Long-Term Care Insurance in Germany (Pflegeversicherung)

Long-term care insurance in Germany (Pflegeversicherung) is the fifth pillar of German social insurance. It pays a contribution towards care costs when you can no longer manage daily life on your own, whether because of old age, illness or disability. It is compulsory for everyone who has health insurance in Germany, and its contribution is deducted from your payslip alongside health, pension and unemployment insurance.

This guide explains how the system works, what you pay in 2026, what each care degree (Pflegegrad) gets you, how public and private cover differ, and how to apply. Every figure comes from German law or official sources, listed at the bottom.

How Pflegeversicherung works

Care insurance follows your health insurance. The rule is simple: whoever has health insurance must also have care insurance, and it is run by the care fund (Pflegekasse) attached to your health insurer.

• Public health insurance members (compulsory and voluntary) are automatically in the public care insurance, the soziale Pflegeversicherung (§20 SGB XI). The Pflegekasse sits with your health fund, so there is nothing separate to sign.
• Private health insurance holders must take out a private compulsory care insurance (private Pflegepflichtversicherung) and keep it (§23 SGB XI).

Care insurance is not a full-cover scheme. It sets fixed monthly amounts per care degree, and anything above that is paid from your income, savings or, if those run out, by social assistance. Think of it as a contribution to care costs, not a replacement for them.

Long-term care insurance contribution rates in 2026

The contribution rate is a percentage of your gross income, up to the contribution ceiling. Employer and employee normally split the base rate equally.

The employer pays a fixed 1.8% regardless of how many children you have. The childless surcharge and the child discounts only change the employee share.

The childless surcharge

Members pay a surcharge of 0.6 percentage points from the month after their 23rd birthday if they have no children (§55 SGB XI). Exceptions include people born before 1 January 1940, military and civilian service, and recipients of Grundsicherungsgeld. If you become a parent, send proof of the child to your employer or Pflegekasse so the surcharge is removed.

Discounts for children

Parents get a reduction of 0.25 points for each child from the second to the fifth, as long as the child is under 25. The reduction ends at the end of the month in which the child turns 25. A first child removes the surcharge but does not lower the rate below 3.6%.

Saxony is different

Saxony did not abolish a public holiday when care insurance was introduced, so employees there carry a larger share. Of the 3.6%, employees in Saxony pay 2.3% and employers 1.3%, and childless employees pay 2.9%.

For how care insurance fits into your total payroll deductions, see our taxes in Germany guide and the salary in Germany guide.

Care degrees: Pflegegrad 1 to 5

Since 2017, Germany uses five care degrees. An assessor scores how independent you are in six modules (areas of life). The weighted points give your degree (§15 SGB XI).

What the assessor looks at

The score is built from these areas, each with a different weight:

• Mobility (10%): moving around the home, changing position, climbing stairs.
• Thinking, communication and behaviour (15%): memory, orientation, understanding, and behavioural or psychological problems. These are two modules, and only the higher of the two scores counts.
• Self-care (40%): washing, dressing, eating, using the toilet. This is the heaviest area.
• Coping with illness- or therapy-related demands (20%): medication, wound care, doctor visits, therapies.
• Daily life and social contacts (15%): structuring the day, keeping in touch with others.

The assessment is not a medical exam of your diagnoses. Two people with the same illness can get different degrees, because only the practical impact on independence is scored.

What Pflegeversicherung pays: benefits by care degree

The amounts below are the 2026 monthly maximums set in SGB XI (they have been unchanged since the 1 January 2025 adjustment).

Pflegegeld vs Pflegesachleistung

Pflegegeld is paid to you for care at home by relatives or friends. Pflegesachleistung is a budget for a professional care service, which bills the Pflegekasse directly. You can mix both (Kombinationsleistung): the part of the service budget you do not use reduces your Pflegegeld proportionally.

If you receive Pflegegeld, you must request a care advice visit at home (Beratungseinsatz) every six months (§37 SGB XI). In Pflegegrad 4 and 5 you may choose one visit per quarter instead. If you skip it, the Pflegekasse can cut the payment.

Other benefits worth knowing

• Relief amount (Entlastungsbetrag): up to €131 per month for care at home, for approved relief services such as day care, short-term care or recognised everyday-support services (§45b SGB XI). This is the one cash-like benefit that reaches Pflegegrad 1.
• Care aids for consumption: up to €42 per month for gloves, disinfectant, bed protection and similar items (§40 SGB XI).
• Home adaptations: grants of up to €4,180 per measure, for example a walk-in shower or removing thresholds, with a higher cap when several people share the home (§40 SGB XI).

Public vs private care insurance

The benefits are the same on paper. The difference is how you pay and who insures you.

If you hold private health insurance

You are required to have a private compulsory care insurance with benefits equivalent to the public scheme (§23 SGB XI). The default is that you take it with the same insurer as your health cover, and you can move it to another private insurer within the rules of §23. Insurers must apply the same care-degree criteria as the public scheme, and time you spent in the public scheme counts toward the waiting period.

If you are an employee, your employer pays a subsidy to your private care insurance. It is the lower of half your premium and the employer share that would be due in the public scheme (§61 SGB XI).

Not sure whether you qualify for private cover in the first place? See who qualifies for private health insurance, compare public vs private health insurance, or read how public health insurance (GKV) works. If you are self-employed, our freelancer guide covers the choice, and the complete private health insurance guide explains the full picture, including the care insurance part of your premium.

Supplementary care insurance (Pflegezusatzversicherung)

A supplementary care insurance is an optional private policy that pays an extra amount when you are assessed with a care degree. It is the main way to close the gap between what the statutory care insurance pays and what care really costs.

Main types

• Daily benefit (Pflegetagegeld): a fixed daily amount per care degree, paid out in cash, which you can use freely.
• Monthly benefit (Pflegerente): a fixed monthly pension, sometimes with a capital element.
• Cost reimbursement (Pflegekostenversicherung): refunds the part of your care costs not covered by the statutory benefits.

The state-subsidised option

Germany subsidises certain supplementary policies through the Pflegevorsorgezulage (colloquially "Pflege-Bahr"). If you pay at least €10 per month of your own money into an eligible policy, the state adds €5 per month (§§126-127 SGB XI). To qualify for the subsidy, a policy must accept all applicants without health questions, risk surcharges or exclusions, pay at least €600 a month at Pflegegrad 5, and have a waiting period of at most five years. You cannot claim the subsidy if you already receive or have received care benefits before taking out the policy.

Things to check before you sign

• Health questions: unsubsidised policies usually check your health, and your premium rises sharply with age. Start early.
• Which care degrees pay: some tariffs start only at Pflegegrad 2 or 3.

Supplementary cover is where independent advice has the biggest effect. MyHealthcareBroker's independent consultants compare tariffs across insurers, so you see the whole market and not one company's products. This is especially useful if you already have private health insurance and want your care cover to fit the rest of your plan.

How to apply for a care degree

Benefits are only paid on application (§33 SGB XI), and they start from the date of your application. Apply as soon as care is needed. You do not have to wait for the doctor to say so.

1. Contact your Pflegekasse. Call or write to the care fund at your health insurer and ask for a care degree application (Antrag auf Pflegeleistungen). If you are privately insured, contact your private insurer. A relative or authorised person can apply for you.
2. Collect documents. Medical reports, a list of medication and a care diary of daily help needed make the assessment more accurate. Note everything you cannot do alone, especially on bad days.
3. The assessment. For public insurance, the Pflegekasse commissions the Medizinischer Dienst or an independent assessor (§18 SGB XI). Privately insured people are assessed under the same criteria. The assessor visits you at home and scores the areas above. Have a relative or carer present.
4. The decision. The Pflegekasse must decide in writing within 25 working days of receiving the application (§18c SGB XI). If it misses the deadline through its own fault, it owes you €70 for each week of delay it began.
5. Choose your benefits. Decide between Pflegegeld, Pflegesachleistung or a combination, and arrange the first care advice visit if you take Pflegegeld.
6. Object if you disagree. If the care degree is lower than you expected, you can file an objection (Widerspruch) against the decision. Keep your care diary and ask for the assessment report.

Special points for expats

• Contributions start with your job or enrolment. You do not choose care insurance separately. It begins the day your health insurance does. See our Anmeldung guide and moving to Germany checklist for the order of steps.
• The two-year rule matters most for new arrivals. If you arrive as an adult with no earlier German cover, expect a gap before you can claim. A supplementary policy is one way to plan for it, so compare waiting periods.
• Residence permits require health insurance. Care insurance comes with it. See the visa guide for what the Ausländerbehörde asks for.
• Other cover to compare. The expat health insurance guide, the dental insurance guide and liability insurance cover the other policies expats usually need.

Long-term care insurance Germany: common questions

Sources

Figures checked on 15 October 2026 against the sources below. Benefit amounts are the 2026 values in SGB XI. The law allows them to be adjusted, so check the current figures with your Pflegekasse before relying on them for a decision.

• Contribution rate, childless surcharge, child discounts: §55 SGB XI; rate table and Saxony: GKV-Spitzenverband, Beitragssatz and Federal Ministry of Health, Finanzierung
• Definition of need of care: §14 SGB XI; care degrees, points and weightings: §15 SGB XI
• Pflegegeld and advice visits: §37 SGB XI; Pflegesachleistung: §36 SGB XI; care home: §43 SGB XI
• Care aids and home adaptations: §40 SGB XI; relief amount: §45b SGB XI
• Application, waiting period and benefit start: §33 SGB XI; assessment: §18 SGB XI; decision deadline and delay payment: §18c SGB XI
• Compulsory public insurance: §20 SGB XI; private compulsory care insurance: §23 SGB XI; employer subsidy: §61 SGB XI
• State-subsidised supplementary insurance: §126 SGB XI and §127 SGB XI