"(1) Upon application by the entitled persons, services for participation are provided in the form of a Personal Budget, in order to enable the entitled persons to lead as self-determined a life as possible under their own responsibility. [...] Budget-eligible services also include the [...] necessary services provided by health insurance funds and long-term care insurance funds, services of accident insurance providers in cases of need for long-term care, services of social compensation authorities for medical treatment, long-term care, and the continuation of household activities, services of the military compensation authority for medical care and long-term care, as well as assistance for care provided by social welfare authorities, insofar as they relate to everyday and regularly recurring needs and may be provided either as monetary benefits or in the form of vouchers. [...]"
Your Legal Entitlement
As a person with a disability (for example, with care level 5 or care level 4), you are legally entitled under Section 29 of Social Code Book IX (SGB IX) to receive monetary benefits instead of in-kind services from the relevant authorities. This includes not only medical care but also services to ensure social participation. The responsible authorities may include health insurance funds, long-term care insurance funds, accident insurance providers, social compensation authorities, and even the military compensation authority.
With Section 29 SGB IX, the legislator explicitly gives you, as a person with high care needs or a disability, the opportunity to lead a self-determined life.
You therefore have a legal entitlement. You are not a petitioner!
Because this legal foundation exists, you have the right to take legal action if your application for a Personal Budget is rejected by an authority.
Everything clear so far,
but how am I supposed to manage all this?
The Personal Budget is a unique way to receive care in familiar surroundings while still leading a self-determined life. In practice, however, your personal situation often demands so much of your attention that the truly important aspects of life take centre stage, leaving you neither the energy nor the time to navigate the sometimes complex path to a Personal Budget on your own.
The good news is:
You are not alone. We handle everything for you – from submitting applications, communicating with the authorities, calculating and accounting the budget, recruiting care staff, creating work schedules, payroll, in fact everything necessary to ensure that you receive adequate care at home.
Personal Budget – what makes it unique?
Once your Personal Budget has been approved, it usually means that you, as a person with high care needs or a disability, become an employer. You directly employ the carers who will care for you or your relative. The carers may either be employed on a social insurance basis or work as freelancers. Their wages or fees are financed by the relevant authority – for example, a health insurance fund – within the framework of your approved Personal Budget. In plain terms: the authority pays the carers just as it would fund a care service.
Even if this sounds unusual: for children or legally incapacitated persons, who must of course be represented by an authorised person, the same rules apply.
The unique aspect of the Personal Budget is that you personally assemble your care team. You choose the people who will care for you day and night. In practice, this usually creates small, highly efficient, and well-coordinated care teams that know your needs and preferences intimately. In most cases, a strong bond of trust develops between you and your care team. This greatly reduces the risk of carers being unavailable.
If you ever need inpatient treatment, want to take a long-awaited holiday, attend a rehabilitation programme, or simply go to the cinema, theatre, or out for a nice meal – a member of your care team will accompany you. This supports you and relieves your relatives. You and your family can focus on what truly matters: your life.
As you can see: with a strong care team by your side, you can lead a self-determined life.
The First Steps to Your Personal Budget
First, an application for a Personal Budget must be submitted to the relevant authority.
You can do this yourself as the person concerned, or an authorised representative can submit it on your behalf.
Before that, however, it must be clarified to whom the application should be addressed. The often difficult question is: who is responsible?
In some cases, multiple authorities may be involved.
The second step is the assessment of needs. The goal is to determine exactly how much and what type of care you require. The authority reviews the documents submitted, such as medical reports. Occasionally, an assessor may be called in to determine your care needs.
Finally, as the budget holder, you must conclude an agreement with the authority, for example, your health insurance fund. This agreement sets out the approved monetary benefits (instead of in-kind services) and the amount of your monthly and annual Personal Budget, as well as the procedures for documenting the care received.
Once you have successfully completed this final step, the authority issues a notice approving your Personal Budget. If necessary, you may appeal this notice.
What Happens Next?
You have already achieved a lot. But what good is an approved Personal Budget if you don’t yet have a single carer in your team?
You now need to recruit and hire carers or engage freelance carers under a service contract.
Once your team is assembled, the carers must be scheduled and a monthly roster prepared in advance. The hours actually worked by the carers are documented in a timesheet. This timesheet serves as the basis for payroll or fee payments and as proof for the authority.
At the end of each month, payroll is processed, or freelancers invoice for their services based on the timesheets.
You then “simply” pay the wages or fees to the carers. This is done from your Personal Budget, for which a separate account has been set up at a bank of your choice following approval.
Quite a lot to consider and manage, isn’t it?
That’s why it makes sense to appoint a budget assistant – and that’s where we come in.
WE LOOK AFTER YOU!
