What is long-term care insurance (Pflegeversicherung)?

Long-term care insurance is one of the many components of Germany’s healthcare program. It provides financial security by reducing the burden of nursing and other care expenditures, which reduces the need to depend on friends and family.

In this post, you will learn everything there is to know about long-term insurance in Germany, including:

• What it is
• Who is covered
• How contributions work
• And what benefits you are entitled to

Let’s dive in.

What is long-term care insurance?

Long-term care insurance (Pflegeversicherung) is a mandatory social insurance program introduced in 1995. 

Designed to support those who require long-term care due to illness, disability, or old age, the system helps people maintain their independence and quality of life while receiving necessary care at home or in facilities. 

It provides access to high-quality medical treatments, equipment, and options for home care, assisted living, or nursing home care.  Long-term care insurance offers access to palliative and hospice care when needed and supports dignified end-of-life care arrangements.

Who is insured with long-term insurance in Germany?

Long-term care insurance covers every German resident, regardless of age. This includes:

• Employees with statutory health insurance are automatically enrolled in long-term care insurance, which employers partially contribute to.
• Self-employed individuals must have long-term care insurance through the statutory system or a private company.
• Pensioners continue to contribute towards long-term care insurance coverage from their pension.
• Unemployed individuals receiving benefits, like health insurance during job loss, from the state are included in the long-term care insurance system.
• Students are generally covered by long-term care insurance through their statutory health insurance.
• Children and non-working spouses are typically covered by long-term care insurance under family insurance plans, which comes at no extra cost in statutory insurance.

What's really important for eligibility is if you've been paying into the system via PV Beitrag

Who is eligible for long-term care?

There are a few criteria to become eligible for long-term care:

1. The individual must be a legal resident of Germany and covered by the German long-term care insurance system.
2. The individual must have a physical, mental, or psychological illness or disability that limits or prohibits their ability to live independently.
3. The individual must require significant assistance with daily activities for at least six months.
4. You must have a valid SVNR number.

We’ll detail how to apply for long-term care later in this article.

How are long-term care insurance costs calculated?

Mandatory contribution from salary

As of 2025, the contribution rate for long-term care insurance in Germany ranges from 2.6% to 4.2% of gross salary. This contribution is typically split between the employee and the employer, with the latter paying 1.8% of the gross salary. The contribution is automatically deducted from salary alongside other social security contributions.

Childless employees over 23 years of age who don’t have children pay a small surcharge.

Contributions are only calculated up to a certain income threshold, known as the contribution assessment ceiling (Beitragsbemessungsgrenze). In 2025, this ceiling is €66,150 annually.

In Saxony, the split is slightly different. Employees pay slightly more because the state enjoys an additional public holiday: “Buß —und Bettag” (Day of Repentance and Prayer).

Contribution for self-employed people

Self-employed people covered by statutory health insurance must pay the total long-term care insurance contribution rate themselves (3.4% of their reported income as of 2025). Self-employed people opting for private healthcare must purchase private long-term care insurance with equivalent coverage. 

This calculation applies to the contribution assessment ceiling (Beitragsbemessungsgrenze), which is also €62,100 annually. Any income above this ceiling is not considered for contribution calculations.

The minimum income basis for calculating contributions is €1.131,67 per month as of 2025. Even if a self-employed person earns less than this amount, they still have to pay contributions calculated based on the minimum income threshold.

Contribution for pensioners

Pensioners pay the total long-term insurance contribution rate (3.4% as of 2025) from their pension, usually deducted directly from their pension payments. If an individual receives pensions from different sources or has additional income, contributions will be deducted from each source. Again, a contribution assessment ceiling of €62,100 annually applies (as of 2025). 

Difference in contribution for public and private insurance

• While the public long-term care insurance amount is calculated based on income, the private long-term care insurance amount is fixed.
• Private long-term care insurance is calculated based on risk factors such as age and health condition when signing up.
• While children and non-working spouses are covered at no extra cost under statutory long-term care insurance, private insurance requires each person to contribute to their policy.
• Benefits, incentives, and other finer details vary across private insurance companies but are standardized across public health insurance companies.

Supplementary long-term care insurance

Individuals can purchase private supplementary long-term care insurance (Zusätzliche Pflegeversicherung) to complement the mandatory statutory long-term care insurance. 

Its purpose is to provide additional support and benefits for long-term care needs and maintain a higher living standard when care is required. 

Its price is generally fixed and starts at €15 monthly, but it can vary depending on age and health condition.

What caring services are covered by long-term care insurance?

Mobile care (Ambulante Pflege)

This refers to the system in which professional caregivers provide services in the person’s home.

Inpatient care (Vollstationäre Pflege)

This refers to full-time nursing home or facility care for individuals with extensive care needs.

Partial inpatient care (Teilstationäre Pflege)

This refers to individuals who receive care in a facility for part of the day or night and then return home.

What benefits do you get with long-term care insurance?

Cash benefits for home care (Pflegegeld)

This category of long-term care benefit provides the flexibility to the recipient to stay at home for longer and utilize the benefit amount as they see fit, including but not limited to compensating family members who provide care, hiring professional caregivers, or purchasing care-related items. As of 2025, this amount ranges from €316 to €901 per month.

In-kind benefits for professional care services

As of 2025, the benefit amount under this category ranges from none for the lower care levels, and up to  to €2,200 per month for level 5 care. It aims to cover the cost of services like (but not limited to) primary medical care, household help, and personal care.

How do you claim long-term care insurance?

1. Obtain a long-term care insurance application form by contacting your health insurance company.
2. Fill out the application form with personal details, information, and a description of care needs.
3. Send the completed form back to your insurance.
4. The Medical Service of the Health Insurance Funds (MDK) will contact you to schedule a home visit for an assessment (more on that below).
5. After the assessment, you’ll receive a written decision about your care level (more on that below) and the benefits that come with it.
6. If you disagree with the decision, you can appeal within a specified timeframe (usually one month).
7. Once approved, you can receive the benefits, including financial support, care services, or equipment.

To note: The process can take several weeks from application to receiving benefits. If you need immediate help, discuss options with your insurance or local social services.

How does the assessment of the need for long-term care work?

When an individual or their representative applies for long-term care benefits, the first step is for an assessor from the Medical Service of the Health Insurance Funds (MDK) to visit the applicant’s home to evaluate the person’s care needs.

The assessment focuses on six key areas:

• Mobility
• Cognitive and communicative abilities
• Behavior and psychological issues
• Self-care
• Handling of illness/therapy-related demands and stress
• Organization of daily life and social contacts

The assessor specifies a score for each key area based on the level of independence or assistance required. Based on the total score, the person is assigned a care grade (Pflegegrad) from 1 to 5, with 5 indicating the highest level of care needed (find details below). 

Periodic reassessments are conducted, and the care grade is altered when appropriate. 

What are care levels, and how do they work?

In Germany, long-term care needs are categorized into five levels (Pflegegrade). These levels determine the amount and type of benefits a person is eligible for.

The tiered care grade system allows personalized financial support to adapt to individual needs as they evolve.

What if I never claim my long-term care insurance?

Germany’s statutory long-term care insurance amounts go into a collective pool instead of in individual amounts. If an individual does not claim long-term care benefits, they don’t receive a refund. Unclaimed long-term care insurance funds remain in the system and are used to contribute towards the care of others who need it. 

For private long-term care insurance in Germany, handling unclaimed insurance amounts can differ from the statutory system and vary across insurance companies and contracts.