Why “Care Assistance” Is Important to Many People

Long-term care assistance is a key social benefit in Germany that kicks in when long-term care insurance and personal funds are insufficient to cover the costs of care. For many people in need of care, their relatives, and those affected, it provides vital financial and organizational support.

With rising long-term care costs—such as those associated with nursing homes or intensive home care—many households quickly reach their financial limits. In such cases, long-term care assistance under SGB XII can cover the remaining costs.

This magazin a comprehensive guide to who is eligible, what benefits are available, and how to apply.

What is long-term care assistance?

Long-term care assistance is a social welfare benefit that supports people who require care and are unable to finance it on their own.

The legal basis is provided by SGB XII. It stipulates that a person in need of care is entitled to assistance if:

• there is a need for care
• the benefits provided by long-term care insurance are insufficient
• Income and assets are insufficient to cover the costs

Difference between long-term care insurance and long-term care assistance

Long-term care insurance is mandatory and provides various benefits to support those in need of care.

These include, among other things:

• Care allowance
• Services provided by the home care agency
• Care aids
• Short-term care
• Relief amount

When does long-term care assistance apply?

Since long-term care assistance is a social benefit, it is available only in certain cases and only after all other sources of funding have been exhausted.

In practical terms, this means that people in need of care can receive care assistance if:

• the benefits provided by long-term care insurance are insufficient
• additional care costs are incurred
• there is financial need

Who is eligible for long-term care assistance?

You are entitled to assistance if the following conditions are met:

• an officially recognized care level and documented need for care
• lack of financial resources (income and assets)
• habitual residence in Germany

A recognized care level can be obtained by submitting an application to the responsible long-term care insurance fund. After the application is submitted, a representative from the MD (Medical Service), which assesses the individual in various categories to determine their level of care need. Only after successful classification into one of the five care levels can benefits from the long-term care insurance fund, such as the respite care allowance or the care allowance, be claimed from the fund.

Another key factor is that the individual lacks the financial resources from income and assets to pay for care out of pocket, although a certain exemption amount is taken into account.

Your usual place of residence in Germany is also a determining factor in applying for and receiving long-term care benefits.

Existing Assets in Long-Term Care Assistance

When applying for long-term care assistance, the so-called exempt assets play an important role. These are the assets that applicants are allowed to keep without having to use them to cover long-term care costs.

Under the provisions of SGB XII, there are certain exemptions that are not counted toward social assistance. These include, among other things, reasonable household goods, personal belongings, or small amounts of money needed to cover living expenses. Owner-occupied housing may also be protected under certain conditions.

The exact amount of the exempt assets depends on individual circumstances, such as whether the person is single, married, or in a domestic partnership.

It is important to note that the social services office will only assess eligibility for assistance if disposable income and assets exceed these exemption limits. Therefore, those affected should carefully disclose their financial situation to ensure an accurate assessment.

Income and Asset Review

As part of its long-term care assistance program, the Social Welfare Office conducts a thorough review of the applicant’s financial situation to determine whether they are in financial need.

In particular, two areas are taken into account:

• recurring income (e.g., retirement benefits, pension, rental income, or other regular income)
• existing assets (e.g., savings, securities, or real estate)

However, not all income and assets are fully taken into account. The law under SGB XII provides for so-called exemptions and protective measures to ensure that those affected do not end up completely destitute.

The most important non-countable assets include:

• basic household items (e.g., furniture, clothing, everyday items)
• smaller savings as a financial cushion for unexpected expenses
• personal needs, such as a certain amount of cash to spend as they wish
• under certain conditions, owner-occupied residential property as well, provided it is deemed reasonable

When calculating income, the amounts that must actually be spent are also taken into account. Certain expenses, such as rent, health insurance, or special financial burdens, can be considered and deducted from income.

The Social Welfare Office does not consider only the financial situation of the person in need of care. Spouses and domestic partners are also included in the assessment, as they live in what is known as a “joint household.” Their income and assets may therefore also play a role, although exemptions apply here as well.

Children are only required to contribute to their parents' financial support if their annual income exceeds 100,000 euros. For many family members, this provides significant relief.

In general, the assessment follows this principle: Only if one’s own income and liquid assets, after taking all exemptions into account, are insufficient, is there a right to long-term care assistance.

Care Levels and Their Meaning

The care level describes the extent of functional limitations in daily life.

Overview of Care Levels

• Care Level 1: mild impairment
• Care Level2–3: Significant limitations
• Care Level4–5: Most severe need for care

The higher the care level, the greater the potential benefits under the long-term care insurance program.

What services are covered by long-term care assistance?

Long-term care assistance includes various forms of support:

• Coverage of nursing care costs
• Financing of care aids
• Support for home care
• Coverage of home care costs
• supplementary care services

However, these differ between home care and inpatient care, as different needs take priority in each setting.

Home Care Benefits

In the case of home care , the following care services are covered:

• Costs of home care services
• Care provided by family members
• Nursing care products and assistive devices

Combination with long-term care insurance

Long-term care assistance is closely linked to long-term care insurance benefits and operates according to the so-called principle of subsidiarity. This means that the long-term care insurance fund is initially responsible for covering the costs. Only when its benefits are insufficient does long-term care assistance step in as a supplementary social benefit.

Depending on the care level, long-term care insurance covers only a set portion of care costs, for example through care allowances, in-kind benefits for a care service, or subsidies for short-term care and care aids. In practice, however, these amounts are often insufficient to fully cover actual care needs, especially for higher care levels.

This is where long-term care assistance comes in: it covers the remaining costs that are not covered by long-term care insurance or by the individual’s own income and assets. These include, for example:

• additional costs for outpatient care services provided as part of home care
• Copayments at nursing homes
• supplementary care services that are necessary on an individual basis

One major advantage is the ability to combine different types of benefits. For example, a person in need of care can receive benefits from both long-term care insurance and the long-term care assistance program at the same time. Example:

Long-term care assistance is always based on actual needs. It covers the financial shortfall that remains after all other benefits have been exhausted, thereby ensuring that the person in need of care receives appropriate care.

Inpatient Care: Support in a Nursing Home

When a person is admitted to a nursing home, various types of care-related costs arise, consisting of several components. Long-term care assistance may cover these costs in full or in part if the benefits provided by long-term care insurance, as well as the individual’s own income and assets, are insufficient.

What costs are incurred in a nursing home

Monthly nursing home costs are generally broken down into three categories:

• Long-term care costs: These include the actual care services (e.g., assistance with personal hygiene, nutrition, or mobility). A portion is covered by the long-term care insurance fund, depending on the care level.
• Accommodation and meals: This includes rent for the room as well as costs for food and general living expenses. These costs must generally be covered by the student.
• Capital costs: These include costs related to the building, maintenance, and equipment of the nursing home.

The Role of Long-Term Care Assistance in Financing

The long-term care subsidy covers exactly the portion of care costs that remains after deducting benefits from long-term care insurance and the individual's own income.

1. First, long-term care insurance pays a fixed subsidy based on the individual’s care level.
2. Next, an assessment is made of how much the person in need of care can contribute themselves.
3. The remaining balance will be covered by the social services office if financial need is demonstrated.

What exactly does the copayment mean?

The so-called copayment is the amount that individuals in need of long-term care must initially pay out of pocket. This amount typically consists of:

• uncovered nursing care costs
• Accommodation and meals
• Investment costs

In many cases, these costs far exceed what those affected can afford. This is exactly where long-term care assistance comes in:

It may reduce the patient's copayment or cover it in full if the patient lacks sufficient income or liquid assets.

Role of the Social Services Office and Social Assistance Providers

Care assistance is organized by the relevant social welfare agency, usually the local social services office or, depending on the state, a regional district.

The Social Services Office determines whether a person is eligible for long-term care assistance. In doing so, it takes into account the care level, individual care needs, income and assets, as well as long-term care insurance benefits.

In addition to the assessment, the Social Services Office also handles:

• Counseling for patients and their families
• Support with the application process
• Coverage of Uncovered Nursing Care Costs

The Social Services Office works closely with the long-term care insurance fund, home care agencies, and nursing homes to ensure appropriate care.

Applying: How to Apply for Long-Term Care Assistance

Applications should be submitted to the appropriate social services office. Please follow these simple steps.

1. Contact us
2. Filling out the application
3. Submitting the documents
4. Review by the authority
5. Notice of Eligibility

What documents are required?

To apply, you will need:

• ID card
• Proof of care level
• Proof of income
• Proof of assets
• Rent and housing costs
• medical reports, if applicable

Please ensure that all required documents are included; this can significantly speed up the processing of your application.

Real-life examples: Help with daily care

Example 1: Home care is not sufficient

An elderly person in need of care who has been assigned care level 3 continues to live at home and is partially cared for by family members. In addition, a home care service visits regularly to assist with personal hygiene, medication administration, and daily living activities.

The long-term care insurance fund covers a fixed monthly amount for this. However, in this case, the actual need for care is significantly higher—for example, because the person requires additional assistance with mobility or multiple daily care visits. This results in higher care costs that are not fully covered by either the care allowance or in-kind benefits.

This is where long-term care assistance comes in, covering the remaining costs of home care services. This ensures that the necessary home care can continue without placing an excessive financial burden on the person receiving care.

Example 2: Nursing home following a serious illness

After suffering a severe stroke, a person is permanently and severely disabled and is classified as requiring the highest level of care (Care Level 5). Under these circumstances, it is no longer possible to provide care at home, making a move to a nursing home necessary.

Monthly nursing home costs consist of care costs, room and board, and capital costs, and can quickly amount to several thousand euros. Although long-term care insurance provides a subsidy, it covers only a portion of the total costs.

Their own income (e.g., pension) is insufficient, and they have virtually no liquid assets.

Long-term care assistance covers the majority of the remaining costs. In practical terms, this means that the social services office makes up the financial shortfall, ensuring that the necessary nursing home care is provided, regardless of the individual’s financial situation.

How much is the long-term care benefit?

The amount of long-term care assistance depends on:

• individual needs
• Degree of care
• Income and Assets

What exactly is covered?

• actual care costs
• required additional services
• medical procedures

Tips for a Successful Application

• notify in advance
• submit all required documents
• Take advantage of advice
• Carefully review the notices

Avoid common mistakes

When applying for long-term care benefits, delays or rejections often occur because important details are overlooked.

Common problems include:

• Incomplete information: If information regarding income, assets, or personal circumstances is missing, the social services office will not be able to properly review the application.
• Missing documentation: Without supporting documents (e.g., bank statements, pension notices, or proof of care level), the application is often not processed or is significantly delayed.
• Late application: Benefits are generally granted only from the date the application is submitted; those who apply late risk financial penalties.

Tip: Document all relevant measures, care services, and care-related costs as accurately as possible. Keep track of invoices, contracts, and medical records; this will make the review process easier and increase your chances of getting approval quickly.

Checklist: Applying for Long-Term Care Assistance

Before you submit your application, you should clarify the following points:

• Has a care level been determined by the long-term care insurance fund?
• Have your income and assets been realistically assessed?
• Are all the necessary documents available?

Good preparation saves time and prevents the social services agency from having to ask for clarification.

When submitting your application, please note the following:

• Fill out the application form completely and accurately
• Please include all required documentation
• Submit the application to the appropriate social services office in a timely manner

In many cases, the application can initially be submitted informally in order to meet deadlines. The complete documentation can be submitted later.

Additional support and guidance regarding long-term care assistance

Applying for long-term care assistance can be a complex process, so those affected and their family members should seek support early on. Key resources include:

• Local Social Services Office: Your first stop for information, applications, and personal counseling
• Care Counseling Centers: Independent advice on care services, care levels, and care options
• Charitable organizations (e.g., Caritas, Diakonie, German Red Cross): Assistance with the application process and support throughout the entire procedure

Many of these positions offer:

• face-to-face meetings on site
• telephone consultation
• Contact us by email

Take full advantage of these services. Seeking advice early on can help you avoid mistakes, accurately assess your eligibility for long-term care assistance, and receive the appropriate support.

Conclusion: Care assistance as an important form of social security

Long-term care assistance is an essential social benefit that ensures people in need of care receive adequate support despite financial constraints.

It applies in cases where:

• long-term care insurance is insufficient
• own funds have been exhausted
• there is a genuine need

Thanks to clear legal provisions in SGB XII, structured assistance services, and support from the social welfare office, it provides reliable security.

If you or your family members are affected: Find out what’s available early on and submit an application. Long-term care assistance can make a significant difference.