New benefit under sickness insurance

A new benefit has been introduced with effect from 1 June 2018. This benefit is to help sickness insurance payers who need to care for a family member requiring a long-term and all-day home care following a hospital stay after a serious illness or injury and who are unable to carry out their job due to the care. The new benefit is called a long-term family member care benefit. The caregiver must be:
  1. the spouse or the registered partner of the care receiver;
  2. in a direct lineal relationship to the care receiver or the care receiver’s sibling, mother-in-law, father-in-law, daughter-in-law, son-in-law, niece, nephew, aunt or uncle;
  3. the care receiver’s cohabitant;
  4. the spouse, registered partner or cohabitant of the person listed sub point 2.
Decisions about the entitlement to the benefit are made by an inpatient care doctor. At the care receiver’s request, the doctor also issues a “decision on the need of long-term care”. This form comprises three parts:
  • Part 1 is sent by the doctor to the Czech Social Security Administration (CSSA);
  • Part 2 is provided by the doctor to the care receiver upon discharge from hospital and then provided by the care receiver to the doctor to see the care receiver for regular check-ups for the term of the illness or injury. The outpatient doctor will then inform the CSSA that the care receiver has been taken into care and will notify the CSSA at least once a month that the need of long-term family care persists.
  • Part 3 is provided by the doctor to the care receiver on the day of discharge to home care and is intended for the care receiver to substantiate the long-term care benefit.
A prerequisite for the entitlement to the benefit is that the caregiver must be a sickness insurance payer. The long-term care benefit may be provided for up to 90 days. Nevertheless, there is a possibility to share the care with another family member. Applications for the long-term family member care benefit are made via the employer. The employer is required to grant the application in all cases and the employee must not be served a termination notice during the period of the care. The benefit is 60 per cent of the reduced daily assessment base. A decision on the termination of the long-term care within a period shorter than 90 days is made by the outpatient doctor. The doctor will also issue a long-term care termination form. The caregiver may apply for another long-term care benefit after the expiry of 12 months of the day on which the benefit under the previous long-term care is paid. Unfortunately, it may not be provided earlier. We trust you will find this article informative and useful. Do you have any questions? Or do you need assistance with payroll processing? Do not hesitate to contact us. We can solve this problem for you.