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de004 Antrag Pflegeunterstützungsgeld

AOK (mehrere Landesverbaende: Bayern, NordWest, Rheinland-Pfalz/Saarland, Rheinland/Hamburg; Bundesverband gp/fk)Federal (Bund)Fillable in the browser

de004 Antrag Pflegeunterstützungsgeld is an official form from AOK (mehrere Landesverbaende: Bayern, NordWest, Rheinland-Pfalz/Saarland, Rheinland/Hamburg; Bundesverband gp/fk). It applies nationwide in Germany.

You can fill in the PDF directly in your browser and then print or save it. It has 2 pages.

The official source (Gesetzliche Krankenkassen) and the exact version date are listed below.

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Where this comes from

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Source
Gesetzliche Krankenkassen
Fetched on
13/07/2026
SHA-256
127610f5b16947cf…
Fill it hereGo to the official form (source)Open in Formularamt

What this form asks for

A selection of the fields this form asks for, so you know what to expect before you start.

  • Hier klicken, um alle Formularinhalte zu löschen
  • Nachname, Vorname des Versicherten
  • Geburtsdatum des Versicherten
  • Postleitzahl und Wohnort des Versicherten
  • Straße und Hausnummer des Versicherten
  • Rentenversicherungsnummer des Versicherten
  • Staatsangehörigkeit des Versicherten
  • Telefonnummer des Versicherten (freiwillige Angabe)
  • Name der Krankenversicherung des Versicherten
  • Anschrift der Krankenversicherung des Versicherten
  • Geldinstitut des Versicherten
  • Kontoinhaber
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Frequently asked questions

Is this form free to use?

Yes. All forms in the Formularamt are free - no account, no sign-up. Only comfort features like automatic pre-filling from your Amtsprofil belong to Werkzeu.ge Plus.

Where does this form come from?

This form comes from AOK (mehrere Landesverbaende: Bayern, NordWest, Rheinland-Pfalz/Saarland, Rheinland/Hamburg; Bundesverband gp/fk). Source: Gesetzliche Krankenkassen, fetched on 13/07/2026. We mirror it unchanged (byte-identical) and always link back to the authority.

Can I fill in this form directly in the browser?

Yes. This PDF is a real form with fields, so you can fill it in here in the browser, save it and print it. Your entries stay on your own device.

Does Werkzeu.ge replace the authority or professional advice?

No. Werkzeu.ge is a private service by Cryon UG (haftungsbeschränkt), not a government agency, and it replaces neither the authority nor legal or tax advice. We help you understand and prepare your own paperwork - the responsible office decides and processes it.

Can I use this health and care form for free?

Yes. All forms in the Formularamt are free, even without an account. You submit it to AOK (mehrere Landesverbaende: Bayern, NordWest, Rheinland-Pfalz/Saarland, Rheinland/Hamburg; Bundesverband gp/fk).

How up to date is this form?

Last checked on 13/07/2026. Forms still go stale and authorities change their processes without notice - if in doubt, the version on the official source counts.

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