In short and in plain language
This post is about nursing care that a doctor prescribes. One example is a new dressing on a wound.
Some sites only list it as one word. But families have questions. Who writes the prescription? Who pays? How does it start?
A page of its own can answer these questions. The post shows what belongs on that page. It also shows a good order.
Such a page helps families and local doctors. It explains the steps and makes no promises.
We build this page for you.
For many home care services, doctor-prescribed nursing care is the segment that carries the business, and on most websites it appears as a single word in a bullet list. Someone searching for a dressing change, an insulin injection or compression therapy is looking for something other than a care level: for a doctor's prescription, for approval by the health insurer, and for a process that holds from tomorrow onwards. A list of services answers none of that. A dedicated page that describes the route from the doctor's practice through the health insurer to the first visit, and that keeps health insurance and long-term care insurance cleanly apart, takes the uncertainty out of the conversation and gives local GP practices an address they can link to. This article shows which details belong on that page, in what order they should appear, and how to phrase them without promising anything.
Key takeaways
- Doctor-prescribed nursing care is a health insurance benefit, not a building block of the care level. It is provided when it is necessary to secure the objective of the medical treatment (SGB V).
- Only what appears in the schedule of the Federal Joint Committee directive may be prescribed. Measures not listed there are in principle neither prescribable nor approvable (G-BA), and that belongs on the page before anyone picks up the phone.
- The initial prescription should not exceed a period of up to 14 days (G-BA). Naming that period on the website spares relatives the surprise that a follow-up prescription becomes necessary after two weeks.
- If the prescription is submitted no later than the fourth working day following the date of issue (G-BA), the health insurer covers the costs even before it decides on approval. That sentence removes the biggest worry from the first conversation.
- Adults pay a co-payment of 10 per cent of the costs plus 10 euros per prescription (SGB V), capped at the first 28 calendar days of using the benefit per calendar year (SGB V). Above that sits the annual burden limit.
Why doctor-prescribed nursing care stays invisible on care websites
On almost every home care service website, medical nursing care sits in a bullet list between basic care and domestic help. That is factually correct and practically worthless, because the three terms come from two different social codes and are paid for by two different funders. Relatives searching after a mother's hospital stay have no idea that the dressing change runs through the health insurer and help with washing through the long-term care fund. The bullet list pushes that clarification onto the telephone, where it typically costs the same ten minutes every time. Which content relatives actually read on a care website is set out in Care website: the content that convinces relatives.
The second reason is caution. Medical nursing care touches on treatment, and many services fear that a detailed page might edge towards impermissible health advertising. That caution is justified but leads to the wrong conclusion. What is delicate is not the explanation, it is the promise. A sentence describing an approval procedure is information; a sentence holding out the prospect of a treatment outcome is an advertising claim. Anyone who knows where that line runs can write in considerable detail without exposure. The third reason is mundane: the page was built once and not touched again afterwards, while the directive behind it has been amended several times since.
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What doctor-prescribed nursing care means under SGB V
Medical nursing care is one part of home nursing care under Section 37 SGB V. It is not provided because someone is in need of long-term care, but because a course of medical treatment has to be secured at home. Everything else on the website hangs on that: the entitlement arises from the illness and the medical treatment, not from a care level. People with no care level at all can be entitled to it, and people with care level 4 are not automatically entitled. Getting that one idea across clearly on the page answers, in our experience, half the follow-up questions in advance.
The statute recognises several forms. Hospital-avoidance care applies where hospital treatment is indicated but not feasible, or where home care avoids or shortens it; here the entitlement runs for up to four weeks per case of illness (SGB V), longer in justified exceptional cases. Securing care under subsection 2 is the standard case in outpatient practice: it secures the objective of the medical treatment and lasts as long as that treatment requires. For insured people with a particularly high need for medical nursing care, out-of-hospital intensive care under Section 37c SGB V applies instead, which has its own framework and deserves its own page on the website; how to win hospitals as referral partners with it is covered in Intensive care website: winning hospitals as referral partners.
Insured persons receive medical nursing care as home nursing care in their household, their family or otherwise at a suitable place, in particular in assisted living arrangements, schools and kindergartens, and in the case of a particularly high care need also in workshops for people with disabilities, where this is necessary to secure the objective of the medical treatment.
The prescription: who issues it and how long it runs
The prescription comes from panel doctor care, usually from the GP practice, and after a hospital stay frequently from discharge management. What may be prescribed is not a matter of free discretion: the prescribable measures are set out in the schedule to the directive on the prescription of home nursing care, and measures not listed there are in principle neither prescribable nor approvable (G-BA). Exceptions remain possible but must be medically justified and part of the treatment plan. For the website that means a service list with freely invented items raises expectations the health insurer will not then meet. If you offer the prescription form or a filling-in aid as a download, make sure the file stays usable; the pitfalls are set out in Making PDF downloads on the care website accessible.
- Who issues it. The prescription comes from panel doctor care; state on the page that the GP practice or the discharging hospital is the right first step.
- The schedule as the frame. Describe the measures you provide using the schedule's own terms rather than your own coinages, otherwise the page will not match the prescription.
- Duration of the initial prescription. It should not exceed a period of up to 14 days (G-BA); one sentence on this prevents the most common disappointment after two weeks.
- Timing of the follow-up prescription. It is to be issued in the last three working days (G-BA) before the prescribed period ends, so that care does not break off.
- What cannot be prescribed. Measures of medical diagnosis and therapy are not prescribable as home nursing care (G-BA) and may not be approved by the health insurer either.
- Household members. The entitlement exists only in so far as a person living in the household cannot nurse and care for the sick person to the extent required (SGB V); that condition surprises many families.
- Who passes the prescription on. Write on the page whether your service submits the prescription to the health insurer on behalf of the insured person or whether the family does that themselves.
- A contact person with name and role. A page without a name reads like a leaflet; one with a name reads like a commitment to be reachable.
From the practice to approval: the route in four stations
The process is set out in the Federal Joint Committee directive and is therefore structured the same way across all statutory health insurers. Insured people apply for the benefit by submitting the prescription; the benefits applied for by the insured person through submission of the prescription require approval by the health insurer (G-BA). Approval may only be given in so far as the measures of home nursing care can be carried out neither by the insured person themselves nor by a person living in their household (G-BA). The point that matters most for the website concerns the time in between, because that is exactly where the fear of private costs arises. How the services provided are then documented and signed off is explained in The electronic service record: how to explain it.
| Station | Who acts | What the page says about it |
|---|---|---|
| Prescription | Panel doctor practice or discharging hospital | Which measures you provide and how the practice reaches you at short notice |
| Submission to the health insurer | Insured person or the commissioned service | By the fourth working day after issue, stating who takes care of it |
| Approval | Health insurer, if requested with the medical review service | That care continues to run in the meantime |
| First visit | Care service | When you typically start and what should be ready for the first visit |
| Follow-up prescription | Practice, prompted by the care service | That you remind people about the follow-up prescription and when that happens |
Co-payment, burden limit and what may go on the page
The co-payment is the second major uncertainty, and it can be dealt with in three sentences. Adult insured people make a co-payment; for home nursing care the co-payment amounts to 10 per cent of the costs plus 10 euros per prescription (SGB V). That is capped at the first 28 calendar days of using the benefit per calendar year (SGB V). Anyone who has not yet reached the age of 18 pays nothing for home nursing care. The page needs no more than those three statements at this point, and in our experience anything less is not enough.
Above that sits the burden limit under Section 62 SGB V. It amounts to 2 per cent of annual gross income for living expenses (SGB V), and 1 per cent for chronically ill people under continuous treatment for the same serious illness. On the website it is enough to note that the health insurer issues an exemption on application and that receipts should be kept for that purpose. Do not work through a sample calculation: the assessment basis depends on the household, allowances and types of income, and a worked example on the page will be read as binding advice. What other limits apply to statements on a care website is set out in Legally compliant care website: imprint and advertising law.
What is better left off the page
What belongs on the service page
A service page on doctor-prescribed nursing care is not a longer version of the list entry but a page with its own address, its own headline and its own purpose. Two groups read it: relatives who need a solution for next week after a hospital stay, and practices looking for a service that reliably accepts a prescription. Both type different words and land on the same page if it contains both vocabularies. The service overview points there, not the other way round: the overview orders, the sub-page answers.
- A headline that names the term. Doctor-prescribed nursing care under Section 37 SGB V belongs in the title, not in the third paragraph.
- The measures you provide, in the terms used by the schedule, grouped into wound care, medication administration, injections and compression.
- The route in four stations as a sequence, not as running text. Four lines naming who acts are grasped faster than a paragraph with the same content.
- The deadlines in one place: the guide value for the initial prescription, the timing of the follow-up prescription, submission to the health insurer.
- The co-payment in two sentences, plus one sentence on the exemption available on application to the health insurer.
- What should be ready for the first visit: prescription, insurance card, medication plan and a settled arrangement for keys.
- A form with few fields and a telephone number side by side. The page is often read by older people with enlarged text; what to watch out for is set out in Putting an accessible care website into practice.
- A separate section for practices: who they reach, which details you need in order to accept a case, and within what period you respond.
The sentence that belongs on every page about prescribed nursing care
SGB V or SGB XI: the distinction relatives are searching for
The most common confusion in a first conversation is between prescribed nursing care and long-term care benefits in kind. The same service provides both, often in the same visit, both appear on the same invoice, and both nevertheless follow entirely different logics. Medical nursing care is prescribed by a doctor and approved by the health insurer; the benefit in kind requires a care level determined by the long-term care fund. Explaining that application route as well gives you two pages that support each other: the route to a care level is set out in Applying for a care level: the guide page that works, and from there one sentence points to prescribed nursing care for everyone without a care level.
The distinction also matters commercially, because remuneration for home nursing care is agreed between health insurers and care services under Section 132a SGB V, whereas the benefit in kind hangs on the framework agreements of the long-term care insurance. For a newly founded service that means two negotiation routes, two sets of contracts and two billing streams. How that shapes the structure of a first website is set out in Starting a care service: the website from day one. On the service page itself it is enough to place both funding pots side by side and to show the split using an example the family recognises.
Prescribed care under SGB V
Dressing changes, medication, injections. Prescribed by a doctor, approved by the health insurer, independent of any care level.
Benefits in kind under SGB XI
Support with personal hygiene, nutrition and mobility. Granted by the long-term care fund on the basis of a care level, without a prescription.
Two forms, two routes
One needs the prescription from the practice, the other the application to the long-term care fund. On the page they belong in separate blocks.
Two cost logics
Co-payment under Section 61 SGB V on one side, monthly ceilings of the long-term care insurance on the other. Mixed together they create false expectations.
Two time axes
The prescription runs in days and weeks, the care level in months and years. Placed side by side, the difference becomes visible without explanation.
One contact person
For relatives the split is administration, not daily life. Name one person who knows both routes, with a name and how to reach them.
Maintain the page, do not just build it once
A page on prescribed nursing care ages faster than a page about your mission statement, because it hangs on a directive that is amended regularly. The effort is small when it is planned in and irritating when it turns up as a special case. Put the review into the same rhythm in which you go through your forms anyway, and measure whether the page actually produces enquiries; which metrics are useful for that is set out in Winning more enquiries through the care website.
- Check twice a year whether the cited sections and the version of the directive still hold, and put the date of the last review visibly on the page.
- Reconcile the list of measures with the nursing management whenever new qualifications join the team or services are handed over.
- Reconcile the note on the follow-up prescription with your own reminder procedure; a process on the page that the service no longer runs is worse than no note at all.
- Check the contact person as soon as responsibility changes. A name that is no longer in the house costs you the enquiry.
- Go through the section for practices once a year with two local practices and ask what details are missing.
- Read the page once a year on a phone with enlarged text, deliberately reading only the headings.
- Sample the form submissions for the questions people still ask despite the page; that question is exactly what the text is missing.
In our experience the effort for such a page comes to about one working day for text and structure, plus the coordination with the nursing management. Against that stands a page that serves two audiences at once and that local practices can link to without having to explain anything. If you would like to build this element into an existing or new care website, we clarify in the first conversation which measures are actually prescribed in your case and what the process looks like at your service; the route there runs through the contact form.
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