Consultation visits when receiving care allowance – why, how come, what for?

Anyone who is awarded a care level and decides to receive care allowance is making a conscious choice: care is provided mainly by relatives, friends or other close persons – without regular support from an outpatient care service for basic care. This model allows for a great deal of self-determination and closeness, but also entails responsibility and stress. In order to ensure the long-term quality of home care and not leave caring relatives alone, so-called advisory visits are required by law. But what exactly does this involve? Why are these visits mandatory, how do they work – and how do families actually benefit from them?

Care allowance and home care: a tried-and-tested but demanding model

Care allowance is paid when people in need of care from care level 2 onwards organise their own care and do not make use of the services of a care provider. Care is then usually provided in the family environment by relatives, often in addition to their job, their own family and other commitments. This model is attractive to many families as it allows for individual solutions and offers those in need of care a high degree of familiarity and continuity.

At the same time, home care is complex. Care needs change, physical and emotional stress can increase, aids are lacking or are not used, even though they would make everyday life much easier. This is exactly where the advisory visits pursuant to Section 37 (3) SGB XI come in.

Legal basis: Care advice in accordance with Section 37(3) of Book XI of the Social Code (SGB XI)

The obligation to conduct regular advisory visits is enshrined in Social Code XI. It applies to all persons in need of care who receive care allowance and do not receive outpatient care from a care service. The aim is to ensure that care is professionally appropriate, humane and affordable in the long term, even without professional support.

It is important to note that these visits are expressly not inspections, assessments or reviews in the sense of the Medical Service. They serve to ensure quality and support family carers.

New regulations under the BEEP Act: What has changed?

The Act on the Expansion of Powers and Debureaucratisation in Care (BEEP Act) introduced an important simplification. From 2026, a uniform rhythm will apply to care allowance recipients in care grades 2 to 5: the advisory visit will only be mandatory every six months for all care grades.

Previously, people in care grades 4 and 5 had to provide evidence of a quarterly consultation visit. This more frequent schedule has now been abolished in favour of reducing bureaucracy. For families, this means less organisational effort without compromising the quality of the consultation. Additional consultations can still be requested if necessary.

A special rule continues to apply to care level 1: here, the consultation visit is voluntary, but can also be taken every six months and is seen by many families as helpful support.

Why are advisory visits necessary at all?

The central question many relatives ask is: if the care is working, why is this obligation necessary? The answer lies in prevention. Care often takes place over many years, and creeping overload or small deficits are not always immediately recognised in everyday life. Advisory visits create a structured space to pause, reflect on the situation and identify potential risks at an early stage.

This is not only about the person in need of care, but also explicitly about the family members providing care. Their stress, health and resources are just as much a focus as the question of whether the current care situation is sustainable in the long term.

How does a consultation visit actually work?

The consultation visit is carried out by a qualified nurse. This can be an outpatient nursing service or another recognised counselling centre with nursing expertise. The family has the right to choose and is free to select the provider.

The visit usually takes place in the home environment, but on request – for a limited period until 31 March 2027 – every second visit can also be conducted via video conference. This option is particularly appreciated by working relatives or families in rural areas.

During the consultation, the nursing professional will talk to both the person in need of care and the primary caregiver, if possible. The focus is on questions such as: How are all those involved doing? Are there any uncertainties in everyday care? Have health conditions or care needs changed? Is there any overload or need for support?

Practical aspects are also discussed, such as the use of aids, questions about adapting the home or respite services for family carers. The aim is to work together to find solutions that make everyday care easier and more stable.

Documentation and proof for the nursing care insurance fund

After the consultation visit, the nursing professional fills out a form provided by the GKV Spitzenverband (National Association of Statutory Health Insurance Funds). This form documents both the professional’s assessment and the family’s perspective. It also records recommended measures, such as the use of certain aids or references to further support services.

This form is sent to the care insurance fund and serves as official proof that the consultation visit took place. Both the family and the advisory service receive a copy. There are no costs for those in need of care – the consultation is covered in full by the care insurance fund.

Medical aids without a doctor’s prescription: an often underestimated advantage

A particularly practical aspect of the advisory visits is the possibility of recommending aids without the need for a doctor’s prescription. If the nurse considers certain aids to be useful and necessary, they can issue a separate form that replaces the doctor’s prescription.

If this form is submitted to the nursing care or health insurance fund within two weeks, approval is usually granted quickly. This is a great relief, especially for family carers, as it eliminates time-consuming visits to the doctor and means that the necessary support is available more quickly.

What happens if the advisory visit does not take place?

As supportive as the nature of the consultation is, the legal requirements are just as clear. If proof of the mandatory consultation visits is not provided, the care insurance fund is obliged to reduce the care allowance. In the event of a repeat offence, the care allowance may even be cancelled altogether.

In practice, care insurance funds usually send reminders about missed deadlines. Nevertheless, it is important to keep track of appointments and arrange a consultation visit in good time. Especially in stressful care situations, this can otherwise quickly be overlooked.

Not control, but support on equal terms

A common misunderstanding is that the advisory visits are seen as a form of control or ‘inspection’. This concern is unfounded. The nursing staff treat the families with respect and appreciation. They do not come to look for mistakes, but to support, advise and relieve the burden.

After the first advisory visit, many relatives report that they found the conversation helpful and empowering. Often, aspects are addressed that are not discussed in everyday life, such as their own exhaustion or uncertainties in dealing with the care situation.

Seeing consultation visits as an opportunity

When used correctly, consultation visits are much more than a legal obligation. They offer the opportunity to consciously develop home care, gain new insights and organise support at an early stage. They can be an important anchor, especially in phases when care needs change or the burden increases.

If necessary, the counselling specialist can also suggest applying for a reassessment by the Medical Service, for example if the care level no longer corresponds to the actual needs. Ultimately, this also serves to protect the family.

Viva FamilienService: Your point of contact for care allowance and counselling services

For many families, once a care level has been assigned for the first time, the question arises as to what happens next. What are the obligations? Who carries out the advisory visits? What other support options are available?

At Viva FamilienService, we support employees of our partner companies in precisely this area. If you receive care allowance and need to organise a counselling visit for the first time in accordance with Section 37 (3) of SGB XI, please do not hesitate to contact us. We will research suitable providers in your region, explain the procedures to you in a comprehensible manner and also assist you with any further questions you may have about care, relief and balancing work and care.

After all, good care requires not only commitment, but also information, support and reliable structures. The advisory visits are an important building block for this – and a real opportunity to organise good, healthy home care in the long term.