Long-term care insurance offers a wide range of benefits to meet the different needs of people with care requirements and their individual care situations.
The Agency for Home Help provides you with a comprehensive overview of the care services available, their financial amount and your individual entitlements.
The waiting time
To be eligible for long-term care insurance benefits, you must both be officially in need of long-term care and meet the insurance conditions. Before you can apply for benefits for the first time, you must have been insured under statutory long-term care insurance for at least two years within the last ten years. This is known as the waiting period. For children who are insured through their parents, the waiting period is deemed to have been fulfilled as soon as one of the parents has fulfilled it.
For persons who leave private long-term care insurance because they are subject to compulsory social long-term care insurance, the following applies: The period of insurance in private health insurance is counted towards the waiting period.
Entitlement to care services
Certain requirements must be met in order to be able to claim care services:
- You must have either statutory or private long-term care insurance.
- You must be eligible for benefits from your long-term care insurance.
- You must have a recognized care degree.
Most people in Germany are automatically insured for long-term care, as long-term care insurance is a compulsory insurance policy.
To be able to claim benefits from statutory long-term care insurance, you must meet certain requirements. These include having paid contributions for at least two years within the last ten years or having family insurance. However, other conditions may apply for private long-term care insurance.
To get an overview of the benefits provided by the long-term care insurance fund, the care advice can be a great help.
The allocation of a degree of care is used to determine your need for care. If you do not yet have a care degree and apply for care benefits, your care insurance fund will carry out a care assessment. Based on this assessment, you will then if you are in need of care, you will be assigned a care level from 1 to 5. If there is no need for care, your application will be rejected and you will have the opportunity to lodge an objection within a period of four weeks.
Applying for long-term care insurance benefits
If you do not already have one, you must application for a recognized care degree with the relevant long-term care insurance fund in order to receive benefits from the insurance. For those with statutory insurance, the long-term care insurance fund is usually linked to their health insurance fund, while privately insured persons are free to choose their compulsory long-term care insurance (PPV).
After you have submitted your application, your long-term care insurance company will commission a long-term care assessment to check your entitlement and determine your care degree. Once a care degree has been determined, you are entitled to benefits that are granted retroactively from the date of your application.
Which long-term care insurance benefits can be claimed?
Here you will find an overview of long-term care insurance benefits:
Measures to improve the living environment
The care insurance fund grants up to 4,180 euros per measure to fund structural adaptations in the living environment such as installing a barrier-free shower or adjusting window handles to reach height for wheelchair users. All you have to do is submit a cost estimate to the care insurance fund. If you live in a shared flat with other people in need of care, you have the option of combining the grants. These can be used up to a total amount of 16,000 euros.
Care aids
These aids are designed to support care at home and promote independence. They include, for example, disposable gloves, disinfectants and technical devices such as a home emergency call system, a care bed or a back support. A doctor's prescription is not required. You can apply for the required aids by telephone or in writing to your care insurance fund.
Relief amount
The relief amount is 131 euros per month and is available to you if you are cared for at home. The money can also be used for care and everyday support. Trained helpers volunteer to provide hourly care in the home or outside the home. For higher care levels, the relief amount can also be used for short-term care as well as day and night care.
The relief amount is not paid out directly, but is reimbursed after you have used the services of a service. You must pay in advance and submit the receipt to the health insurance fund. The possibilities of which services can be reimbursed via the relief amount vary depending on the federal state. It is therefore advisable to ask your care insurance fund or a care advice center what services are available in your region.
Care allowance
If you are in care level 2 or higher, you are entitled to a care allowance. This money is intended to provide your relatives or carers with recognition for their care services. The amount of the care allowance depends on the level of care required by the person concerned. According to § 37Para . 3 SGB XI [mfn]§ 37 Para. 3 SGB XI[/mfn], care allowance recipients are legally obliged to receive regular advice depending on their care level: This applies every six months for care levels 2 and 3 and every quarter for care levels 4 and 5. The aim of this advice is to ensure appropriate care and to provide the caregiver with practical and professional support.
compass provides this advice for privately insured persons and their relatives, whereby the costs are borne in full by the private care insurance. Alternatively, approved care services or recognized advice centres can also provide this advice.
Long-term care benefits in kind
Instead of care allowance, you can also care benefits in kind in kind. This means that qualified care staff will help you with personal hygiene, dressing and undressing, taking medication and housekeeping. These carers must be either directly or indirectly linked to your long-term care insurance fund or long-term care insurance.
Nursing staff are eligible,
- who are employed by an outpatient care facility,
- with whom the long-term care fund/nursing care insurance has concludeda contract in accordance with § 77 Para. 1 SGBXI [mfn] § 77 Para. 1 SGB XI[/mfn],
- who are employed by the long-term care insurance fund.
The care benefits in kind that can be claimed vary depending on the level of care.
Care services that have a care contract can also provide care services. They may offer nursing care services and help with housekeeping as benefits in kind. Approved outpatient care services can also provide supplementary care services to support their benefits in kind.
Combination services
It is also possible to receive both care allowance and benefits in kind at the same time. These combined benefits mean that care is provided partly by a non-professional carer, such as a relative, and partly by a care professional, such as an outpatient care service. Both types of benefit are combined. The care allowance is reduced accordingly by the percentage that you use to claim benefits in kind. However, the sum of the percentages of care allowance and benefits in kind may not exceed 100 percent.
Conversion claim
If you do not make full use of your budget for care benefits in kind, you have the option of using up to 40% of the maximum entitlement for recognized support services in everyday life. This regulation is known as the conversion entitlement in accordance with Section 45a (4)SGB X I [mfn]Section 45a (4) SGB XI [/mfn]. However, it is important to note that your care insurance must recognize such services as eligible for reimbursement (in accordance with Section 45a (4) sentence 1 SGB XI [mfn]Section 45a (4) sentence 1 SGB XI[/mfn]). Reimbursable services may also include neighborhood assistance services. The conversion entitlement of up to 40 percent does not have to be applied for in advance.
This option is available to anyone who care benefits in kind, care allowance or the combined benefit. If you have any questions about the settlement of cost reimbursements, you can contact a care advice center.
Preventive care
Preventive care is a long-term care insurance benefit that provides relief for family members who are temporarily unable to provide care. If the main carer, for example a family member or friend, is absent, a substitute carer can take over the care for up to six weeks a year, as there is an entitlement to care. Care on a temporary basis is used if the main carer is temporarily unavailable due to illness, vacation or other reasons.
You can take advantage of respite care both at home and in a care facility. The care insurance fund reimburses the costs for respite care up to €1,685 per year. This amount can also be combined with the unused budget for short-term care. This is intended to ensure that care is provided continuously even in such situations.
Day and night care
If care at home is not sufficient or is additionally required to support care at home, you are entitled to unlimited partial inpatient care in day or night care facilities to. This entitlement applies if you have at least care level 2.
Day and night care is often required if you:
- only need care for a few hours a day or at night.
- want to relieve your caregiver at least partially.
- want to give your carer the opportunity to work (part-time).
- require more extensive support due to a short-term deterioration in your care needs.
Care services for care level 1
People in need of care with care level 1 have access to various care services, including
- A monthly relief amount of 131 euros for additional care and relief services.
- Technical care aids such as subsidies for the home emergency call, which covers monthly operating costs of 25.50 euros and one-off installation costs of 10.49 euros.
- Care aids for consumption worth up to 42 euros per month.
- Grants of up to 4,180 euros per measure to adapt the living space.
- Digital care applications with a monthly budget of up to 53 euros.
- Care advice, care courses and advisory services.
- Care support allowance and social security for carers.
- Subsidies for residential groups and financial support for their establishment of up to € 224 per month.
- In a nursing home, you will receive monthly benefits of 770 euros for full inpatient care.
Care services for care level 2
People in need of care with care level 2 have access to a range of care services:
- care allowance of 347 euros per month if they are cared for at home and do not use an outpatient care service.
- Care benefits in kind for 796 euros per month for care provided by a recognized care service.
- Possibility of combining care allowance and care benefits in kind.
- A monthly relief amount of 131 euros for additional care and relief services.
- Provision of technical care aids such as subsidies for home emergency calls for monthly operating costs and one-off installation costs.
- Care aids for consumption up to 42 euros per month.
- Preventive care: Up to 1,685 euros per year plus a maximum of 806 euros from the unused budget for short-term care.
- Short-term care: Up to 1,854 euros per year plus the unused budget for respite care.
- Day and night care services amounting to 721 euros per month.
- Grants of up to 4,180 euros per measure to adapt the living space.
- Digital care applications with a monthly budget of up to 53 euros.
- Care advice, care courses and advisory services.
- Care support allowance and social security for carers.
- Subsidies for residential groups and financial support for their establishment of up to € 224 per month.
- In a nursing home, you are entitled to benefits for full inpatient care amounting to 770 euros per month.
Care services for care level 3
People in need of care with care level 3 have access to a range of care services:
- care allowance of 599 euros per month if they are cared for at home and do not use an outpatient care service.
- You are entitled to care benefits in kind of 1,497 euros per month if you are cared for by a professional care service.
- Possibility of combining care allowance and care benefits in kind.
- A monthly relief amount of 131 euros for additional care and relief services.
- Provision of technical care aids such as subsidies for home emergency calls for monthly operating costs and one-off installation costs.
- Care aids for consumption up to 42 euros per month.
- Preventive care: Up to 1,685 euros per year plus a maximum of 806 euros from the unused budget for short-term care.
- Short-term care: Up to 1,854 euros per year plus the unused budget for respite care.
- Day and night care services amounting to 1,357 euros per month.
- Grants of up to 4,180 euros per measure to adapt the living space.
- Digital care applications with a monthly budget of up to 53 euros.
- Care advice, care courses and advisory services.
- Care support allowance and social security for carers.
- Subsidies for residential groups and financial support for their establishment of up to € 224 per month.
- In a nursing home, you are entitled to monthly benefits of EUR 1,262 for full inpatient care.
Care services for care level 4
People in need of care with care level 4 have access to a wide range of care services:
- care allowance of 800 euros per month if they are cared for at home and do not use an outpatient care service.
- If you receive care from a professional care service, you can receive monthly care benefits in kind amounting to 1,859 euros.
- Possibility of combining care allowance and care benefits in kind.
- A monthly relief amount of 131 euros for additional care and relief services.
- Provision of technical care aids such as subsidies for home emergency calls for monthly operating costs and one-off installation costs.
- Care aids for consumption up to 42 euros per month.
- Preventive care: Up to 1,685 euros per year plus a maximum of 806 euros from the unused budget for short-term care.
- Short-term care: Up to 1,854 euros per year plus the unused budget for respite care.
- Day and night care services amounting to 1,685 euros per month.
- Grants of up to 4,180 euros per measure to adapt the living space.
- Digital care applications with a monthly budget of up to 53 euros.
- Care advice, care courses and advisory services.
- Care support allowance and social security for carers.
- Subsidies for residential groups and financial support for their establishment of up to € 224 per month.
- In a nursing home, you are entitled to monthly benefits of EUR 1,775 for full inpatient care.
Care services for care level 5
People in need of care with care level 5 are entitled to a range of care services:
- Care allowance of 990 euros per month if they are cared for at home and do not use an outpatient care service.
- If you receive care from a professional care service, you will receive monthly care benefits in kind amounting to 2,299 euros.
- Possibility of combining care allowance and care benefits in kind.
- A monthly relief amount of 131 euros for additional care and relief services.
- Provision of technical care aids such as subsidies for home emergency calls for monthly operating costs and one-off installation costs.
- Care aids for consumption up to 42 euros per month.
- Preventive care: Up to 1,685 euros per year plus a maximum of 806 euros from the unused budget for short-term care.
- Short-term care: Up to 1,854 euros per year plus the unused budget for respite care.
- Day and night care services amounting to 2,085 euros per month.
- Grants of up to 4,180 euros per measure to adapt the living space.
- Digital care applications with a monthly budget of up to 53 euros.
- Care advice, care courses and advisory services.
- Care support allowance and social security for carers.
- Subsidies for residential groups and financial support for their establishment of up to € 224 per month.
- Benefits of EUR 2,005 per month are available for comprehensive care in a nursing home.
Care services without a care level
Care benefits in the strict sense refer to benefits provided by long-term care insurance and are therefore always linked to a specific level of care. However, under specific conditions, it is possible to receive benefits similar to care benefits from the health insurance fund for a limited period of time.
To receive these services, you need a specific medical prescription. This will be issued to you by your attending physician if you require temporary nursing support due to hospitalization or a serious illness.
The possible care services provided by the health insurance fund include
- Home nursing care, treatment care and transitional care
- Short-term care without a care level
- Domestic help
Short-term care
The short-term care makes it possible to place a relative in need of care in a care home for a limited period of time, for example if you are ill or want to go on vacation. Since 2022, the long-term care insurance fund has been granting an amount of up to €1,854 for a maximum of eight weeks per calendar year for this purpose. From July 2025, there will be a joint total benefit amount for respite care and short-term care, which will make funding easier.
Preventive care
The respite care is provided when someone replaces you in your home care. The care insurance fund will reimburse up to 1,685 euros for a maximum of six weeks per calendar year. The amount of the reimbursement depends on who takes over, be it a relative or a professional care service. If the available budget for respite care is not sufficient, it is possible to use part of the budget for short-term care. This allows you to use up to 2,418 euros per year for respite care.
Day and night care
The Day and night care makes it possible to spend the day or night in a facility with temporary care and support. These benefits can be combined with care allowance and care benefits in kind.
It is important to note that the costs of caring for relatives can be deducted as extraordinary expenses in the tax return, but only after deducting the benefits from the care insurance and the reasonable personal burden.
