. Maintenance funds pay fees to a nursing home. At the treatment level I, the sum is EUR1023; at level II, EUR1,279; and at level III, EUR1,432. In extreme cases, up to EUR1,688 can be paid. The cash benefits are only for the cost of care and social support determines the home. If the income of all family members required to pay for treatment is not sufficient to pay for the remaining hospitalization expenses, the appropriate social assistance agency may be requested.
Financing
With the introduction of nursing care, the risk of treatment cases is recognized as a common life risk. This is a budgeting system. This means that depending on the level of care people get the fixed amount paid by insurance as support, regardless of how high the price for such services, such as inflation, will increase over the years. The amount of the fee is based on the level of contribution and revenue that can be assessed by the member. For publicly insured persons, the contribution rate is 1.7%.
However, people who do not have children aged 23 years or over must pay a rate of 1.95%. This is paid from the gross amount of salary or pension but only up to the maximum amount for health insurance from EUR4,012.50 per month at present. This rule applies equally to all Germans as of 1 July 1996. Family members are in non-contributory insurance if the coverage of the family is eligible for health insurance. However, the receipt of benefits from long-term care is not exempt from the payment of contributions.
Gaps in nursing insurance
The care insurance is so complex that some citizens have the information necessary to make a claim right. Evaluator of a medical service test whether a person is entitled to have treatment. The patients are not ready for the report. This creates a false impression of fitness and then a faulty (less comprehensive) classification of those people. This leads to the problem that families and patients can not handle the situation financially.
There are many ways to care for family members or provide assistance: home emergencies, short-term and day care, life support, household help, home-delivered food, driving and escort services, and elderly care centers. This is only a small picture of the diversity of these opportunities. Because the problem is so complex, patients often do not receive help and personal insurance for treatment.
Furthermore, important factors in determining the time required for treatment are not taken into account in general. Emerging treatment reforms include the care of people suffering from dementia and need to get a permanent presence from someone. Conversely, there is no support in the social sphere of life nor assistance to manage crisis and isolation or deal with death and death. Similarly, cases of care that are shorter than half a year do not get payment from the original insurance.
In principle, the legislature requires a combination of two conditions in the case of the right to benefit. On the one hand, patients should receive assistance in both the care and the household. On the other hand, outside help is required on a regular and permanent basis. If any of these conditions are not met, there is no payment. Regular need for help means that care is needed at least once a week. Durable means that the need for treatment exists for more than six months. "The actual duration is not important, but the prognosis, the prospect for the future".
Also, people in need of care must meet formal requirements. Patients should be insured in compulsory or private health insurance as well as they should be in care insurance with contributions or non-contributions and applicable to nursing care. To apply this person the person concerned must have an insurance before about five years in the care fund.
Meanwhile, shortage of nurses has become an important topic as well. Almost one in five nursing employees want to leave the profession due to excessive work hours. For the most part, it concerns the younger and more qualified nursing staff. The time pressure given to professional nurses in difficult care situations usually affects the quality of care for people in need.
Care reform
Membership rate
Twelve years after its introduction, long-term care was reformed for the first time in 2008. This law provides, among other things, the expansion of services. Maintenance reforms provide a variety of changes. The membership rate for long-term care was raised on July 1, 2008 by 0.25% so the treatment rate increased from 1.7% to 1.95%. For people without children, already at least 23, the level of care increased up to 2.2% of gross salary. Higher care premiums should be sufficient for 2014. After that, maintenance maintenance levels should be adjusted for a price increase every 3 years.
Home care promotion
For elderly care centers, there should be more alternative possibilities. Firstly, it is planned to include someone such as a treatment adviser who identifies the need for assistance, creates an individual care plan and oversees its implementation. Second, support for supervised living arrangements and bases for near-home care. This residential community has the opportunity to order shared nursing support. A home care base is established when a country decides. In addition, maintenance funds can close contracts more easily, not only with nursing services but also with individual nurse contracts. Inpatient facilities, however, work together more easily with doctors or they can hire their own doctors.
Performance increases
The care reform also gradually increased the care of benefit services in shape by 2012. At my treatment level, the number rose from EUR384 to EUR450; at the treatment level II, from EUR921 to EUR1,100; and at treatment level III, from EUR1,432 to EUR1,550.
Stationary number only changes in maintenance level III. Here, performance gradually increased from EUR1,432 to EUR1,550 in 2012. In extreme cases, its performance is from EUR1,688 to EUR1,918.
For people with dementia, Alzheimer's or mental disabilities, the show should be prolonged. They get it if they are not already in care level I. Here they go from EUR460 to EUR2400. On July 1, 2008, an increasing number of base and amount were introduced. The base amount can reach EUR1.200 per year and is intended for those with relatively lower overall support costs. The amount referred to EUR2,400 is for people with higher overall support costs in relation to maintenance needs. This amount is paid in addition to proper care. People with dementia receive better care in nursing homes. For these people, additional support staff are deployed, financed by care funds. Further service of EUR200 million will be spent.
Maintenance services at elderly care centers are also compensated. Further, short-term treatment claims are also stepped up gradually in care levels III and in cases of adversity. Short-term care for children in need of assistance from institutions for the disabled is expanded. Benefits for day and night care are improved, higher subsidies are offered, and shows are indexed. Also, the insurance period has been shortened to two years. In addition, maintenance funds have short review periods so they must deliver results within five weeks for the proposed application. For stays in hospital, the review period should be performed by a medical health insurance service within a week.
Pension rights increase for the caretaker's interests. These people are paid in the future during their leisure as a contribution to the official pension insurance.
In the future, patients are entitled to comprehensive care advice for individuals insured individual counseling, support and guidance, tailored to individual needs.
Right to unpaid leave
Treatment reform is a claim for unpaid exemption but is socially insured. As already stated, this means for members that an opportunity should be offered to receive six months of unpaid leave from work with the right to return to work for an employee in a company with more than 15 employees. In addition, the employee is entitled to temporary leave, not paid up to 10 business days given to arrange the care of a relative, requiring unexpected care. During this period workers are insured again.
Improving the quality of homes
To ensure widespread quality assurance in elderly care centers, they are given a one-fold bonus of EUR1536 if a caretaker reaches a better level of care because of good care. To prevent misuse, a more favorable classification should remain at least six months. It also stipulates that health care insurance pays a settlement amount of EUR3,072 if rehabilitation can be given on time. Thus, the transition from hospital care to rehabilitation and maintenance work should be smooth. To ensure the quality of the institution, expert standards bodies should be established.
Prior to testing once a year, all agencies are reviewed beforehand. These tests are generally not announced. The insured will be able to obtain a better estimate on the basis of published reports for each institution.
Care and additional training for volunteers
To support the population, health insurance is allowed to communicate private care insurance.
The care reforms provide support from citizens who dedicate themselves in their spare time to care. They will be promoted, for example, by earning training fees. They can participate in support groups or child care.
See also
- Health in Germany
References
Source of the article : Wikipedia
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