Applying for a care level in 6 steps

1. Submit your application to the long-term care insurance fund

The first step is an informal application to the long-term care insurance fund, which is part of your health insurer. A phone call or a short letter is enough at first – what matters is the date, because the start of your benefits depends, among other things, on when you apply and since when the conditions have been met. Ask for confirmation that your application was received.

2. Fill in the application form

The fund will send you the documents. Take your time and describe the help you need honestly and completely. Understating it is the most common mistake here.

3. Keep a care diary

Over one to two weeks, write down what you need support with and how often. These voluntary notes – your care diary (Pflegetagebuch) – help you describe specific everyday situations.

4. Prepare for the assessment

The Medical Service (MD, Medizinischer Dienst) or Medicproof will come for an appointment. Prepare well: everyone involved should be present, and your daily life should be shown realistically – not made to look better than it is.

5. Check the decision notice

After the assessment you will receive the decision notice. Check it carefully: does the care level match the help you actually need?

6. Objection – if necessary

If you think the decision notice is wrong, check the information on how to appeal that comes with it (Rechtsbehelfsbelehrung) and the applicable deadline. Have the decision notice checked legally, for example by a social welfare association (Sozialverband) or a lawyer specialising in social law. I am happy to go through the assessment report (Gutachten) with you and help you prepare an objection (Widerspruch).

Tip: Getting advice even before you apply will spare you many detours. I will gladly prepare you specifically for each step.

Before you call: have three things ready

Have your insurance number, your contact details and a short description of the situation to hand. If you are acting on behalf of someone else, first check that you are authorised to do so. After the call, note down the date, the person you spoke to and the next step you agreed. Ask for confirmation that your application was received.

Describe everyday life in concrete terms

Instead of “Things are not going so well any more”, an example helps: getting dressed needs guidance, getting up needs a helping hand, or help is needed repeatedly at night. Write down what works independently and what you need help with. Days when things vary belong in the picture too. A short collection of such observations helps more than a long list of diagnoses alone.

Keep planning after the decision notice

File the decision notice and the assessment report together. Mark anything that is unclear and compare it with your everyday examples. Check the information on how to appeal in the notice and get qualified support early if you have legal questions. After that, it is about practical care: who takes on which help, which providers are an option and what still needs to be applied for?