Mandatory Long-Term Care insurance - German:Pflegepflichtversicherung - is an independent part of every German health plan, and sits besides medical insurance.
The intention of the German government in 1995 was to introduce an insurance, compulsory to all German long-term residents, that will provide financial provision in the event that nursing becomes necessary.
Implemented in the German Social Security Book XI, the scope of cover is clearly defined for both the statutory (public) and private insurers to comply with and level of care is based on a 5-grade care system, of which the benefits overall comprise of:
- Home care
- Nursing allowance
- Day-patient care
- In-patient care
- Short-term nursing
- Financial relief for relatives
- Prevention care
- Nursing aids
- Housing reconstruction measures
- Housing groups
To receive Long-Term Care benefits in general, the insured person must have paid into a statutory or private plan for at least 2 full years within the last 10 years, hence there is a 2-year deferred period one needs to bear in mind. Yet once latter is overcome, it is possible to leave Germany, return with 7 years and 11 months and claim for benefits.
Residing in Germany on a provisional permit (VISA), the Residence Act exempts those from the obligation to insure themselves against long-term care events for the first 60 months of their stay. Although the German Residence Act §2(3) states that the livelihood of a foreigner is secured if adequate health insurance can be paid for without recourse to public funds, hence one would assume this includes Long-Term Care insurance (LTC), looker closer into legislation poves this assumption to be wrong.
The term ‘Health Insurance’ in Germany is defined by inter alila the inclusion of both medical and long-term care insurances, however latter is in fact exempted as its purpose is to secure exceptional safeguarding reasons, see German Residence Act §68 (1,1). Therefore it is in principle generally not part of the means to secure ones livelihood under residence law.
There are circumstances of individual cases in which the Foreigners’ Office can make LTC a requirement, but these are on a discretionary basis and only ever implemented when e.g. the person is already in need of special care.
A circular from the ‘Ministry of Internal Affairs and Municipal Issues’ confirms the above (link).
Long-Term Care becomes mandatory to all those who are no longer classed as short-term German residents - after the initial 60 months of residency – consequently should their permit not be extended, they must initiate the application for long-term residency and until approved, are classed as “tolerated” in Germany. To receive approval one part of the requirements is fully substitutive health insurance and this is when people need to find a German health insurance solution.
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