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Salzgitter

Statutory health insurance benefits for people with disabilities in full inpatient facilities and special forms of accommodation

Description

Description

Are you a person with a disability living in a residential home or another full-time residential facility that enables you to participate in social life and supports your integration into the workforce? If so, your long-term care insurance provider will cover 15 percent of the costs under certain conditions.

However, the long-term care insurance fund pays a maximum of EUR 266.00 per month. You are responsible for the remaining costs. If your income is insufficient to cover these costs, you are eligible for benefits under the Basic Income Security for the Elderly and Persons with Reduced Earning Capacity program or for housing assistance. To receive these benefits, you must submit an application to the social assistance agency. This is typically the social services office in your place of residence.

This also applies to special living arrangements, such as a residential home or a group home for people with disabilities. In such cases,

  • the focus must be on communal living and social integration,
  • the Housing and Care Act must apply, and
  • the level of care must largely correspond to that provided in a full-time residential facility.

If you are at home with your family members on weekends or during school breaks, you are entitled to the following benefits for that time:

  • In-kind long-term care benefits: These refer to the services provided by an outpatient long-term care service. Your entitlement to in-kind long-term care benefits is reduced by the amount that the long-term care insurance fund pays that month for accommodation in the residential home or group home. For example, if you are at home for 10 days a month, the amount your long-term care insurance fund paid for the 20 days you spent in the residential care facility or boarding school will be deducted from the amount of in-kind benefits to which you are entitled each month.
  • Long-Term Care Allowance: If you receive support from family members or volunteers while at home, you may be eligible for a long-term care allowance. For each day you spend at home, you receive 1/30 of the monthly long-term care allowance. The day of arrival and the day of departure each count as a full day at home. You also receive the long-term care allowance even if you are simultaneously receiving long-term care benefits in kind. This does not reduce your long-term care allowance.

Explanations and notes