Long-term care insurance (Pflegeversicherung) was added to Germany’s social security system in 1995 to ensure that everyone is prepared for the eventuality of needing long-term nursing care, whether due to accident, illness or old age.
Long-term care benefits are funded by mandatory contributions from all employees in Germany (currently 2,55-2,8% of annual salary). The scheme is either provided by your statutory health insurance or your private health insurance. The type of long-term care support you receive depends on your situation.
Long-term care requirements
To be eligible for long-term care benefits, you need to fulfil the following requirements:
- You are covered by statutory health insurance or private health insurance and have been contributing to a long-term care insurance scheme.
- You must demonstrate a “need for long-term care” (Pflegebedürftigkeit) - defined as exhibiting health-related restrictions to your independence or abilities that require the help of others. This need must also be expected to last at least six months (if the expected duration is less than this and you are employed, you may qualify for sickness benefit instead).
Your need of care will be assessed individually and classified with a “care grade” from 1-5 that reflects how severely your independence and abilities are impaired.
Long-term care benefits (Pflegegeld)
The long-term care provision recognises that most people in need of care want to stay in familiar surroundings for as long as possible. The focus is therefore on providing benefits that can keep you out of hospital, improve home care and lighten the load of family carers.
The exact type and value of the benefits you receive depend on your personal situation, including any pension or other benefits you are receiving, and which care grade you have been allocated. Your long-term care benefits might include:
- Mobile care (ambulante Pflegesachleistung).
- Long-term care allowance (Pflegegeld), up to 901 euros per month.
- Support allowance (Entlastungsbetrag), up to 125 euros per month.
- Home care assistance (i.e. care service or individual carer), up to 1.995 euros per month.
- Subsidies for home modifications, up to 4.000 euros per project.
- Free nursing care courses for relatives.
- Care advice (Pflegeberatung) for individuals and their relatives.
- (For those requiring full-time institutional care) inpatient care allowance for care-related costs (not accommodation or meals), up to 2.005 euros per month.
How to apply for long-term care benefits
To apply long-term care, you will need to submit an application to your long-term care insurance fund, which is an arm of your health insurance fund. Your family members, neighbours or close friends can also submit an application on your behalf if you authorise them to do so.
Once the application is received, the long-term care insurance fund will pass it on to the Medical Service of the German Health Insurance Funds (Medizinische Dienst der Krankenversicherung) or an independent assessor to assess your individual care needs. This will usually include a visit to your home by a carer or a doctor, who considers things like your mobility, cognitive and communication abilities and self-care.
Within 25 working days, the long-term care insurance fund will then respond with a written assessment notice, sent to you by post. This will include the outcome of their assessment and details of any benefits due to be paid to you.