Home nursing care
Service description
Insured persons are entitled to home nursing care, which basically includes treatment care, basic care and domestic care. The service is prescribed by a doctor and must be authorised by your health insurance provider. Provided that there is no other person living in the household who can take over the care. Which services are covered depends on the individual clinical picture:
If home nursing care ensures the success of medical treatment, the costs for treatment care are covered as long as this is medically necessary (backup care). Your health insurance fund may also provide for basic care and domestic care to be covered in your policy.
If hospitalisation can be replaced, avoided or shortened with home nursing care, the costs of treatment care and, if necessary, additional basic care and domestic care are covered (hospital avoidance care).
Anyone who is dependent on support due to serious illness or acute exacerbation of an illness, particularly after hospitalisation, outpatient surgery or outpatient hospital treatment, receives so-called support care (basic care and domestic care).
In the case of hospital avoidance and supportive care, costs are generally covered for up to four weeks, depending on the illness. An extension for medical reasons is possible. Both benefits also include outpatient palliative care.
Procedure
Home nursing care must be prescribed by a doctor. Please enquire with your treating contract doctor or your statutory health insurance provider.
Prerequisites
- Care is provided in your household, in your family or in another suitable place, in particular in assisted living facilities, schools and nurseries, and also in workshops for disabled people if the need for care is particularly high.
- There must be no person living in your household who can care for and look after the patient to the extent required
- The service has been prescribed by your doctor and authorised by your health insurance company.
Which documents are required?
You need a doctor's prescription.
What fees are incurred?
If you are at least 18 years old and are not exempt from statutory co-payments, you pay a co-payment of 10 euros per prescription and 10 per cent of the costs for the first 28 days of treatment per calendar year.
Legal basis
Legal remedy
If the health insurance company refuses the benefit, an objection can be lodged. If the objection is not upheld, you can appeal to the social court.
Applications / Forms
A prescription from a doctor is required.
Special information for the city of Rodgau