Long-term care insurance in Germany: How to properly insure your care costs
Imagine your father suddenly needs care. Everything turns upside down overnight. Long-term care insurance in Germany does help with care and support, but many families are still unsure: What services does it cover? What out-of-pocket costs remain? Especially for family caregivers and self-employed caregivers, it's important to understand how to secure oneself with private long-term care insurance in advance.
We know that care costs – but with the right protection, you are well-prepared for the future. This includes one main thing: clarity. You need information you can rely on – simply explained, understandable, and practically applicable. So that care does not become a financial worry, but is easier to bear with knowledge, heart, and support.
When someone becomes in need of care, high costs quickly arise – for support in daily life, caregivers, or a place in a nursing home. To ensure that you don't have to bear everything alone in such a situation, there is long-term care insurance. It ensures that those in need of care and their relatives are financially relieved.
In the Eleventh Book of the Social Code (SGB XI) , you will find all important regulations regarding long-term care insurance.
Why is long-term care insurance necessary?
Our society is getting older: In Germany, around 21.5 million people are expected to be 67 years or older by 2040. As we age, the likelihood of needing external help increases – especially after the age of 80.
Currently, there are around 5.2 million people in need of care in Germany, most of them are over 60 years old. Among those over 75, it is nearly 17%, and among those over 90, more than 81%. These numbers show: The older we get, the more likely we are to need help.
Being in need of care means high physical, mental, and financial burdens for those affected and their families. Additionally, family structures have changed: There are fewer children, many are employed, and cannot take care of their parents as intensively as before.
Definition and introduction of long-term care insurance
The long-term care insurance was introduced in Germany in 1995. Since then, it has been a fixed part of the social security system. Its goal: to support people in need of care – whether they are cared for at home or in a facility. It works on a simple principle: You pay regular contributions, and in the event of care, the insurance covers part of the costs.
The long-term care insurance as the 5th pillar of social insurance
Long-term care insurance is the fifth pillar of social insurance in Germany – alongside health, pension, accident, and unemployment insurance. This means: It is just as important as the other areas of social security and protects you and your family from a financial risk that can affect anyone.
Difference: Germany vs. Austria
In Germany, you are automatically covered by long-term care insurance – either through statutory or private long-term care insurance. It covers benefits such as care allowance or care services, depending on the level of care. This means: Anyone who is covered by health insurance is automatically also covered by long-term care insurance. This ensures that no one is left without support in the event of care needs.
The long-term care insurance in Austria works a little differently: There is a government care allowance, which is graded in seven levels, and people in need of care receive it monthly. It serves as financial support to partially cover care costs.
Statutory insured (GKV)
If you are insured with a statutory health insurance company (GKV), you are automatically also a member of the social long-term care insurance. Contributions are collected directly with your health insurance and split between you and your employer. Even retirees continue to pay contributions – usually through their health insurance company.
Privately insured (PKV long-term care insurance)
If you are privately health insured, you must take out a private long-term care insurance (PPV) . It works similarly to the statutory long-term care insurance but is offered by private insurance companies. Without this proof, no private health insurance can be taken out – so the protection in the event of care is mandatory here as well.
Special regulations (Civil servants, self-employed, retirees)
- For civil servants there is a special regulation: they receive assistance from the employer in the event of care and secure the rest with private long-term care insurance.
- Self-employed can freely choose whether they are insured with statutory or private health insurance – their decision automatically determines where they are covered for long-term care insurance.
- Retirees generally remain in the long-term care insurance they were insured with before and pay their contributions directly through their pension.
On July 1, 2025, the benefit amounts of long-term care insurance will increase by 4.5%. Additionally, there will be improvements in care support allowances and a stronger promotion of relief offerings. The goal is to better support family caregivers and cushion care costs.
Contribution rate in Germany
In Germany, the contribution rate for long-term care insurance in 2025 is 3.6% of your gross income. Childless individuals over 23 years old pay a higher rate of 4.2%. The contributions are usually split equally between you and your employer – so you pay about half.
Special feature in Saxony: Here, employees pay a slightly higher share, while employers pay a lower share.
Table: Contribution rate long-term care insurance Germany 2025
Financing & redistribution process
Long-term care insurance is financed through a redistribution process: The ongoing contributions of the insured are directly used for the current people in need of care. This ensures the care of the people in need of care immediately.
Care allowance (cash benefit)
If you or a relative are cared for at home, you can receive care allowance. This allows you to decide for yourself who will provide the care – e.g. family caregivers.
How much does long-term care insurance pay per care level?
The amount of benefits depends on the care level. In Germany, the care allowance in 2025 ranges from about €332 per month (care level 2) to €947 per month (care level 5).
Table: Care allowance in Germany 2025 per care level
Step-by-step guide: Applying for care level
The application for a care level is submitted informally to the care insurance (i.e. the health insurance of the person in need of care). A guide like this removes the initial uncertainty and shows you exactly which steps are necessary to ensure everything runs smoothly.
1. Submit the application
The application is submitted informally to the care insurance (the health insurance of the person in need of care).
2. Prepare for the assessor's appointment
The appointment with the assessor from the care insurance is often emotionally challenging. Prepare yourself and your family mentally to present the situation calmly and objectively.
Note the current care needs, support in daily life, mobility, nutrition, medication, medical measures, as well as special occurrences or deterioration. Have all medical reports, diagnoses, therapies, and current medication ready. A clear, comprehensible presentation of the care needs strengthens the argument for the correct care level.
3. Assessor's appointment
- Be on time and have all documents ready.
- Show the care log, answer questions truthfully and in detail.
- Emphasize the actual daily burdens and support needs.
4. After the appointment
The care insurance evaluates the application and the assessor's report, and you will then receive a decision about the care level.
Care in kind services (nursing service)
Alternatively or additionally, you can use care in kind services, i.e. professional help from a nursing service. The services are directly billed by the care insurance.
Combination services
You can combine care allowance and care in kind services if you use both family members and professional care. This reduces the care allowance proportionally to the used care in kind service.
Nora's formula tip:
Short-term care & respite care
If you or your relatives temporarily need additional help – for example, after a hospital stay or because the primary caregiver is unavailable – you can use short-term care or respite care.
Maria cares for her mother – but who takes care of Maria? This is where support services come in: They are specifically designed to relieve the burden on caregivers. Sabine can take breaks, recharge, and be sure that her loved ones are still well cared for. These services ensure that caregiving is not only a duty but also sustainable and manageable.
Day & night care
Day or night care allows you to be cared for during the day or at night while still living at home. This relieves relatives and ensures professional care.
Inpatient care (nursing home, co-payments)
If care at home is no longer possible, the insurance covers some of the costs for a nursing home. However, co-payments for accommodation, meals, and uncovered care costs must be paid by you.
Care aids & relief allowance
For aids like wheelchairs, nursing beds, or incontinence products, you can use services from the care insurance. There is also a relief allowance of €125 per month for supportive services, e.g. nursing bed or bathroom modifications.
Home environment improvements (renovations, grants)
To make caregiving at home easier, you can receive a grant of up to €4000 for barrier-free renovations like ramps or stair lifts.
Care services in Austria (care allowance levels 1–7)
InAustria there is care allowance after seven levels, depending on the care needs. The higher the level, the greater the financial support for care at home or by relatives. The care allowance amounts in 2025, depending on the level, range from about €192 to over €1,900 per month.
Source: Federal Ministry for Labor, Social Affairs, Health, Care and Consumer Protection, status: January 2025
To truly focus on care, it is important to know the financial truth. This way, you avoid unpleasant surprises and can trust your budget.
Understanding combination services
When you use care allowance together with care in kind services, the care allowance is reduced proportionally.
Example:
- Care level 3: Care allowance €545 per month, care in kind services up to €1,300 per month
- You use care in kind services worth €650
- Then your care allowance is reduced to half, i.e. €272.50
This way, you can immediately see how much money is actually available to you – and how you can cleverly combine the services without having to give up anything.
Average costs for outpatient care in Germany
If you are cared for at home, average monthly costs of €1,500–2,500 for a professional nursing service are incurred (depending on the care level).
Average costs for inpatient care (nursing home costs, 24h care)
A nursing home costs in Germany – depending on the region and facilities – about €3,500–5,500 per month. This amount includes accommodation, meals, investment costs, and nursing services. Outpatient care (nursing service at home) costs an average of about €2,000 per month.
The often mentioned €3,000–3,800 for inpatient care usually refers not to the total costs, but to the nursing portion or average co-payments after the care insurance benefits have been deducted.
Summary for classification
- Nursing home costs in total = nursing costs + accommodation/board + investment costs
- Care insurance only covers nursing costs (limited by care level).
- Co-payment = total – care insurance contribution.
- Amounts of €3,500–5,500 are total costs.
- Amounts like €3,000–3,800 usually only reflect the care-related co-payment or a partial component.
Table: Average care costs vs benefits (care gap)
Scenario examples
Anna, 80, care level 3 (nursing home stay)
Costs €3,200, benefit €1,262, care gap ~€1,940.
This care gap of €1,940 per month must be closed either with private savings or an efficient care solution. This is where noracares comes in: We help you find the necessary 24h caregiver without expensive agency-commissions that unnecessarily widen the gap.
Peter, 50, healthy, planning for the future
Purchased supplementary insurance for €60 per month → Coverage for old age.
Maria, 65, care level 2, home care
Care allowance €332, costs ~€800, gap ~€470.
If care insurance is insufficient: A real-life story
Anna is 80 years old and recently moved into a nursing home because she needs round-the-clock care. She used to manage her life independently: she went for walks, took care of the household, and enjoyed time with her grandchildren. However, after several falls and increasing weakness, it is no longer possible to manage alone.
The move to the nursing home was a big step – for Anna herself, but also for her family. Suddenly, she finds herself in an unfamiliar environment, with familiar rooms and the neighborhood far away. Every day, she is supported by caregivers: with washing, dressing, eating, and every movement she can no longer manage on her own.
The care insurance covers only part of the nursing home costs. The rest must be covered by Anna or her daughter and son – several thousand euros per month, which put pressure on the family’s income. The family feels the financial burden strongly, but at the same time, they want to provide Anna with the best possible care. It is a constant balancing act between care, financial worries, and the desire to ensure a dignified life, showing how important early planning and support through private supplementary insurance are.
Difference between compulsory insurance and supplementary insurance
Thelong-term care insurance is legally required in Germany – it provides basic coverage. Private supplementary long-term care insurance, on the other hand, is voluntary. It supplements the services of compulsory insurance and can reduce the so-called care gap, i.e., the difference between actual care costs and the benefits provided by statutory or private compulsory insurance.
Typical benefits of private supplementary long-term care insurance
- Care daily allowance: You receive a fixed amount daily when you become in need of care, whether at home or in a care facility.
- Care pension: Monthly payment that provides long-term financial security.
- Care cost insurance: Directly covers part of the care costs not covered by compulsory insurance.
Costs & Contributions (Examples)
- Affordable rates: Basic coverage from about €30 per month.
- Meaningful coverage: For more extensive benefits, contributions are usually between €50 and €100 per month. The exact costs depend on your age, health status, and the desired benefits.
Advantages of private long-term care insurance
- Closes the care gap and reduces financial burdens.
- Flexibility in choosing the type of care (at home or in a facility).
- Coverage for family members who provide care.
- Customizable rates based on needs.
Disadvantages & Risks
- Waiting periods: Some benefits only apply after a waiting period.
- Exclusions: Pre-existing conditions may be excluded.
- Rising premiums: Contributions can increase with age or rising care costs.
Contribution Rate Adjustments
From July 2025, the contribution rate for long-term care insurance in Germany will increase slightly. This affects both those with statutory insurance and private long-term care insurance. Employers and employees will continue to share the costs. The adjustment ensures that the long-term care insurance remains stable in the long term.
Increase in Benefit Amounts by 4.5% (Outpatient + Inpatient)
The benefits of long-term care insurance will be increased by 4.5% from July 2025 – both for outpatient care at home and for inpatient care in nursing homes. This is to better align long-term care insurance with rising costs and improve financial relief for people in need of care and their relatives.
New Care Support Payment
The new Care Support Payment will help relieve relatives who need to provide short-term care to individuals in need, for example, after a hospital stay or during acute illness. The payment helps alleviate financial pressure and makes it easier to reconcile work and caregiving.
Impacts for Insured & Relatives
For you and your family, this means: more financial support in case of need for care, higher benefit amounts, and better protection when short-term care is required. At the same time, the slightly increasing contributions may be noticeable, but they ensure the long-term stability of long-term care insurance.
Long-term care can affect any family – suddenly, concerns about health, daily life, and finances arise. But you are not alone: with long-term care insurance, you have a reliable foundation that gives you and your loved ones security. The better you understand the benefits and prepare early, the easier it is to close the care gap – and the more dignity and security you can offer those who rely on help.
The long-term care insurance 2025 provides important basic services in Germany, but it only covers part of the actual costs. Quickly, several hundred to a thousand euros per month remain, which you should additionally secure. Here, it is worth considering private insurance, even for those working abroad.
Care means dignity, security, and care. Those who plan ahead today ensure that their loved ones are relieved tomorrow – and can give the most valuable gift: time, closeness, and peace in the heart.
At noracares there is no agency in between. Caregivers and families connect directly and transparently through their accounts. The transparent fee negotiation at noracares directly reduces the care gap, as no high, hidden intermediary costs apply. This way, you negotiate fairly, see the terms immediately, and decide for yourself how the care should be arranged. noracares creates clarity, security, and independence – for you and your loved ones.
Now that you know your care level and the benefits? Use noracares now to directly find the appropriate 24h caregiver to close your care gap!
- SGB XI (Eleventh Book of the Social Code): The legal code that anchors all the legal foundations of social long-term care insurance in Germany.
- Care Level (1 to 5): The classification of care needs. It determines how much financial support someone receives. The higher the impairment of independence, the higher the care level.
- Care Gap: The difference between the actual care costs (e.g., in a nursing home) and the benefits covered by the statutory long-term care insurance. This remaining amount must be privately financed.
- Care Services: Professional care assistance provided by an outpatient care service and billed directly with the care insurance fund.
- Care Allowance: A financial benefit for individuals in need of care who are cared for at home by relatives or friends. The person can freely use the money.
- Combination Benefit: The simultaneous use of care allowance and services. If a care service only consumes part of the budget, the remaining care allowance is paid out proportionally.
- Respite Care: Money for replacement care (up to 6 weeks per year) if the primary caregiver is absent due to vacation or illness.
- Short-term Care: Temporary full inpatient care in a facility, usually after a hospital stay or in crisis situations.
- Relief Amount (125 €): A monthly fixed amount that can be used for qualified support offers (e.g., daily helpers or cleaning assistance).
- Care Day Allowance: A private supplementary insurance that pays a fixed daily rate in the event of care needs to close the care gap.
- Apportionment Procedure: The financing principle of statutory long-term care insurance, where today's contributors directly finance the benefits for today's care recipients.
- Home Environment Improvement: Financial subsidies (up to 4,000 €) from the care insurance fund for structural measures that facilitate or enable home care (e.g., installation of a stairlift).
