Combining in-kind care benefits and cash care benefits: How to use the combined benefit

Caring for a relative presents many families with organizational and financial challenges. Many affected individuals are unaware that they don’t have to choose between care allowance and in-kind care benefits – both can be combined. This so-called combined benefit makes it possible to access professional support from outpatient care services while simultaneously relieving the financial burden on family caregivers.

This combined benefit is aimed at people requiring care with a recognized care level of 2 to 5 who are cared for at home. It offers flexibility for families who neither want to rely exclusively on professional care nor manage entirely without external support. Especially in situations where family members are employed or where care becomes physically demanding, this combination provides a practical middle ground.

This article systematically explains how the combination of in-kind care benefits and care allowance works, what requirements must be met, and how those affected can make the best use of the available benefits. The aim is to provide family caregivers and other caregivers with clear guidance so they can make informed decisions for their individual care situations.

Basics: What are in-kind care benefits and care allowance?

Before the combined power can be used effectively, it is important to understand the two types of power that are being linked together.

Care benefits in kind: Professional support through care services

In-kind care benefits are payments from long-term care insurance that are used to pay for the services of an approved outpatient care provider. The care provider bills the long-term care insurance fund directly. The amount of in-kind care benefits is tiered according to care level and is as follows per month: Care level 2 up to €724, Care level 3 up to €1,363, Care level 4 up to €1,693, and Care level 5 up to €2,095.

Care allowance: Financial recognition for home care

Care allowance is paid when family members, friends, or other non-professional individuals provide care. It serves as financial recognition for the care provided and can be used freely. The monthly amounts are: care level 2 up to €316, care level 3 up to €545, care level 4 up to €728, and care level 5 up to €901.

Voting rights and flexibility

Those requiring care can generally choose whether they wish to receive only care allowance, only in-kind care benefits, or a combination of both. This right to choose allows for flexible adaptation to their individual life situation and actual care needs.

The combined power as a third option

The combined benefit represents an independent form of benefit in which both entitlements exist proportionally alongside each other. It is particularly useful when neither pure family care nor full care by a professional care service meets individual needs.

How it works: How is the combined power calculated?

The calculation of the combined benefit follows a clear mathematical principle based on the ratio of the care benefits in kind used.

Understanding the percentage principle

The amount of care allowance paid out depends on what percentage of the available care benefits are actually used. For example, if 40 percent of the care benefits are used, 60 percent of the care allowance remains. The long-term care insurance fund calculates this automatically based on the monthly invoices from the care service.

Practical calculation example

With care level 3, €1,363 per month is available for in-kind care benefits and €545 in care allowance. If a family uses in-kind care benefits worth €680, this corresponds to approximately 50 percent of the in-kind benefit budget. Consequently, 50 percent of the care allowance is also paid out, i.e., €272.50. The family thus receives professional support worth €680 and an additional €272.50 in care allowance.

Monthly adjustment possible

The allocation between in-kind care benefits and cash benefits can change from month to month, depending on the intensity of care service use. A fixed advance agreement is not necessary – the long-term care insurance fund automatically adjusts the cash benefit payment to the actual in-kind benefits billed.

No disadvantages if not fully utilized.

If the full amount of care benefits is not used in a given month, the unused portion is forfeited. However, this does not affect the entitlement in the following month. Each month is considered and billed separately.

Requirements and application process: What needs to be considered?

In order to use the combined service, certain formal and content-related requirements must be met.

A recognized care level is a basic requirement.

The combined benefit is only available to individuals with a recognized care level of 2 to 5. Those with care level 1 are not entitled to care allowance or in-kind care benefits in the regular sense, but only to the relief allowance. The care level is determined by the Medical Service after an application has been submitted to the long-term care insurance fund.

Home care situation required

The combined benefit is tied to home-based care. This means that the person requiring care lives in their own home, with relatives, or in a shared living arrangement. In the case of full-time residential care in a nursing home, the entitlement to care allowance and in-kind care benefits in this form does not apply.

Commissioning an approved care service

To receive in-kind long-term care benefits, you must engage an outpatient care service that has a service agreement with the long-term care insurance funds. Only these approved services can bill the long-term care insurance fund directly for their services. Private caregivers without the appropriate approval cannot be financed through in-kind long-term care benefits.

Application and notification to the long-term care insurance fund

The combined benefit does not need to be applied for separately if a care level has already been assigned. It is sufficient to inform the long-term care insurance provider that a care service has been commissioned. The provider will then automatically switch from pure care allowance to the combined benefit. An informal notification or the first invoice from the care service is usually sufficient.

Optimal use: Strategies for maximum support

The combined service offers scope for design that can be used in a targeted manner to improve the care situation.

Plan task allocation according to needs

A sensible division of labor is based on the actual needs and abilities of everyone involved. Physically demanding tasks such as personal hygiene, mobilization, or medical treatment can be delegated to professional care services, while family members can focus on support, companionship, and household assistance.

Schedule relief at fixed times.

Regular visits from the home care service create reliable respite for family caregivers. Fixed times in the morning for basic care or in the evening for overnight care are particularly helpful. This structure allows family members to fulfill their professional obligations or schedule their own rest periods.

Include additional services

In addition to the combined benefits, further support services are available and can be used concurrently. The monthly relief allowance of €125 can be used for additional care and relief services. Respite care and short-term care also remain available as separate benefits and can supplement home care.

Regular review of the allocation

Care needs often change over time. Regularly reviewing whether the chosen allocation of care is still appropriate helps to adjust the care plan. If care needs increase, the proportion of in-kind care benefits can be increased; if the care level stabilizes or improves, more cash benefits can be claimed.

Avoid common mistakes: What should you pay attention to?

Misunderstandings can arise when using the combined service, which can be avoided through clear information.

Don’t overestimate automatic calculations.

Although the long-term care insurance fund calculates the allocation automatically, those affected should keep a close eye on the invoices from the care service. This is the only way to understand how much care allowance is still available and whether the services were provided as agreed.

Do not misunderstand care allowance as freely disposable income.

The care allowance is intended as recognition for home care and should benefit the caregivers. There is no legal obligation to pass it on, but this is in keeping with the purpose of the benefit. Transparent communication within the family about how the money is used prevents conflicts.

Use the advisory services

Long-term care insurance providers are obligated to offer consultations. Those receiving long-term care benefits and classified as needing care at levels 2 and 3 must provide proof of a consultation visit every six months, while those at levels 4 and 5 must provide proof of a visit every three months. These consultations serve to ensure quality and offer an opportunity to clarify questions regarding combined benefits.

Please notify us of any changes between service types in a timely manner.

If someone wishes to switch from pure care allowance to combined benefits, or vice versa, they should inform their long-term care insurance provider promptly. Retroactive changes are generally not possible, so early notification is important to avoid financial disadvantages.

conclusion

The combination of in-kind care benefits and care allowance offers a flexible and needs-based solution for many home care situations. It makes it possible to deploy professional support precisely where it is most needed, while at the same time financially recognizing the contribution of family caregivers.

The decision to opt for a combination of services should be based on a realistic assessment of one’s own capabilities and limitations. Neither overburdening family members nor unnecessarily hesitating to seek professional help serves the well-being of the person requiring care. An open discussion of the actual care needs and available resources forms the basis for sustainable care.

The monthly flexibility of the combined benefit allows for adjustments to be made in response to changes. This is particularly valuable in cases of fluctuating health or altered family circumstances. Those affected should actively utilize this adjustability and not cling to a previously agreed-upon allocation if it no longer suits their needs.

On another page, we delve deeper into the options for respite care and how it can be combined with other services. The application process for a care level assessment and preparation for the assessment are also covered in detail elsewhere. This information complements your understanding of the entire range of services offered by long-term care insurance.

Ultimately, the goal is to utilize available support services in such a way as to ensure dignified care and provide necessary relief for all involved – both those needing care and their caregivers. Combined services are an important tool in achieving this.

FAQs

Q1. Can the allocation between in-kind care benefits and care allowance be changed monthly? Yes, the allocation adjusts automatically to the actual in-kind care benefits used. Each month is considered individually. If the care service provides more services in a given month, the care allowance decreases accordingly, and vice versa. Active notification of changes is not required, as the long-term care insurance fund calculates the allowance based on the care service’s invoices.

Q2. Does unused budget expire with combined benefits? Unused in-kind care benefits expire at the end of the month and cannot be carried over to the following month. The care allowance is paid out proportionally only for the portion not used for in-kind benefits. There is no way to save unused amounts or access them later. Each month begins anew with the full benefit entitlement.

Q3. Can multiple care services be commissioned simultaneously? In principle, it is possible to commission several approved care services, as long as the total costs do not exceed the amount of available long-term care benefits. In practice, however, this is rarely advisable, as coordination is complex. It is important that all services bill the long-term care insurance fund directly and that the services are clearly defined to avoid double billing.

Q4. What happens if the costs of the care service exceed the benefits in kind? If the care service provides more services than are covered by the benefits in kind, the difference must be paid privately. In this case, no further care allowance will be paid, as the benefits in kind have already been fully utilized. It is advisable to have a clear agreement with the care service regarding the scope of services to avoid unexpected additional payments.

Q5. Does the right to advisory visits still exist when receiving combined benefits? Yes, as long as a portion of the care allowance is being received, there is an obligation to attend regular advisory visits. The frequency depends on the care level: every six months for care levels 2 and 3, and every three months for care levels 4 and 5. These consultations can be conducted by the contracted care service or by independent advisory centers and serve to ensure the quality of home care.

Q6. Can I switch from combined benefits back to pure care allowance? Switching back to pure care allowance is possible at any time. All that’s required is to terminate the contract with the care service. The long-term care insurance fund will then automatically switch back to the full care allowance payment. This change should be reported to the long-term care insurance fund, but usually also occurs automatically when the care service fails to submit further invoices. There is no waiting period or disqualification period.

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This article was created with the assistance of AI and is for general information purposes only. It does not replace individual advice.