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Coverage
After the assessment, the AEC will prepare a summary of the care and assistance to which the dependent person is entitled per week. This summary will also be used to determine whether or not the person reaches the entry threshold of 3.5 hours a week of care and assistance for activities of daily living (ADLs).
Depending on the care and assistance needs listed in the summary, the applicant will be placed in one of the 15 care and assistance categories. Each category corresponds to a specific range of allocated minutes per week. The granted allocation category covers the various type of ADL support required by the person based on their specific situation and individual needs.
If the dependent person lives in a care and assistance facility
For the purpose of long-term care insurance, the care and/or assistance provided by a professional care and assistance service provider – i.e. a care and assistance establishment or network, or a semi-inpatient facility – is referred to as benefits in kind.
If the dependent person lives in an elderly home or an establishment for the disabled, the long-term care insurance provider will cover the costs of the care and assistance required: the CNS will pay the lump-sum coverage for benefits in kind in connection with ADLs directly to the provider. There are 15 categories of lump-sum payments, which vary depending on the amount of care and assistance required. Where applicable, the costs in connection with the various approved activities will also be paid directly to the establishment.
Board and lodging – which includes the cost of accommodation, meals and supervision – is at the dependent person's own expense. For all queries in connection with contributions towards the cost of board and lodging in care and assistance facilities, interested parties can contact:
The National Solidarity Fund (Fonds national de solidarité)
Tel.: (+352) 491081-1
If the dependent person lives at home
If another person helps provide the care and assistance
The law provides that a person who regularly contributes to the care and assistance of a dependent person, at least once a week, may be engaged as a caregiver, subject to certain conditions. The caregiver may be a close relative or friend, or another private individual engaged by the dependent person.
The caregiver in question must be registered with and evaluated by the AEC in order to have benefits in kind – care and/or assistance provided by a care and assistance network – replaced by a cash benefit:
- The caregiver must be present during the assessment of the applicant's needs by the AEC contact person.
- The caregiver's ability and availability to provide all or some of the care and assistance will also be evaluated.
- The applicant and caregiver will be required to fill in a caregiver information form.
- Once approved, the caregiver must give an undertaking to provide the required care and assistance until the time of the next assessment.
On the basis of these criteria and the AEC contact person's observations, the latter will decide whether or not the person contributing to the care and assistance can be approved as a caregiver under the law:
- If the person in question is not approved as a caregiver, all the benefits will be allocated in kind and not as cash benefits. Benefits in kind can only be allocated to a care and assistance network (Réseau d'aides et de soins – RAS) that is recognised by the National Health Fund (Caisse nationale de santé – CNS)
- If the person is approved as a caregiver, they will be able to provide the care and assistance either on their own or in collaboration with a RAS:
- It is up to the AEC contact person to determine whether or not the caregiver is able to provide the care and assistance on their own, or needs to be assisted by a RAS.
- If the assistance of a RAS is deemed necessary, the AEC contact person will decide how the required care and assistance should be allotted to ensure the best possible care.
In the event that the caregiver is unavailable, the dependent person can avail themselves of the care and assistance network (RAS) of their choice.
If the assistance of a care and assistance network (RAS) is deemed necessary
The dependent person can avail themselves of the provider of their choice. They must choose a RAS themselves and complete the formalities required to commence the care and assistance, in accordance with the contact person's instructions.
Useful telephone numbers and addresses:
Ministère de la Famille et de l'Intégration (Ministry of Family Affairs and Integration)
Senioren-Telefon: (+352) 247-86000
Service de renseignements pour personnes âgées (Information Service for the Elderly)
List of services for the elderly
Info Handicap
Tel.: (+352) 366466
Centre national d'information et de rencontre du handicap (National Information and Meeting Centre for the Disabled)
Concerning the payment of benefits for persons living at home
If the care and/assistance is provided only through a RAS, the lump-sum coverage for benefits in kind in connection with activities of daily living (ADLs) is paid directly to the RAS by the National Health Fund (CNS). Where applicable, the costs in connection with the various approved activities are also paid directly to the RAS.
If the care and/or assistance is provided by both a RAS and caregiver, the allotment of the required care and assistance – i.e. how the care and/or assistance is allotted between the RAS and the caregiver – will be shown in the summary of care and assistance. Based on the allotment appearing in the summary, the CNS will pay the lump-sum benefits in kind directly to the RAS, and the cash benefits directly to the dependent person.
If the care and assistance is provided by the caregiver only, the dependent person may be paid a lump-sum benefit for the assistance provided by the caregiver to perform ADLs and/or household chores. The lump-sum allocation is expressed in euros per week (cash benefits) and paid in recognition of the assistance provided by the caregiver.
There are 10 different categories of cash benefits, which vary depending on the level of assistance provided by the caregiver.