Long-term care insurance
Our services in case of care
BKK EWE's long-term care insurance benefits serve to provide financial support in the event of a need for long-term care and are provided upon application. A distinction is made between home care and full inpatient care in a care facility. In order to receive benefits from the nursing care insurance fund, a pre-insurance period of two years within the last ten years must first be fulfilled for both home and full inpatient care.
When care is needed
Persons in need of care are those who, due to illness or disability, require assistance with the "usual and regularly recurring activities of daily living" for an expected period of at least 6 months. In order to do justice to the varying severity of the need for care, it is divided into care degrees. The exact classification is made in cooperation with the Medical Service. The MD doctors visit the insured person in his or her living quarters to determine the extent of the need for care.
The five degrees of care
The prerequisite for access to care services is the existence of care degrees 1 to 5. The care degree is determined with the help of an assessment instrument based on care expertise.
- Care level 1: minor impairment of independence
- Care level 2: considerable impairment of independence
- Care level 3: severe impairment of independence
- Care level 4: most severe impairment of independence
- Care level 5: most severe impairment of independence with special requirements for nursing care
Looking for a suitable care facility?
Are you looking for an adequate care facility? Then use the BKK Care Finder.
Professional nursing advice from spectrumK
Our long-term care insurance offers all insured persons and their relatives qualified and comprehensive long-term care counseling if there is a need for individual counseling. The care consultation can take place both by telephone and in the home.
If you would like a nursing consultation, please feel free to contact the nursing hotline of our cooperation partner spectrumK.
Contact
Phone: 0800 7237267
E-mail: pflegeberatung@spectrumK.de
Care services
Outpatient care
Care level 1
Care advice
- Consultation in the patient's own home by a nursing service,
- additional benefits for persons in need of care in outpatient assisted living groups,
- Supply of nursing aids,
- financial subsidies for measures to improve the individual or shared living environment,
- additional care and activation in inpatient care facilities,
- Caregiving courses for family members and volunteer caregivers.
- In addition, the care insurance fund grants the relief amount of €131.00 per month. For care level 1, this can also be used for benefits in kind from the care service (basic care), which is not possible for other care levels.
- An allowance of € 131.00 is paid for full inpatient care.
- Caregiver security benefits are not provided for Care Level 1.
Care level 2-5
Care benefits in kind
Benefits in kind can be claimed if approved outpatient care services provide care in the home. The costs for this are settled directly by the care service with the care insurance fund.
The following amounts are available each month for billing the nursing service, depending on the level of care:
- Care level 2: up to €796.00
- Care level 3: up to € 1,363.00
- Care level 4: up to € 1859.00
- Care level 5: up to €2299.00
Care allowance
Care allowance can be claimed if the person in need of care is cared for by a private caregiver (e.g. spouse, relatives, friends,...) in the home.
Depending on the level of care, the following amounts are paid monthly:
- Care level 2: € 347.00
- Care level 3: € 599.00
- Care level 4: € 800.00
- Care level 5: €990.00
It is required that for care levels 2 and 3, a counseling session is conducted every six months by an approved outpatient care service. For care grades 4 and 5, this consultation must be carried out on a quarterly basis. We will bear the costs for this on your behalf.
Combination power
It is possible to claim benefits in kind in addition to the care allowance ("combination benefit"). In this case, a percentage of the care allowance is paid out after the outpatient care service has settled its accounts.
Partial/full inpatient care
Part day and night care
Day and night care refers to temporary accommodation during the day/night in a semi-inpatient facility. Here, the care-related expenses are covered by our long-term care insurance.
Costs for room and board must be borne by the patient, but may be reimbursed via the care and respite benefits. Day and night care can also be claimed in addition to the care allowance. The entitlement to care allowance remains unaffected.
The following amounts are available:
- Care level 2: up to €721.00
- Care level 3: up to € 1357.00
- Care level 4: up to € 1685.00
- Care level 5: up to € 2085.00
Short-term and preventive care
(Entitlement with care degree 2 to 5)
Preventive care:
If home care is temporarily not possible, the long-term care insurance fund will cover the costs of necessary replacement care. This can be provided by another person, a care service, or a care facility. There are two types of respite care:
- Daily respite care: When the caregiver is unable to provide care for a full day, for example due to illness or vacation.
- Hourly respite care: If the caregiver is prevented from providing care for less than 8 hours a day, e.g., due to doctor's appointments.
For the period of daily respite care, the last care allowance paid will be reduced by half for the duration of the respite care.
If respite care is provided by relatives up to the second degree or by persons living in the household of the person requiring care, the expenses may not exceed twice the amount of the care allowance for the respective care level. In the case of higher expenses, such as loss of earnings or travel costs, reimbursement of costs up to the maximum budget is possible.
Please note that proof of expenses must be submitted to the BKK EWE long-term care insurance fund by December 31 of the following year at the latest.
Short-term care:
If home care is not possible or cannot be provided to the extent required, and semi-inpatient care is not sufficient, the patient is entitled to full inpatient care in a suitable facility. This may be necessary, for example, after hospital treatment or in crisis situations. During short-term care, the care allowance continues to be paid, but is reduced by half.
Persons with care level 1 can have costs of short-term care reimbursed via the entitlement to respite care, provided that the budget for this is sufficient.
Important to know:
Respite care and short-term care are financed from a joint budget. This means that the amount you claim for either of these two services reduces the total available annual budget of €3,539.00. If you have already used respite care, the amount still available for short-term care is reduced—and vice versa.
- Both benefits are limited to 56 days per calendar year.
- The total annual budget of €3,539.00 applies to both types of care .
Care and relief services
Costs associated with the following services may be reimbursed as additional care and respite services:
- Day, night and short-term care (e.g. for accommodation, meals, investment costs)
- Special offers of general guidance and care or offers of domestic care from approved outpatient care services
- Low-threshold care and respite services
People in need of care can claim additional care and respite services of up to €131.00 per month.
Those who do not fully exhaust their entitlement to outpatient care benefits in kind can additionally use the amount not used for the receipt of outpatient care benefits in kind - but no more than 40% of the benefit amount earmarked for this purpose - for low-threshold care and respite services.
Neighborhood help
Some German states also allow the use of neighborhood assistance as part of these benefits. Since the regulations vary from state to state, you can find more detailed information on the websites of the ministries for social affairs, labor, health, and equality of the respective states. If you have any questions, you can also contact BKK EWE directly .
Pension and unemployment insurance obligation for caregivers
Under certain conditions, we assume the contribution payments for pension and/or unemployment insurance for the caregivers. The amount of the contributions depends on the respective care degree of the person in need of care and the weekly care hours.
Published on: February 22, 2022 - Last updated on: April 17, 2026
