Care in the home: Co-payments are increasing significantly

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Residents and carers in a home in Baden-Württemberg: Regional differences in co-payments

Photo: Bernd Weissbrod / dpa

For those in need of care, co-payments for care in the home have increased further.

As of January 1st, a nationwide average of 2179 euros per month was due out of pocket, according to new data from the Association of Substitute Health Insurance Funds.

That was 111 euros more than at the beginning of 2021.

However, there are still major regional differences: the most expensive places are in North Rhine-Westphalia with an average of 2542 euros and in Baden-Württemberg with 2541 euros. It costs the least in Saxony-Anhalt at 1588 euros. At the beginning of the year, however, the first relief measures initiated by the old federal government will also take effect. Demands for further steps are getting louder.

On the one hand, the sums include the personal contribution for pure care and support.

Unlike health insurance, long-term care insurance only pays part of the costs.

For residents of the home, however, there are also costs for accommodation, meals and also for investments in the facilities.

The personal contribution alone for pure care has now risen to 912 euros on average nationwide, after it had been 831 euros on January 1, 2021.

But it is not only the co-payments for pure care that have increased.

As of January 1, 801 euros per month were due for board and lodging on average nationwide – after EUR 779 at the beginning of 2021. The average additional payment for investment costs in the homes was EUR 466, compared to EUR 458 on January 1, 2021.

To protect against heavier burdens, new regulations of a care reform came into force at the beginning of the year. In addition to the payments from the care insurance fund, residents of the home now receive a surcharge that increases with the length of care. The personal contribution for pure care should fall by five percent in the first year in the home, by 25 percent in the second, by 45 percent in the third and by 70 percent from the fourth year.

It is already evident that the changes that have just come into force would hardly do anything for the 820,000 residents, said the board member of the German Foundation for Patient Protection, Eugen Brysch. Increases must also be expected in the future, and subsidies of five percent in the first year in the home cannot cover the additional burden. Therefore, the care share must be taken over completely in the future. "Everyone should pay for their own accommodation, food and above-average comfort," says Brysch.

The Confederation of German Trade Unions (DGB) called for "a genuine care reform," which is now up to the new government. “Long-term care insurance must finally be expanded to include full insurance in order to finally put an end to the poverty trap in long-term care,” said board member Anja Piel. Linke boss Susanne Hennig-Wellsow said that "the cost spiral of ever-increasing own shares" must be capped immediately. And in the medium term, a fundamental change of lane is needed for dignified aging with the conversion to full nursing care insurance that covers all nursing services.

The honorary chairman of the Association of Substitute Funds (vdek), Uwe Klemens, said that rising wages and better staffing were right and important. “But they eat up the relief in the care-related personal contributions again.” A study by the University of Bremen came to the conclusion that these could be neutralized by cost increases from 2023. Around ten percent of those in need of care are currently dependent on “help for care” services, and that is too many.

The reform decided by the grand coalition also aims at better wages for urgently needed nursing staff.

From September 1st, there may only be supply contracts with institutions that pay according to collective agreements or at a similar level.

According to the Ministry of Labour, in geriatric care with around 1.2 million employees, only just under half receive standard wages.

For financing, the care contribution for people aged 23 and over without children rose from 3.3 to 3.4 percent on January 1st.

In addition, the federal government now gives one billion euros a year as a subsidy to long-term care insurance.

fdi/dpa