Household assistance with the statutory health insurance; application

If you are temporarily unable to manage your household on your own due to serious illness, a cure or during a hospital stay, you can apply for household assistance from your statutory health insurance fund under certain conditions.

Description

Prerequisites

You must meet the following requirements if you apply for household assistance during a hospital stay, a preventive medical treatment for mothers or fathers, or
due to medical rehabilitation:

  • You have statutory health insurance.
  • You have received a medical certificate confirming the necessity and duration of the household help.
  • There is a child living in your household who is
    • is younger than 12 years of age at the start of the home help, or
    • is disabled and dependent on help.
  • There is no other person living in your household who could continue it.

You must meet the following requirements if you apply for household help for 4 weeks due to a serious illness, after a hospital stay or
after an operation:

  • You have statutory health insurance.
  • You are not in need of care with care degree 2, 3, 4 or 5 (note: in this case, however, household help for the care of the child may be eligible).
  • You have received a medical certificate confirming the necessity and duration of household help.
  • There is no other person living in the household to continue it.
  • Entitlement is extended to up to 26 weeks if.
    • there is a child living in your household who
      • is younger than 12 years of age at the start of the household help, or
      • is disabled and dependent on assistance.

Procedure

You can submit the application for household assistance by mail and - for many statutory health insurance funds - in person at the office or online.

  • Fill out the application form of your statutory health insurance and submit it to your health insurance together with the medical certificate on the necessity and duration of the household help.
  • Your health insurance fund will check your entitlement to household help and advise you on suitable providers. Alternatively, you can select a home help yourself, provided that the home help is a contractual partner of your health insurance company.
  • You commission the household help.

Deadlines

You must apply for domestic help from your health insurance fund before you claim the benefit. If you have independently commissioned domestic help without the consent of your health insurance fund, the costs can only be reimbursed in exceptional cases.

Processing time

Processing normally takes about 1 to 15 working days.
For rapid processing and decision-making, your health insurance fund must be provided with the necessary information and any required documents in a complete and meaningful manner.
The health insurance company decides on applications promptly, adhering to the statutory processing time limit in order to protect patients' rights.
Please note that the processing time indicated is an average value for all health insurance funds. It may vary in individual cases.
The exact processing time also depends on the complexity of the individual case and may be longer accordingly. The same applies if documents or records are sent to you or your health insurer by mail.
If necessary, the Medical Service must be involved. This will take up to an additional 5 weeks to process your request.

Required documents

  • Required Documents

    • ärztliche Bescheinigung über die Notwendigkeit und Dauer einer Haushaltshilfe

Forms

Fees

  • The home help usually settles the costs directly with your health insurance. For each day of home help, you make a co-payment if you are over 18 years old. The co-payment is 10 percent of the costs, but at least EUR 5.00 and at most EUR 10.00 per day.

    The statutory co-payment does not apply if

    • you need the home help because of pregnancy or childbirth.
    • you are exempt from the statutory co-payment obligation.

Remedy

  • Objection
  • Action before the Social Court

Status:30.09.2022

Responsible for editing:Bundesministerium für Gesundheit

Contains machine translated content. Show the original content

  • Online transactions, Bavaria-wide
  • Online transactions, locally limited
  • Form, Bavaria-wide
  • Form, locally limited
  • Prefillable Form, Bavaria-wide
  • Legal bases, Bavaria-wide
  • Legal bases, locally limited
  • Fees, Bavaria-wide
  • Fees, locally limited
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