Care council compass clarifies: Four common mistakes when children …

kompas private care consultancy GmbH


There are often moments of uncertainty when a child is assigned a level of care, the costs of aids are covered by the care insurance or the temporary accommodation of a child in need of care to relieve parents and siblings – because here different rules apply than for adults, people in need of care. The care council compass makes it clear.

Misconception 1: The assessment of children for classification into a level of care is based on an assessment instrument specifically designed for children

The need for childcare is determined according to the same principles as for adults. A classification in a degree of care is based – just like with adults – on how independent a child is and what they can do without help. Account is always taken of how the age-appropriate abilities would be developed in a child without functional impairments. This assessment principle applies to children of all ages.

An exception is children requiring care up to the age of 18 months. Children in this age group are by nature dependent in all areas, so they can usually receive only a low level of care or none at all. To ensure that these children still receive an appropriate level of care when needed, age-independent areas 3 and 5 from the assessment instrument, which deal with behavioral and psychological problems and managing illness-specific/therapy-related demands, will is used. In addition, the assessor assesses whether there are serious problems with food intake. This can result in an unusually high maintenance need for nutritional support. A special regulation also allows for children up to 18 months to be assigned a level of care that is higher than that determined by the assessment of the elderly. They can remain at this established level of care until they are 18 months old without further assessment.

The children are then put on an equal footing with older children and adults in the assessment of the degree of care. However, children up to the age of eleven are always assessed using comparison tables.

“From the age of eleven, a child is considered independent in all areas included in the calculation of the degree of care. From this age, the degree of care for children is determined in the same way as for adults.” explains Inga Kosboth, care advisor at Kompas Care Council.

Misconception 2: I can simply buy the necessary aids for my child and then submit them to my insurance company.

With aids, a distinction is made between care aids such as nappies and technical aids such as wheelchairs. In principle, they can only be made available if care is provided at home. If there is a need for aids, an application must first be made to the nursing fund or the insurance company for the supply of aids – regardless of whether you buy them or borrow them from, for example, a drug store. As part of the medical service’s or Medicproof’s assessment to determine care needs or during subsequent consultation visits when receiving care services, recommended aids can be documented in the report as necessary. This is then considered an application for aids, if the person in need of care or their guardian agrees to this. In addition, the aid must help facilitate care, relieve symptoms or lead to a more independent lifestyle. “The aim of the nursing funds’ and insurance companies’ supply of aids is to enable home care, to relieve the care staff physically and mentally and to be able to provide humane care,” explains Inga Kosboth. Therefore, long-term care insurance does not cover the costs of all the aids that are available. The nursing aids must appear at the end of the nursing funds’ or nursing insurance’s list of aids. “Special aids for children can be provided up to the age of 18,” explains Inga Kosboth.

Misconception 3: Diapers as aids: Diaper supply for my child is covered by long-term care insurance

Expenses for consumables are covered by the cost bearer up to a maximum of 40 euros per month. This includes diapers. But since healthy newborns also need diapers for a certain period, it can only be assumed that after a certain age, children in need of care will have an additional medical need. According to the majority opinion in private long-term care insurances, the age limit is 4 years. Until then, an existing incontinence does not represent a pathological finding. Expenses for diapers can therefore only be reimbursed at the expense of the long-term care insurance from the age of 4. There is, however, the possibility of reimbursement before this age limit, if the expert has assessed that the additional need for care is necessary. In this case, in contrast to the presented basic assumption, the incontinence represents a pathological finding, which is different in the case of statutory insurance. Here the expenses for nappies are usually taken over from the age of 3 and are a benefit that the health insurance provides instead of nursing insurance.

Misconception 4: A hospice only accepts children in the last phase of life

Inpatient hospices are facilities that take care of the care of people with terminal illnesses in the final stages of life. However, in contrast to hospices for adults, children’s hospices can also accept children in need of care who do not meet the requirements for admission to hospice. “Hospices are therefore suitable care facilities that can provide services such as short-term care, relief and 24-hour treatment, and for whose reimbursement these corresponding care insurance services can be provided,” explains care consultant Inga Kosboth. This means that families with a child in need of care can temporarily use accommodation in a children’s hospice to bridge the gap or to relieve themselves. Contact your care advisor if you need help finding a suitable hospice in your area.

More info:

The care service portal, for example, offers more information about the need for childcare.


compass private pflegeberatung GmbH advises those in need of care and their relatives via telephone, video call and, if desired, also at home in accordance with the statutory right of all insured persons to free and neutral care advice (§ 7a SGB XI and § 37 section 3 SGB XI). Telephone counseling is available to all insured persons, face-to-face counseling and counseling via video call is reserved for privately insured persons.

As an independent subsidiary of the private health insurance association, Compass operates nationwide with around 600 care advisors. The Kompas care advisors advise on all questions regarding care during telephone campaigns and during normal service hours.

Press contact:

kompas private care consultancy GmbH
Department for Policy and Communication
Mareike Schiffels
Telephone: 0221 93332 -111

Original content from: compass private pflegegeberatung GmbH, transmitted by news aktuell

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