What do Germany’s care reforms mean for you?

Germany’s federal cabinet has agreed on a draft of the so-called “Care Reorganisation Act” (Pflegeneuordnungsgesetz). Here’s what it means for people who pay into Germany’s long-term care insurance scheme.

German cabinet signs off care reform draft

Germany’s CDU/CSU-SPD coalition cabinet has signed off on the Care Reorganisation Act, aiming to close a budget gap of around 8 billion euros in the coming year. Federal Health Minister Carsten Linnemann (CDU) said the reform marked the “first important step” towards stabilising Germany’s long-term care system. 

Everyone who works in Germany must make long-term insurance contributions, which are deducted from their income. Long-term care insurance (Pflegeversicherung) was added to Germany’s social security system in 1995 to ensure that everyone who needs long-term nursing care, whether due to accident, illness or old age, can receive the care they need when they need it, without it burning a hole in their pocket.

What does the Care Reorganisation Act mean for workers?

The reform will impact both those people who are in work and contributing to the long-term care insurance scheme, and those who are already receiving long-term care. First, what does it mean for workers?

Higher surcharges for childless employees

Currently, employees pay a base rate of 3,6 percent of annual income towards long-term care insurance. This 3,6 percent is paid by employees and their employer, with each contributing 1,8 percent. On top of the base rate, those aged over 23 and without children pay an additional “surcharge” of 0,6 percent. 

According to the reform, the additional surcharge will increase to 0,9 percent. Unlike the base rate, employees pay the surcharge entirely. This means employees without children will now contribute 4,5 percent of their annual income to long-term insurance from the start of 2027.

New surcharge for co-insured spouses

As it stands, married couples and civil partners benefit from free spousal long-term insurance coverage. This means that employees covered by insurance can extend their plan to cover their non-working spouse or civil partner and their children at no extra cost.

This will change. Starting in 2027, insurees will have to pay a surcharge of 0,52 percent to insure their spouse. There will be an exception for parents of children who are disabled and those who are caring for relatives.

Higher income earners will pay more

Higher income earners will also have to make larger contributions come 2027. Currently, the contribution assessment ceiling is 5.812,50 euros per month, or 69.750 euros per year. This means that any income over this amount is not subject to contribution rates.

This ceiling will be increased by 300 euros to 6.112,50 euros per month.

Minijobbers must contribute

Currently, people who are employed in mini-jobs are not obliged to make long-term care insurance contributions. From 2027, mini-job incomes will be subject to long-term care contributions; this is expected to bring in around 1,4 billion euros in tax revenue.

A mini-job describes a work contract where the employee earns no more than 603 euros per month (in 2026) or works less than three months or 70 days per year (Kurzfristige Minijobs). These limits are typically adjusted annually.

Care workers will have more tasks

In addition to contributing more to their insurance, care workers will have more on their plate. Care employees will be expected to carry out tasks which previously required authorisation from a doctor, such as dressing certain wounds and diabetes care. 

There will be cuts to other tasks, such as reducing daily documentation requirements. Alongside this, care assistant training will be standardised nationally.

Family carers will get 300 euros per month

Those providing informal care for family members will receive 300 euros per month, earmarked to cover everyday costs.

And what does it mean for people already in care?

Then there are the people on the direct receiving end. What does the Care Reorganisation Act mean for those currently in care?

Care assessment will change

The government is yet to publish details on this change, but plans to reorganise how different care levels are assessed. These care levels decide what benefits and services recipients are entitled to.

The current relief contribution of 131 euros per month, currently available to level one care recipients, will be abolished.

Preventative check-ups for over 60s

Finally, people aged 60 and over will be entitled to attend a so-called “Check-up 60+”, an appointment with the doctor, with the aim of detecting health problems earlier on.

What happens next?

Now that the cabinet has signed the draft law, it will head to the Bundestag and Bundesrat for consideration. This process could result in further changes. If the changes are minor, the law will likely pass this autumn and take effect in 2027.