The written decision on benefits will inform both the person in need of care and you of the determined care level. The expert opinion is automatically included. The notice also specifies the date on which the need for long-term care began, based on the specified care level. If you have any questions, it’s best to contact your long-term care insurance provider by phone.

If you disagree with the care level, you have the option to file an appeal. The deadline for this is four weeks after receiving the notice, provided that this is specified in the so-called notice of appeal rights. Otherwise, an appeal may be filed with the long-term care insurance fund within one year. The Appeals Committee will then review your application. There is a possibility that another review will take place. If the application is rejected again, the applicant may file a lawsuit with the Social Security Court.

Upgrade

If the condition of your family member in need of care worsens, you can apply to the long-term care insurance fund at any time to have their care level upgraded. You can do this by calling or sending a brief letter to the long-term care insurance fund. You will then usually be given an appointment right away for a re-evaluation by the Medical Service.