Consultation visit under § 37 (3) SGB XI: duty, frequency, who advises

What is the consultation visit about?

The consultation visit under § 37 (3) SGB XI applies to people in need of care who are looked after at home and receive care allowance. It safeguards the quality of home care and gives practical, professional nursing support to those providing the care. The first consultation always takes place in the person’s own home.

How often is it due?

• Care level (Pflegegrad) 2 to 5 with care allowance: mandatory once every half-year.
• Care levels 4 and 5: a consultation can voluntarily take place once per quarter.
• Care level 1: an entitlement every half-year, which can be taken up voluntarily.

On request, every second consultation can take place by video conference. This rule is temporary and applies until 31 March 2027. As of October 2026.

Who may carry out the consultation visit?

• approved care services,
• advice centres recognised by the state associations of the long-term care insurance funds (Pflegekassen) that can demonstrate nursing expertise,
• care advisers under § 7a as well as municipal advisers with nursing expertise,
• only if these bodies cannot provide the consultation locally: a care professional commissioned by the long-term care insurance fund.

Advice from people without approval or recognition is therefore generally not accepted as valid proof by the long-term care insurance fund. Before the appointment, ask whether the advice centre is approved.

How does the visit work?

The care professional gets a picture of the care situation, answers your questions, gives practical advice on care, aids and relief services and, where needed, points you to care support centres (Pflegestützpunkte), care courses or further advice. The fact that the visit took place is confirmed to the long-term care insurance fund. You receive the findings; with your consent they also go to the fund.

What does the consultation visit cost?

Insured people generally pay nothing for a visit by an approved body; the body bills the long-term care insurance fund.

What happens if I do not take up a consultation visit?

The long-term care insurance fund reduces the care allowance appropriately. If it happens repeatedly, it can withdraw it. So plan the appointment early.

How to prepare

1. Collect your questions – including ones that seem small.
2. Have your care level decision notice (Bescheid), medication plan and care records ready.
3. Note where things are difficult in daily life: nights, aids, the home environment, your own strain.
4. Check which relief services you already use.

I do not carry out consultation visits myself, but I am happy to prepare you for them and to go through the recommendations with you afterwards.

Organise the appointment and the proof together

Ask your long-term care insurance fund which period you need to provide proof for. Arrange the appointment with an authorised body in good time and clarify who submits the proof. Enter the next period straight into your calendar. If an appointment is cancelled, contact the provider and the long-term care insurance fund promptly instead of simply letting the deadline pass.

Use the visit for your own questions

The appointment leaves room for whatever weighs on you in daily care. Is it hard to move or transfer the person you care for? Are you unsure about aids? Do relatives lack time to recover? Collect two or three concrete situations. That lets the professional advise you specifically. Existing solutions that work well should be mentioned too.

Turn recommendations into next steps

After the visit, go through what was recommended. Which measure do you want, who will take care of it, and when do you want to check progress? Ask if the wording is unclear. A recommendation is not yet arranged help: for an application, the search for a provider or a follow-up appointment, it should be clear who is responsible.