The vast majority of people, especially those in need of care and their families, prefer home care because their own home offers a sense of familiarity and independence.
More than 4.8 million people in Germany who require care are currently being cared for at home, which accounts for over 85 percent of all those in need of care. The German long-term care system systematically prioritizes home care, as it aligns with the wishes of most of those affected.
This magazin what home care really entails, what support and care services are available to all those affected and their caregivers, and how to access them. It is important to organize the care situation effectively and to take advantage of all available resources, information, and guidance to ensure long-term care.
Home Care: What Does It Entail?
Home care encompasses all assistance and support services for people who, due to illness, disability or old age can no longer manage their daily lives on their own but would like to continue living in their own home or with relatives.
This isn't about curing an illness, but about supporting one's own lifestyle.
Home Care Services
Home care services are traditionally divided into four categories:
1. Personal care (basic care)
This is about hygiene and basic needs:
- Personal hygiene: washing, showering, bathing, dental care, combing, shaving.
- Nutrition: Preparing food in bite-sized portions and assisting with eating.
- Bowel movements: Assistance with using the toilet, changing incontinence supplies.
- Mobility: Assistance with getting up and going to bed, moving around, and getting dressed and undressed.
2. Nursing care measures
This is about psychological and social support:
- Assistance with orientation and daily routines
- Accompaniment on walks or to appointments
- Support for hobbies or social activities
3. Housekeeping Services
Home care also includes housekeeping services to ensure that the living environment remains clean and safe:
- Shopping for groceries and everyday essentials
- Cooking meals
- Cleaning the apartment
- Laundry care
Who needs home care?
Anyone with an officially recognized care level is entitled to home care. Specifically, this means that the need for assistance is determined by the medical service . Home care is primarily intended for seniors with physical ailments, people with dementia, those with chronic illnesses, or people with physical or mental disabilities.
Who provides home care?
Home care is usually provided by a combination of different caregivers:
- Family members/informal care: Partners, children, neighbors, or friends provide care, often supported by the care allowance.
- Home Care Services: Professional caregivers come to your home. Billing is handled through in-kind care benefits.
- Daily Caregivers/Household Helpers: Provide specialized support with housekeeping or personal care; this can be covered by the relief amount of €131 per month.
- 24-hour care: Typically provided by caregivers who live in the home. Legally, this often constitutes a hybrid arrangement, financed either privately or through care allowance payments.
Financing at a Glance
- Care allowance: If you receive care from a private caregiver (such as a family member).
- In-home care services: When a professional caregiver comes to your home.
- Combined performance: A mix of both.
- Care supplies: For example, hospital beds, disinfectants, or disposable gloves (up to €42 per month, flat rate).
Home Care vs. Home Health Care
To understand the differences between and the interaction of these two types of support, it is important to clarify the following distinction: Home health care provided by health insurance aims to help you recover or prevent your condition from worsening, while home care provided by long-term care insurance supports your daily life if you have a permanent disability.
Here is the detailed breakdown:
1. Home Health Care (Section 37 of Book V of the Social Code)
This service is covered by health insurance.
Requirement: A doctor's prescription; therefore, no care level is required.
- The three types of services:
- Medical care: Medical procedures provided as part of patient care. These include, for example, changing dressings, administering insulin, administering medication, and putting on compression stockings.
- Basic Care & Housekeeping: Only if it serves to prevent or shorten a hospital stay; in such cases, it is referred to as "hospital prevention care."
- Supportive care: Care that is necessary to ensure the success of medical treatment.
- Duration: Temporary, often lasting only a few weeks after surgery or during an acute phase of illness.
- Costs: Home nursing care is covered by health insurance, but patients are generally required to pay a copayment of €10 per prescription plus 10% of the costs for up to 28 days per year.
2. Home Care
This service is funded by the long-term care insurance fund. The German long-term care system considers home care to be the preferred form of care and provides various care services for this purpose, aimed at people in need of care, their families, and their caregivers.
- Requirement: A recognized care level.Key areas:
- Personal care: Assistance with washing, showering, or brushing teeth.
- Nursing care services: Assistance with daily routines, accompaniment on walks.
- Household assistance: cooking, cleaning the home, grocery shopping.Types of services:
- Care allowance: For care provided by family members, friends, or neighbors.
- Care benefits in kind: For the use of a professional care service.
- Relief amount: €131 per month for all care levels.
Long-term care benefits include various options such as cash benefits, in-kind benefits, and the combined benefit, which allows for a proportional combination of cash and in-kind benefits. The available budget can be used flexibly for these benefits. The amount of long-term care benefits generally increases with the care level.
Long-term care insurance also provides support if individuals in need of care choose to be cared for by family members, friends, or neighbors rather than by an outpatient care service. Recipients of long-term care benefits are required to attend a home visit at least once every six months.
A Comparison of Home Care and Home Nursing Care
| Feature | Home Health Care | Home Care |
|---|---|---|
| Jurisdiction | Health insurance | Long-term care insurance |
| Goal | Healing / Ensuring the effectiveness of the treatment | Compensating for Limitations in Daily Life |
| Need for | Medical prescription | Medical Assessment (Care Level) |
| Focus | Medical assistance (injections, wounds) | Daily living assistance (personal hygiene, household chores) |
| Period | Acute, temporary | Permanent |
When does home care become worthwhile?
The short answer: sooner than many people think.
Home care doesn’t start only at care level 4 or when someone can no longer get out of bed. It begins when daily life becomes more difficult—after an accident, after surgery, during pregnancy when household chores become a burden, or simply when one’s own strength starts to wane.
Especially in the early stages, it is important to seek advice and information about all available options as soon as possible in order to find the right support for both the person in need of care and the caregiver. Accepting professional help is not a sign of weakness; rather, it may be necessary for long-term home care and the well-being of everyone involved.
Home Care and the New BEEP Act of 2026
Starting in 2026, the BEEP Act will provide concrete relief for home care:
- Prevention programs are coming to your doorstep: Health promotion now takes place right in your neighborhood
- Digital healthcare applications (DiPA): are easier to use
- Respite care is becoming more flexible: clear billing deadlines, less bureaucracy
- Consultation visits are being standardized: one point of contact instead of many
The new services and counseling options are available to all individuals in need of care and their family members. In addition to traditional care, they include a wide range of support services and professional counseling designed to ensure the quality of home care and provide relief to family caregivers.
Respite Care: An Important Benefit of Long-Term Care Insurance
If the primary caregiver is unable to provide care—for example, due to vacation, illness, or exhaustion—a substitute caregiver takes over the care of the person in need of care. This is available for up to 6 weeks per year, with funding of up to €3,539. Respite care can also be arranged on an hourly basis. In addition to family members, friends, neighbors, or other individuals can also provide care. Respite care is available to all individuals in need of care and their caregivers to provide relief to affected families.
Home Care Services or Housekeeping Help – Which Is Right for You?
Home care services: when personal hygiene, medication administration, or wound care are needed. The cost of outpatient nursing care is primarily determined by the frequency and duration of visits. The budget for care services can be flexibly allocated to various services such as nursing care, personal assistance, or household help. Individuals in need of care and their caregivers benefit from a wide range of care services and support options that are available to all those affected.
Household assistance: When you need help around the house, someone to accompany you to appointments, and genuine human connection.
Tips for family caregivers
- Take advantage of free care counseling: Comprehensive counseling is especially important for all caregivers and those in need of care. Take advantage of this counseling to receive up-to-date and practical information about all home care services and offerings. Counseling can be conducted in person or via video conference and helps ensure the quality of care.
- Caregiving courses and support services: Relatives, family members, friends, and neighbors can take part in special caregiving courses to receive practical assistance and information on caring for those in need of care. These services are intended for anyone involved in providing care.
- Take your own limits seriously: Seek respite care in a timely manner if the burden becomes too much. Open communication about problems and needs with other caregivers, family members, friends, or neighbors helps you find suitable support options and avoid burnout.
- Don’t try to handle household chores all on your own: Accepting professional help from a housekeeper isn’t a sign of weakness; rather, it’s essential for the long-term well-being of everyone involved.
Frequently Asked Questions About Home Care
How do I arrange home care?
The first step is to contact your long-term care insurance provider or a long-term care counseling service. You are entitled to personalized long-term care counseling under Section 7a of Book XI of the Social Code (SGB XI); this counseling is free of charge and helps create a care plan for all individuals in need of care. During this process, all relevant information, services, and care options for the individuals concerned and their caregivers are discussed.
How much does home care cost?
That depends on the care level and the services requested. The amount of care benefits generally increases with the care level. In many cases, the costs are covered in full or in part by the long-term care insurance fund or health insurance provider. The budget for care services can be used flexibly for various services.
