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Care Insurance

Long-Term Care Insurance in Germany

Pflegeversicherung is mandatory for everyone in Germany. But the statutory coverage leaves a significant gap that many only discover when it's too late.

Why care insurance matters

Germany is facing a demographic challenge. According to official statistics from the Federal Statistical Office (Destatis):

  • As of 2023, approximately 5 million people in Germany are classified as needing care (pflegebedürftig)
  • By 2040, projections estimate this number will exceed 5.6 million
  • By 2060, up to 6.2 million people may require long-term care

The statutory care insurance (Pflegepflichtversicherung) was introduced in 1995 as a "partial coverage" system — it was never designed to cover all care costs.

How Pflegepflichtversicherung works

Long-term care insurance is mandatory for everyone in Germany, regardless of whether you have GKV or PKV health insurance. The principle: Pflegeversicherung follows health insurance (SGB XI §20).

Contribution rates (2026)

CategoryGKV RateNotes
Standard (with children)3.40%Of gross income up to BBG
Childless (age 23+)4.00%0.60% surcharge (Kinderlosenzuschlag)
With 2+ children under 25Reduced0.25% reduction per child (2nd–5th), per PUEG reform

In PKV, the Pflegepflichtversicherung premium is calculated actuarially (by age at entry), not income-based. This means it is fixed and includes aging reserves.

Care levels (Pflegegrade) and benefits

Since the Pflegestärkungsgesetz II (2017), care needs are classified into 5 levels:

GradePflegegeld (home)Sachleistung (professional care)Full inpatient
Pflegegrad 1€125 subsidy
Pflegegrad 2€332€761€770
Pflegegrad 3€573€1,432€1,262
Pflegegrad 4€765€1,778€1,775
Pflegegrad 5€947€2,200€2,005

Values as of 2024 (PUEG reform). Pflegegeld and Sachleistung amounts were increased by approximately 5% with the PUEG. Check current values at the Federal Ministry of Health.

The coverage gap: what statutory care doesn't pay

Full residential care in Germany costs between €3,000 and €5,000 per month depending on the facility and region. Even at the highest care level (Pflegegrad 5), statutory coverage pays only €2,005/month for inpatient care.

The remaining cost — often called the "Eigenanteil" (personal contribution) — must be paid from savings, pension, or family support. The average Eigenanteil for nursing home care in Germany is currently around €2,500/month.

This means: without supplementary coverage, a typical nursing home stay can consume over €30,000 per year from personal assets.

Private supplementary care insurance

There are two main types of supplementary Pflegeversicherung:

1. Pflegetagegeld (Daily care benefit)

  • Pays a fixed daily amount based on your care level
  • You can use the money freely — no receipt required
  • Premiums depend on entry age and daily rate

2. Pflege-Bahr (State-subsidized)

  • The state pays a €5/month subsidy (€60/year) if you contribute at least €10/month
  • Open to anyone regardless of health status (Kontrahierungszwang)
  • Benefits are limited — Pflege-Bahr alone rarely closes the full gap

3. Pflegekostenversicherung (Cost reimbursement)

  • Reimburses actual care costs above the statutory level
  • More comprehensive but requires receipts for reimbursement

PKV vs. GKV: care insurance differences

The statutory care benefits are identical in GKV and PKV — both systems provide the same Pflegepflichtversicherung benefits.

The key difference is in how premiums are calculated:

  • GKV: Income-based (Umlageverfahren) — premiums rise with income and legislative changes
  • PKV: Risk-based with aging reserves (Kapitaldeckungsverfahren) — premiums are more stable long-term

For supplementary care insurance, PKV policyholders often receive better conditions because their care premium already includes aging reserves.

Close your care coverage gap

We help you find the right combination of mandatory and supplementary care insurance.