Healthcare fixed allowance
Because chronically ill people have high expenses, there are various fixed reimbursements that they can combine, including for care. The healthcare fixed allowance is an annual reimbursement for chronically ill people who are highly dependent on others.
The healthcare fixed allowance can be combined with the fixed allowance for incontinence, the palliative care fixed allowance and the PVS fixed allowance.
The annual amount varies depending on the degree of loss of self-reliance, is indexed annually and since January 1, 2024 has been:
- 371.55 euros;
- 557.36 euros;
- 743.12 euros.
Important: the care fixed allowance should not be confused with the care budget for heavily dependent people, which provides reimbursement for the non-medical costs of home care patients requiring serious care.
You don't have to do anything
CM has the necessary information so that the healthcare fixed allowance s in principle paid out automatically if you meet both conditions.
Is your self-reliance decreasing?
If self-reliance decreases over the course of the year and you claim a higher reimbursement, regularization will also happen automatically.
Healthcare fixed allowance?
If you do not receive a refund and you think you are eligible for the healthcare fixed allowance, please contact the Social Work department.
What are the conditions?
High healthcare expenditure
In the relevant and preceding calendar year, have a total co-payment of at least:
- 450 euros per year (chronically ill without increased compensation);
- 365 euros per year (chronically ill with increased compensation.
The calculation of expenses is done as for the maximum invoice (MAF). As a result, a number of expenses are not included. In contrast to the MAF, only the co-payment of the chronically ill person is taken into account.
Loss of self-reliance
- For the refund of 371.55 euros
Are in one of the following situations:- have been recognized for at least six months as a beneficiary with a serious condition in the context of physiotherapy or physical therapy;
- have been admitted to a general or psychiatric hospital at least six times or for at least 120 days in the relevant or preceding calendar year;
- meet the medical conditions that entitle you to additional child benefit for children with a disability or serious illness.
- For the refund of 557.36 euros
Are in one of the following situations:- meet the dependency conditions for the award of the integration allowance for the disabled (at least 12 points);
- meet the dependency conditions for the allocation of the care budget for elderly people with a care need and a disability (at least 12 points);
- are entitled to reimbursement for third party assistance (disabled);
- as a disabled person with dependents, are entitled to reimbursement for assistance from third parties;
- as an invalid without dependents, are entitled to a benefit as a beneficiary with dependents due to a need for assistance from third parties.
- For the refund of 743.12 euros
Be entitled to lump sum B or C for at least three months in the context of home care.
