Nursing Reform: Why You Shouldn't Postpone Your Nursing Grade Application
Do you foresee needing care in the foreseeable future? Or does your current care level seem too low to you? Then you should take action now. The care reform provides for higher hurdles from 2027. What this means in concrete terms.
The Pflegeneuordnungsgesetz, or Care Reform Law, is set to come into effect, bringing with it more stringent requirements for care grades 1 through 3. Barbara Bückmann, an expert from "Stiftung Warentest Finanzen," advises individuals considering their first or increased care request to file it before the end of the year. This is due to the fact that claims submitted until December 31, 2026, will be evaluated under the current, more favorable criteria.
A care grade is a prerequisite for accessing benefits from the care insurance fund, such as coverage for home care services or relief budgets for caregivers. Changes to care grades 1 through 3 Starting in 2027, certain care grades will require higher point scores to be granted. Specifically, care grade 1 will now require 15 points (up from 12.5), care grade 2 will require 30 points (up from 27), and care grade 3 will require 50 points (up from 47).
Those concerned about losing their current care grade have no need to worry. The Federal Ministry of Health assures that individuals already assigned a care grade will have protection against retroactive changes. Process for filing a care grade request To file a care grade request, one must contact their respective care insurance provider, which is linked to the health insurance company they are insured with (either statutory or private).
An initial assessment can be made using a calculator provided by consumer centers. The first step is to submit a simple form, which can be done online, by mail, or by phone. The next step is the care assessment. For insured individuals, the Medical Service (MD) will contact them to schedule an appointment, while for privately insured individuals, they will receive a MedicProof appointment.
The assessment typically takes place two to three weeks after the application has been submitted. It is advised to bring doctor's reports, medication plans, a list of assistive devices, and notes on daily routine to the appointment. If available, a trusted person can also accompany the individual. After the assessment, the care insurance provider will either approve or deny the request.
The consumer center states that the decision must be made within 25 working days of the application being submitted. If the care grade is denied or is lower than expected, one can appeal the decision within one month of receiving the decision notice. A free sample letter for appealing is provided by the consumer center, though it is not mandatory to provide a reason, doing so may increase the chances of success. The Stiftung Warentest notes that nearly one third of appeals are successful.
Written by urgent.news from Handelsblatt's reporting — not their text. Machine-written — may contain errors; check the original before relying on it.
