'Long-Term Care Insurance in Germany: Mandatory Coverage, Contributions,
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Long-Term Care Insurance in Germany: Mandatory Coverage, Contributions, and Benefits
Pflegeversicherung is compulsory insurance for the risk of needing long-term care. It helps pay for care at home, outpatient care services, day or night care, short-term accommodation, and part of the costs of a Pflegeheim. It is not an optional policy, but part of Germany’s social insurance system: it is linked to health insurance.
The main limitation is that Pflegeversicherung generally covers only part of the costs. When receiving care in an institution, a person often has to pay for accommodation, food, investment costs, and part of the care from their own funds.
Who needs Pflegeversicherung
The principle in Germany is simple: anyone with health insurance must also have long-term care insurance.
- If a person is insured with a statutory Krankenkasse, they are automatically enrolled in social Pflegeversicherung.
- Family members covered by GKV family insurance are also covered by Pflegeversicherung without a separate contract.
- If a person has private health insurance, they need compulsory private Pflegepflichtversicherung.
- Additional private long-term care policies can be taken out separately to cover part of future co-payments.
Employees can switch to private health insurance only if they meet the conditions for PKV. In 2026, the general Jahresarbeitsentgeltgrenze is €77,400 per year or €6,450 per month.
How much compulsory Pflegeversicherung costs
The contribution to social Pflegeversicherung depends on income up to the Beitragsbemessungsgrenze and on the number of children. In 2026, the Beitragsbemessungsgrenze for Kranken- und Pflegeversicherung is €69,750 per year or €5,812.50 per month.
The basic Beitragssatz since 2025 has been 3.6%. Childless people pay a 0.6% surcharge, making their total contribution 4.2%. Parents with several children under 25 pay less.
| Insured person’s status | Total contribution | Employee share in most states |
|---|---|---|
| No children | 4.20% | 2.40% |
| 1 child | 3.60% | 1.80% |
| 2 children | 3.35% | 1.55% |
| 3 children | 3.10% | 1.30% |
| 4 children | 2.85% | 1.05% |
| 5 or more children | 2.60% | 0.80% |
The employer usually pays 1.8%. In Saxony, the split is different: the employer pays 1.3%, and the employee share is 0.5 percentage points higher. Pensioners, self-employed people, and voluntarily insured people pay according to their own rules; for an exact calculation, check your insurance status and notifications from your Krankenkasse.
When entitlement to benefits begins
Pflegeversicherung helps when a person needs long-term care because of illness, age, disability, cognitive impairment, or another lasting loss of independence. An important criterion is that the need must be expected to last for at least six months.
If help is needed temporarily, for example after an operation or during rehabilitation, it is not always a case for Pflegeversicherung. The costs may then fall under health insurance, hospital treatment, rehabilitation, or other forms of support.
How to obtain a Pflegegrad
To receive benefits, you must apply to the Pflegekasse. This can usually be done in writing, online, or through the Krankenkasse. Entitlement to benefits is tied to the application date, so it is best not to delay.
After the application, the need for care is assessed:
- The Pflegekasse accepts the application.
- For GKV, the Medizinischer Dienst is usually involved; for private insurance, an expert service working with PKV is used.
- The expert assesses the person’s independence at home, in an institution, or from documents if an in-person visit is impossible.
- The Pflegekasse assigns a Pflegegrad and sends a written decision.
- If the decision appears incorrect, it can be appealed within the applicable deadline.
When speaking to the expert, it is important not to make the situation sound better than it is. It is best to note in advance exactly where help is needed: getting up, moving around, washing, eating, medication, orientation, behaviour, communication, and household tasks.
How the degree of care is assessed
The Pflegegrad system measures not the diagnosis, but the limitation of a person’s independence. Six areas are assessed:
- mobility;
- cognitive and communication abilities;
- behaviour and mental state;
- self-care;
- ability to manage treatment, medication, and related demands;
- organisation of everyday life and social contacts.
The result is assigned to one of five levels:
| Pflegegrad | Meaning |
|---|---|
| PG 1 | Minor impairment of independence |
| PG 2 | Significant impairment of independence |
| PG 3 | Severe impairment of independence |
| PG 4 | Most severe impairment of independence |
| PG 5 | Most severe impairment of independence with special care requirements |
The higher the Pflegegrad, the wider the range of available services and the higher the benefit limits.
Benefits available in 2026
Amounts depend on the Pflegegrad and the type of care. Below are the main regular benefits from social Pflegeversicherung in 2026.
Care at home: family members or a service
If care is provided by relatives or other informal carers, Pflegegeld is paid. If a professional outpatient service is involved, Pflegesachleistung applies: the money is not paid directly to the person, but is used for the service’s care.
| Pflegegrad | Monthly Pflegegeld | Monthly Pflegesachleistung |
|---|---|---|
| PG 1 | €0 | €0 |
| PG 2 | €347 | €796 |
| PG 3 | €599 | €1,497 |
| PG 4 | €800 | €1,859 |
| PG 5 | €990 | €2,299 |
Pflegegeld and Pflegesachleistung can be combined when the family provides part of the care and a service provides the rest.
Entlastungsbetrag and care aids
For Pflegegrad 1–5, an Entlastungsbetrag of up to €131 per month is available. This money is generally not paid out freely in cash; it is used for approved support services, such as help with household tasks or Betreuung.
In addition, the following are available in 2026:
- Verbrauchspflegehilfsmittel of up to €42 per month for consumable care supplies;
- a Zuschuss zur Wohnraumanpassung of up to €4,180 per measure if the home needs to be adapted for care;
- up to €16,720 if several people entitled to this subsidy live together and the conditions are met.
Day, night, short-term, and respite care
For Pflegegrad 2–5, day or night care, Kurzzeitpflege, and Verhinderungspflege may apply. From 2026, Verhinderungspflege and Kurzzeitpflege use a combined Jahresbetrag of up to €3,539 per year, provided the conditions are met. It is best to clarify the specific calculation with the Pflegekasse, because it depends on the type and duration of care and on services already used.
Mandatory consultations for care at home
If a person receives Pflegegeld and is cared for at home, regular advisory visits under § 37 Abs. 3 SGB XI are required. Their purpose is to check the quality of care and give relatives practical advice.
- For PG 2 and PG 3, a consultation is required once every six months.
- For PG 4 and PG 5, it is required once per quarter.
If these visits are ignored, the Pflegekasse may reduce or stop Pflegegeld payments. It is best to arrange dates in advance with a recognised advisory service or the Pflegekasse.
Care in a Pflegeheim
For full inpatient care, Pflegeversicherung covers a fixed portion of care costs. In 2026, the Vollstationäre Pflege limits are:
| Pflegegrad | Monthly benefit |
|---|---|
| PG 1 | €131 |
| PG 2 | €805 |
| PG 3 | €1,319 |
| PG 4 | €1,855 |
| PG 5 | €2,096 |
In addition, for a longer stay in a Pflegeheim, a Zuschlag applies to the person’s own share of care costs: 15% from the first month, 30% after 12 months, 50% after 24 months, and 75% after 36 months of the relevant Eigenanteil.
It is important to understand the structure of the bill. Pflegeversicherung does not pay for the entire place in a care home. Accommodation, meals, the institution’s investment costs, and other services may be charged separately. The actual co-payment therefore depends on the state, the institution, the Pflegegrad, and the length of stay.
Additional long-term care insurance
Compulsory Pflegeversicherung reduces the financial burden, but does not cover all costs. Additional private options therefore exist:
- Pflegetagegeldversicherung pays a daily amount once a Pflegegrad is assigned.
- Pflegekostenversicherung reimburses an agreed share of actual care costs.
- Pflegerentenversicherung provides an insurance annuity when care is needed.
- Pflege-Bahr is a state-subsidised option for additional insurance.
Pflege-Bahr
Pflege-Bahr is private supplementary long-term care insurance with a state Zulage. If the conditions are met, state support is €5 per month, or €60 per year. The contract must provide benefits for all Pflegegrad levels, and for PG 5 the minimum monthly payment must be at least €600.
Pflege-Bahr generally does not require a medical examination, but insurers may impose a waiting period of up to five years. If care is needed because of an accident, exclusions depend on the tariff terms and the law.
What is particularly important for migrants
- Do not expect a doctor or insurer to offer every benefit on their own. The insured person or their representative submits the application to the Pflegekasse.
- Keep medical documents, discharge summaries, prescriptions, a list of medication, and a description of daily help needed.
- Invite someone who understands German well and knows the real care situation to the Pflegegrad assessment.
- Check exactly which insurance applies: GKV, PKV, family insurance, voluntary insurance, or private Pflichtversicherung.
- Do not plan to move elderly relatives to Germany without separately checking health insurance, Pflegeversicherung, residence rights, and possible costs.
Common mistakes
- Confusing Pflegegrad with the old term Pflegestufe. Pflegegrad is now used.
- Assuming that Pflegeversicherung will pay for the entire Pflegeheim.
- Not applying immediately even though help is already needed.
- Understating problems during the assessment in order not to “complain”.
- Missing mandatory consultations while receiving Pflegegeld.
- Buying supplementary insurance without comparing the waiting period, exclusions, benefit indexation, and conditions for pre-existing illnesses.
Conclusion
Pflegeversicherung is a compulsory part of the German insurance system, without which it is impossible to plan properly for the risk of needing long-term care. It provides important benefits and services, but it does not replace personal financial planning or cover every cost. For a family, the practical minimum is to know its insurance type, apply for a Pflegegrad promptly, prepare for the assessment, and understand in advance what co-payment may remain for care at home or in a Pflegeheim.
