Care allowance for children with type 1 diabetes - diabetes guide

Reading this article can bring you cash: Because children with type 1 diabetes have received easier care allowance since 2017. To do this: Apply for the degree of care correctly

Phil (8) has type 1 diabetes. His parents (pictured mother Claudia D.) applied for a degree of care for him – with success

The life of family D. is timed. Phil (8) has type 1 diabetes. His blood sugar needs to be monitored around the clock. Phil’s parents, Claudia and Ingo D., measure the values several times a day and at night. And with every meal they deliver insulin via the pump, which is adjusted to the carbohydrate amount in Phil’s portion.

Every few days, Claudia D. puts new insulin in the pump that Phil has on her stomach and puts a new catheter through which the vital hormone flows into Phil’s body.

More work with diabetes

Claudia D. has a lot of work due to Phils Diabetes – much more than mothers with healthy children. That is why her son has been in nursing care level 2 for a few months and is receiving care allowance.

Since 2017, the chances have been good for a child with diabetes to be cared for to get. "Chronically ill children and their families need our support", says Federal Minister of Health Jens Spahn. "That is why we have significantly improved the access of children with diabetes to statutory long-term care insurance benefits with the care reform."

Dr. Andrea Kimmel, health scientist in the nursing team of the medical service of the central association of health insurance companies in Essen, explains: "Parents of children in need of care with type 1 diabetes have been benefiting from the new type of assessment since 2017." Before 2017, long-term care funds only considered help with personal hygiene and nutrition, support for therapy can now also be counted: for example, injecting insulin, carbohydrates to calculate or accompanying the doctor.

Twice as many receive money

This is also reflected in the numbers of the medical services of the health insurance (MDK): While the MDK 2016 classified only ten percent of the children under twelve with type 1 diabetes who were assessed for the first time as needing care, compared with around 80 percent last year. However, he only recommended grade 1 in 60 percent of the cases; there was therefore no entitlement to care allowance or benefits in kind. Nevertheless, the number of those receiving care allowance or benefits in kind – this is the case from care level 2 – has increased from ten percent in 2016 to around 20 percent in 2017.

MDK visit was successful

If the D. family received a rejection in 2016, the application to the long-term care insurance fund was successful at the beginning of this year: After five weeks of waiting, an expert from the MDK came. He looked at what Phil needs his parents to do to help him cope well with his illness. Using the blood sugar diary, Claudia D. was able to make it clear that Phil’s values fluctuate considerably and close monitoring is necessary.

A few days after the appointment, the notice from the nursing care fund arrived: "We got nursing care level 2 straight away, even slipped past grade 3 because Phil has other health problems besides diabetes, like a crooked spine, which we have to take care of", says Claudia D.

Financial and professional support

For family D., the level of care 2 means financial and professional support. Phil receives care allowance of EUR 316 per month. And not only that: Parents whose child has at least grade 2 are also reimbursed for replacement and short-term care – for 1612 euros each per year. Replacement care can be provided by a nursing service or a private helper if the caregiver is prevented. If you do not take short-term care, you can convert half of it, i.e. 806 euros, into replacement care.

All those in need of care – including children with care level 1 who do not receive care allowance – are entitled to a relief amount of EUR 125 per month, which the care insurance companies do not pay. This service can be used for household help or a caregiver. However, this must be done through a recognized service provider. Information on this is available from a nursing center near you (addresses on the Internet at bdb.zqp.de).

Good chances of a level of care

In 2017, the parents of around 800 children with type 1 diabetes applied for a degree of care, but several thousand fall ill each year. "The word has not yet got around that children with type 1 diabetes have a good chance of being cared for", says Professor Dr. Andreas Neu, pediatric diabetologist at the University Hospital Tübingen. "This positive trend should also be reported in diabetes centers."

Phil only gets the help for two years. Then the MDK reviews again.