© Vadymvdrobot - Depositphotos.comAn illness of the parent who generally takes care of the children often makes it necessary to arrange help for the household.
SGB V, Section 38 Domestic help
(1) The insured person is entitled to domestic help if they are unable to look after their household as a result of hospital treatment or a benefit pursuant to section 23(2), 23(4), 24, 37, 40 or 41. In addition, the household must contain a child who was not yet 12 years old at the onset of illness* or who is disabled and reliant on assistance.
(*Some health insurance providers have extended this in their terms and conditions to 14 years old.)
Insured persons can therefore be provided with domestic help if they are temporarily unable to look after their household due to:
- inpatient hospital treatment
- outpatient or inpatient Kur (health spa) treatments
- they are, for medically necessary reasons, staying in hospital with an insured person receiving inpatient treatment
- pregnancy or childbirth
Some health insurance providers’ terms and conditions also allow for payment to be made for domestic help in the event of outpatient treatment, where it would not otherwise be certain that the children would be cared for.
Note, however, that this benefit will not be paid if there is someone else living in the household who would be able to look after the household.
With the exception of domestic help during pregnancy or childbirth, insured persons aged 18 or over pay a surcharge for each day on which they benefit from domestic help. This surcharge is 10% of the daily cost, but with a minimum of € 5 and a maximum of € 10. The total amount of surcharges payable in any one calendar year is capped to 2 percent of the gross family income, and 1 percent for the chronically ill.
Benefits provided by health insurance providers are generally provided in the form of benefits in kind. This means that domestic help staff are provided by specific organisations which have a contract with the health insurance provider, and costs are taken care of directly by the health insurance provider. Insured persons can, however, with the agreement of their health insurance provider, also organise their own domestic help. However these services cannot be provided by close relatives or in-laws. Close relatives and in-laws can, however, apply for reimbursement of travel costs and, where applicable, loss of earnings.