The Long-term care insurance in Germany

The Federal Ministry of Health and the Long-Term Care Directorate (LTC)

In the field of long-term care, the Federal Ministry of Health is responsible for the legislative process: the drawing up and monitoring of bills of law and draft ordinances. In the case of long-term care, the initiative for bills of law is the almost exclusive prerogative of the Executive – in this case, of the Federal Ministry of Health. The latter monitors the implementation of the Long-Term Care Act with the aim of ensuring its efficient implementation and, to this end, exerts its influence on the federal Laender and the competent associations and organisations in the field. This is eminently important in the wake of major reforms. Furthermore, the Federal Ministry of Health monitors the financing of the Long-Term Care Fund, in particular the compensation fund, and is responsible for the corresponding statistics.

In order to further the development of service provision, the Federal Ministry of Health has pilot projects and research projects conducted, by issuing invitations for research bids. In the past, these have included the development of construction projects in the area of geriatric care, whereas nowadays the projects affect, to a greater extent, care provision structures, care quality issues and the promotion inter alia of new group homes for the elderly. Surveys are also conducted at regular intervals. Within the framework of German reunification, a major programme was set up and implemented to secure financial assistance for investment in long-term care facilities in the new Federal Laender. This programme is still underway today.

The concrete supervision of the Act's implementation by the long-term care funds is the responsibility of the Federal Laender and the Federal Insurance Office, which is under the legal supervision of the Federal Ministry of Health in this area.

The LTC funds

The long-term care insurance funds – as insurance companies under public law – offer their services on a statutory basis and therefore must ensure appropriate long-term care for insured persons in the form of statutory benefits and services. As these funds do not maintain their own facilities, nor supply benefits and services themselves, they conclude inter alia delivery-of-care and remuneration contracts with individual carers, with the institutions managing nursing homes or those providing out-patient care services. Every care facility, which fulfils the requirements, is legally entitled to be allowed to provide care services. As a result, facilities under municipal, non-profit or private ownership co-operate alongside each other.

The Laender

The Laender are responsible for providing efficient long-term care structures and for financing investment in the long-term care facilities; the ongoing operating and nursing care costs are to be paid by the persons in need of long-term care or their financing institutions.

Local Community Level

The local communitiy level is responsible for all social security issues connected with long term care. Furthermore it can provide additional support for citizens in need of long term care, i.e. special housing, social and/or cultural actvities for seniors, public transportation, nursing homes, etc.