29.01.2024 Gabriele Strasser 23923

Financial help and support for cancer

Support for cancer patients: household help, disability pass, exemption from co-payments and more: specialist advisors Margret Kunz, Regina Benzinger, Sylvia Mau-Löffler and Paul Rathjen provide an overview of financial help and support options. 

Cancer turns your whole life upside down. In addition to the painful and physically demanding treatments and psychological stress, there are often financial worries caused by loss of income and higher costs, e.g. due to additional payments. A study by the German Cancer Research Center shows that cancer patients have to cope with an average 26 to 28 percent loss of income within the first year after diagnosis.

Sickness benefit

At the beginning of a cancer illness, working people initially receive six weeks of continued pay and then sickness benefit from the health insurance fund. Sickness benefit is paid for a maximum of 78 weeks within three years (the six weeks of continued pay are included here), regardless of whether you also apply for a degree of care or a certificate of severe disability. Sickness benefit amounts to 70% of your gross income, but not more than 90% of your last net income.

The next building block is the reduced earning capacity pension. The health insurance company will contact you while you are receiving sickness benefit to ask whether you should apply for this. The reduced earning capacity pension is paid for a limited period and can expire again after recovery. 

Note: It is important to have a full sick note; the health insurance fund will not pay sick pay for missing days.

Co-payments for medication and treatments

Being ill is expensive: co-payments for various medications, hospital stays, transportation costs such as cab rides, physiotherapy and lymphatic drainage can quickly add up to a three-figure sum.

Amount of co-payments

The following applies to co-payments: You must pay ten percent of the costs of all services yourself - but at least five euros and at most ten euros. If the costs are less than five euros, you pay the actual price of the medication.

Debit limits and co-payment exemption

However, there is a maximum limit. This is two percent of the gross income of all household members. If this individually determined limit is reached, you are exempt from the co-payment. An application is required for this, the exemption is not granted automatically. 

After one year of cancer treatment, the co-payment is reduced to one percent - this also requires an application to the health insurance company. This reduced limit also applies if the person concerned or a household member has been undergoing medical treatment for a chronic illness for longer than one year. 

Note: Nutritional supplements are generally not covered by health insurance, even though they are often necessary after cancer to regenerate the weakened immune system.

Declare additional payments for tax purposes

Under certain conditions, you can deduct the additional payments from your tax bill as "extraordinary expenses". It is advisable to keep all receipts.
 

Application for a severely disabled person's pass

If you have cancer, you have a good chance of obtaining a severely disabled person's pass. This can at least partially compensate for the disadvantages caused by the illness. Do not be discouraged if the first decision does not meet your expectations, but make use of your right of appeal. 

The severity of the impairments is decisive

If you have a mental, cognitive or physical illness, you can apply to the relevant pension office for a severe disability due to the resulting impairment. A disability is defined as a functional impairment with a degree of disability (GdB) of 20 or more. According to Section 2 (2) SGB IX, people with a GdB of at least 50 are considered severely disabled.

The catalog of the medical care ordinance lists the most common illnesses and also which GdB can be achieved depending on the severity.

How do I apply for a disabled person's pass?

You submit the application to your local pension office. The decisive factor for the recognition of a GdB is illness, which must be documented by medical documents such as doctor's letters, discharge letters from hospital or medical diagnoses. Enclose copies of these medical certificates with your application. If you do not have these, the pension office will obtain them from the doctors named.

You can submit the application at an early stage (e.g. directly after an operation), but also later. Please note, however, that the application process can take several months. As in most cases, the severely disabled person's pass is initially issued for a limited period of time, even in the case of cancer.
 

Possible benefits or compensation for disadvantages

With a disabled person's pass, the following benefits are possible depending on the degree of disability:

The severely disabled person's ID card lists the degree of disability (GdB) and, if applicable, special features (G, aG, B, BL, GL, RF, TBI). These indicate restrictions that require special assistance and provide relief, such as free cab rides to the doctor with the H mark (helpless) or free cab rides to the doctor plus parking relief with the aG mark (exceptionally disabled).

Degree of care with cancer

Anyone who has cancer does not receive a care degree simply because of this diagnosis, as this is merely an indication of possible restrictions. 

Personnel support required

The prerequisite for a care degree is that a need for personal support is expected for more than six months. If a person requires medium-term support with personal hygiene and/or mobility and their state of health is expected to improve, a care degree can be awarded for a limited period (e.g. one year). After this period, the Medical Service of the health insurance funds will carry out a new assessment.

Applying for a care degree: what you need to know

Degree of care for mental stress

The psyche is often severely affected by cancer, and anxiety and depression can occur, for example. Recognition of these problems can possibly lead to care grade 1, which allows the spouse to be released from work and help with household chores.
 

Home help from the health insurance fund

If you are no longer able to manage your household independently due to your illness or its treatment (e.g. chemotherapy), you are entitled to household help if at least one of the following conditions is met:

Duration of the claim

With a child under the age of 12, you are entitled to household help for up to 26 weeks, without a child for up to four weeks. An extension is possible if necessary.

The home help can also take over the care of children if this is necessary. When applying, tell them that you need childcare and mention any special needs and requirements.

Apply for household help 

You can usually apply for household help from your health insurance provider. You will need a medical certificate confirming medical necessity. It is advisable to submit the application as early as possible.
 

Additional payment for domestic help

Those with statutory health insurance also have to make an additional payment for home help. As a rule, this is 10 percent of the costs, but at least 5 euros and a maximum of 10 euros per calendar day. If the sum of the co-payments reaches a certain upper limit, an exemption is possible.

People on low incomes may be exempt from co-payments under a hardship scheme (application to the health insurance fund required).

In the case of chronic illnesses, which can also include certain cancers, there are sometimes special regulations and the co-payment obligation can be reduced or waived.

Home help for privately insured persons

In private health insurance, the benefits depend on the individual insurance tariff and the contractual conditions. It is advisable to contact the insurance company directly. Ask them:

Who can be hired as domestic help?

Help can be provided by different people or organizations, depending on individual needs and availability. 

Family members, friends or neighbors often take over the help. Please note: In the case of close family members, the health insurance company may only cover their loss of earnings or travel expenses.

Recognized services that can bill health insurance companies directly usually include outpatient care services, but also organizations such as family care services. Local social services, welfare associations, village helpers or similar organizations are always the first point of contact.

If you cannot find either a recognized service or a private carer, it is usually possible to obtain individual approval, e.g. for people or companies working in a commercial capacity (e.g. cleaning companies, everyday carers, care agencies), if they agree to cover the costs with the health insurance fund. 

Social benefits and state support 

Citizen's income

Anyone who cannot cover their living expenses from their own income or assets can apply for citizen's benefit (formerly known as unemployment benefit II - or colloquially as Hartz IV and/or social assistance).

Information on the Citizen's Income

Housing benefit

An application for housing benefit can also be successful if your income is limited. You can receive housing benefit as a subsidy towards rent or towards the costs of owner-occupied housing. Housing benefit is usually granted for a period of one year and must then be reapplied for. 

Information on housing benefit

German Cancer Aid hardship fund for financial emergencies

The German Cancer Aid Hardship Fund helps cancer patients and their families who are in financial need as a result of the disease. Under certain conditions
they receive a one-off payment which they can dispose of freely. The money does not have to be repaid. 

Information and application form

Deducting medical expenses from tax 

Health insurance companies do not cover all the costs incurred for the treatment of cancer. It is still possible to deduct these costs (at least in part) from tax. This includes costs for outpatient treatments such as physiotherapy, travel costs to treatments, expenses for medication, remedies and aids. You can also claim statutory co-payments as extraordinary expenses. 

Important: The medical treatment must have been ordered and a medical certificate is required. It makes sense to submit the invoices to the health insurance company first - only if they do not cover the costs should you submit them to the tax office with the note "No assumption of costs".

Sources and helpful links

German Cancer Society

Association Lebensmut

Consumer advice center: Home help

Cancer Information Service: Home help

German Cancer Aid Hardship Fund

About the pme Familienservice

As a provider of employee assistance programs, pme Familienservice accompanies people in a wide variety of life situations and supports employees of its client companies in private and professional crises - including with psychosocial counseling and a 24/7 hotline.

That's why we see it as our job to make employers aware of difficult challenges that can affect their employees and teams, such as cancer in the workplace.

With expert talks, group coaching sessions, personal advice and mental strengthening in the Mindance app, we offer support for HR managers and executives who are directly or indirectly affected by cancer.