Care provision inside and outside the professional care system

The case of long-term care insurance in Germany

Authored by: Hildegard Theobald

The Routledge Handbook of Social Care Work Around the World

Print publication date:  January  2018
Online publication date:  December  2017

Print ISBN: 9781472479457
eBook ISBN: 9781315612805
Adobe ISBN:


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In 1995–1996, long-term care insurance (LTCI) was introduced in Germany, which provides universal but capped benefits based on social rights in a situation of care dependency. Within the framework of LTCI, beneficiaries may choose between home-based and residential care services or a cash benefit. The new policy scheme reinforced the prevalent family-oriented care model, but also triggered a considerable expansion of the professional care system embedded in a care market based on competition between registered for-profit and non-profit providers on equal terms. Due to the capped service benefits, care gaps emerged that were filled either by informal, family care or by services or assistance purchased by private means or the unregulated cash benefit. These services or assistance concern, first, additional privately financed services delivered by registered providers within the framework of LTCI, that is, inside the professional care system. Second, outside the professional care system, beneficiaries purchase different types of services such as, for example, meals on wheels by service providers not registered within the framework of LTCI, or employ domestic or care workers within the household context.

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