Preparing for the Medical Service (MD) assessment

Q: Is it MDK or Medical Service?

The correct term is Medical Service (MD). Until 2021, it was called MDK – Medizinischer Dienst der Krankenversicherung – and was attached to the health insurance funds. Since the MDK Reform Act, the Medical Services have been independent public-law bodies. The task is the same: they carry out assessments on behalf of the long-term care insurance fund under § 18 SGB XI. If you search for MDK, you mean the MD.

One hour that decides things for years

The assessment under § 18 SGB XI by the Medical Service (MD, formerly MDK) takes place at home and usually lasts about an hour. The Medical Service assessor sees only a snapshot and has to judge from it how independent a person is in the long term.

When things go wrong, it is rarely due to bad intent. It is because people pull themselves together when they have visitors. Many of those affected say “I can manage” because they believe it themselves or because they are embarrassed. And because relatives stay silent out of consideration, that is exactly the picture that remains.

Beforehand: what belongs on the table

Care diary (Pflegetagebuch) covering two to four weeks, printed out. This is the most important document at the appointment.
Medication plan with times and a note on who prepares the medication and who checks that it is taken.
Doctors’ reports and discharge letters from the last twelve months.
Aids: rollator, care bed, commode chair, incontinence pads – including things that are rarely used.
List of doctors and therapies with frequency. Module 5 accounts for 20 percent and depends on this frequency.
List of what is no longer possible: shopping, banking, using the phone, laundry. Module 6, 15 percent.

During the appointment: three sentences that help

You do not have to fight. You have to be specific.

Instead of “she can still wash herself”: “She does her upper body herself. I take over her back, lower body and feet completely; it takes 20 minutes, every day.”
Instead of “nights are restless”: “In the last 14 nights she got up 31 times. It’s in the diary, here.”
Instead of “we’ll manage”: “I drive 80 kilometres and am there four times a week. Without that, she would not be cared for on her own.”

The difference is not the tone but the number. Numbers can be taken over into the assessment report; impressions cannot.

Afterwards: request and check the assessment report

Have the assessment report sent to you – you are entitled to it. Check it module by module against your diary. If the rating for self-care (40 percent) differs from your records, look there first; no other module carries as much weight. What to do next is explained under Objection and higher care level.

MDK or Medical Service – who is actually coming?

Until 2021, the Medical Service was called MDK (Medizinischer Dienst der Krankenversicherung, Medical Service of the Health Insurance Funds). It is the same body. Until the MDK Reform Act, it was attached to the health insurance funds; since 2021, the Medical Services have been independent public-law bodies. Their task has not changed: they carry out assessments on behalf of the long-term care insurance fund under § 18 SGB XI.

So if you searched for MDK assessment – you are in the right place. On these pages we write Medical Service, or MD for short, because that is also what your decision letter says.

Frequently asked questions about the assessment

May I be present at the appointment?

Yes, and you should be. You may add information if things are being glossed over. Do not contradict in front of the person concerned – make a note and tell the assessor in private at the end.

Should I tidy the home especially well?

Tidy up as usual, but do not hide any aids. The rollator in the hallway, the grab rails in the bathroom and the pads in the cupboard are part of the picture. A perfectly prepared home gives the impression that everything can be managed alone.

What should I bring to the appointment?

A care diary covering two to four weeks, medication plan, doctors’ reports, severe disability card, list of aids and a list of doctors and therapies with appointment frequency.

How long does the assessment take?

Usually about an hour, sometimes less. That hour is decisive – which is why anything in writing that goes beyond that one day is so valuable.

Is it MDK or Medical Service?

The correct term is Medical Service (MD). Until 2021, it was called MDK – Medizinischer Dienst der Krankenversicherung – and was attached to the health insurance funds. Since the MDK Reform Act, the Medical Services have been independent public-law bodies. The task is the same: they carry out assessments on behalf of the long-term care insurance fund under § 18 SGB XI. If you search for MDK, you mean the MD.

Will I get to see the assessment report?

Yes. Request it if it is not sent to you. Without the assessment report you cannot give reasons for an objection.

Note. This page explains the procedure in general terms and does not replace legal or care advice. Amounts and point values reflect the situation as of 2025 and are taken from the legal basis cited in each case. The binding decision is always made by your long-term care insurance fund (Pflegekasse). Free and independent advice is available from your local care support centre (Pflegestützpunkt) and from care counselling under § 7a SGB XI.

Document everything until the appointment

Care-Assistant keeps the care diary digitally: entries in seconds, evaluation according to the six modules of the assessment, report as a PDF for the long-term care insurance fund and the Medical Service (MD).

Try the care diary for free How it works

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Preparing for the Medical Service assessment (Begutachtung)