01
Pflege-Bahr
State-subsidised daily allowance without health questions, but with a waiting period of up to five years and limited benefits.
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Long-term care insurance: Germany's statutory cover pays only part of the bill
Everyone with health insurance in Germany is automatically in statutory long-term care insurance. It pays fixed amounts per care level, not the actual costs. In a care home, residents paid on average 3,245 euros a month themselves in the first year, according to the substitute health funds association vdek as of January 2026. Private top-up cover closes that gap.
The question almost everyone asks first
Do I need private long-term care insurance in Germany?
If you want to protect savings, property or your family, usually yes. Statutory care insurance pays between 805 and 2,096 euros a month towards a care home, depending on the care level, yet the average own contribution in the first year was 3,245 euros in January 2026. When pension and savings run out, social welfare steps in. Adult children only have to contribute if they earn more than 100,000 euros gross a year.
Do the maths
Your care home gap
German long-term care insurance pays only part of a care home. The rest comes from your pension and savings. Pre-filled is the average own share in the first year according to vdek, as at 1 January 2026.
The care fund's supplement rises with the time in care, which lowers the gap from year two.
How German care insurance works
Care insurance is a separate pillar of social insurance, introduced in 1995. You pay into it together with your health insurance, public or private. If you need long-term help with daily life, an assessor determines one of five care levels, and benefits follow fixed amounts per level.
It was never designed to pay the full cost. Think of it as partial cover: it pays a share for professional care, but accommodation, meals and investment costs in a care home remain yours. Private top-up insurance is designed to fill exactly this gap.
What a care home really costs
The own contribution has three parts: a care-related share that is the same for levels 2 to 5 within one home, accommodation and meals, and investment costs. According to vdek, the care-related share averaged 1,685 euros in the first year at the start of 2026, accommodation and meals 1,046 euros.
Since 2024 the statutory insurance reduces the care-related share the longer you stay: by 15 percent in the first year, 30 in the second, 50 in the third and 75 percent from the fourth. Accommodation, meals and investment costs are not reduced.
If you retire outside Germany
Many expats plan to retire in their home country or elsewhere. Statutory care benefits are largely limited to Germany and, for the cash allowance, to other EU and EEA countries and Switzerland. Outside that area, you may pay contributions for years and receive little.
If you might retire abroad, choose a private plan that pays its daily allowance worldwide. This is one of the few criteria that is more important for expats than for Germans.
What is covered
- Daily care allowance per care level, paid to you without receipts
- Refund of care costs not paid by statutory insurance
- Care at home by relatives or a nursing service
- Care in a nursing home
- One-off payment when care is first needed, depending on the plan
- Premium waiver once you need care, depending on the plan
- Dementia, assessed in the same way as physical limitations
What is not covered
- Care needs that existed or were applied for before the policy started
- Benefits during an agreed waiting period
- Care level 1 in many plans, or only a small amount
- Care needs arising from undisclosed conditions
- Costs above the agreed daily amount
Who needs it
- Homeowners and savers who want to protect assets for a partner or heirs
- People without family nearby who could provide care
- Couples where one partner moving into a care home would strain the other financially
- Anyone between 30 and 55 who can still pass the health questions
Who can do without
- People whose pension and investment income will easily cover a care home
- Short-term residents who will leave Germany before retirement and take out cover at home
Wheel of misfortune
Spin the wheel of bad luck
Six things that really happen. The wheel picks yours and shows who pays.
Cost:
Budget policy
Strong policy
See all six cases
- Mum moves into a care home, own share around 3,000 € or more a month. Budget policy: pays in part, Strong policy: pays. A small state-subsidised policy covers only part of the gap. A high daily benefit can cover most of it.
- Dementia while still physically fit, a few hundred to over 2,000 € a month. Budget policy: pays in part, Strong policy: pays. Simple plans pay less for care at home at levels 2 and 3. Strong plans pay the same at home and in a home.
- Care level 1 after a fall, roughly 100 to 500 € a month. Budget policy: does not pay, Strong policy: pays in part. Many plans exclude level 1. Good ones pay a small amount.
- Care needed while retired in Spain, local care costs each month. Budget policy: does not pay, Strong policy: pays. Some plans pay only in Germany. Strong plans pay worldwide, which matters if you plan to retire elsewhere.
- Walk-in shower and a ramp, roughly 8,000 to 15,000 €. Budget policy: does not pay, Strong policy: pays in part. The statutory fund pays up to 4,180 € per measure. Private plans with a lump sum help with the rest.
- Care already applied for, all future care costs. Budget policy: does not pay, Strong policy: does not pay. Once care is applied for, no insurer will cover it. Cover has to be in place before care is foreseeable.
What it costs
The premium depends mostly on your age when you sign up. At 35 the same cover costs a fraction of what a 60-year-old pays, and many insurers do not accept new customers beyond 65 or 70.
What drives the premium
- Age when you sign up
- Health at the time of application
- Daily allowance insured at care level 5 and the share paid at lower levels
- Benefits for care at home compared with a care home
- Automatic increases without a new health check
- Worldwide payment of benefits
We do not show example premiums because age and benefit level change them too much. Your premium is fixed in the quote.
The policy levels on the market
02
Daily care allowance
A freely usable daily amount per care level, with health questions. The most common and flexible type.
03
Care pension
A lifelong pension if you need care, sold by life insurers. More expensive, with stable premiums and often a surrender value.
How to recognise a good policy
| Criterion | Minimum standard | Strong policy | Why it matters |
|---|---|---|---|
| Care at home | much less than in a care home at levels 2 and 3 | same amount at home and in a care home from level 2 | Most people are cared for at home, which is where money is needed first. |
| Care level 1 | no benefit | small benefit from level 1 | Household help is often needed from the start. |
| Premium waiver | from level 5 | from level 2 or 3 | You should not keep paying once you need care. |
| Indexation | fixed amount | regular increases without new health questions | Care costs rise, a fixed benefit loses value over decades. |
| Payment abroad | Germany only | worldwide | Essential if you might retire outside Germany. |
| One-off payment | none | lump sum when care begins | Adapting a bathroom or installing a stairlift costs money right at the start. |
Insurers on the German market
Daily care allowance and care cost plans are sold by German private health insurers, care pensions by life insurers. The list is a market overview of well-known health insurers with care plans.
| Insurer | Background |
|---|---|
| Allianz | agents and brokers |
| DKV | health insurer of ERGO Group |
| Hallesche | mutual insurer, broker distribution |
| Barmenia | part of Barmenia Gothaer group |
| Signal Iduna | mutual insurer, agents and brokers |
| DFV | listed insurer from Frankfurt, sells mainly online |
| AXA | agents and brokers |
| Continentale | mutual insurer, agents and brokers |
From the BaFin register
42
42 insurers supervised by BaFin, the German regulator, are licensed for this class of insurance. (Krankenversicherer)
Show all 42 names from the register
- Allianz Private Krankenversicherungs-Aktiengesellschaft
- ALTE OLDENBURGER Krankenversicherung AG
- ALTE OLDENBURGER Krankenversicherung von 1927 Versicherungsverein auf Gegenseitigkeit
- ARAG Krankenversicherungs-Aktiengesellschaft
- Augenoptiker Ausgleichskasse VVaG (AKA)
- AXA Krankenversicherung Aktiengesellschaft
- Barmenia Krankenversicherung AG
- Bayerische Beamtenkrankenkasse Aktiengesellschaft
- Concordia Krankenversicherungs-Aktiengesellschaft
- Continentale Krankenversicherung a.G.
- Debeka Krankenversicherungsverein auf Gegenseitigkeit Sitz Koblenz am Rhein
- DEVK Krankenversicherungs-Aktiengesellschaft
- DKV Deutsche Krankenversicherung Aktiengesellschaft
- ENVIVAS Krankenversicherung Aktiengesellschaft
- ERGO Krankenversicherung AG
- Generali Deutschland Krankenversicherung AG
- Gothaer Krankenversicherung Aktiengesellschaft
- Hallesche Krankenversicherung auf Gegenseitigkeit
- HanseMerkur Krankenversicherung AG
- HanseMerkur Krankenversicherung auf Gegenseitigkeit
- HanseMerkur Speziale Krankenversicherung AG
- HUK-COBURG-Krankenversicherung AG
- INTER Krankenversicherung AG
- Landeskrankenhilfe V.V.a.G.
- LIGA Krankenversicherung katholischer Priester Versicherungsverein auf Gegenseitigkeit Regensburg
- Lohnfortzahlungskasse Leer VVaG
- LVM Krankenversicherungs-AG
- Mecklenburgische Krankenversicherungs-Aktiengesellschaft
- MÜNCHENER VEREIN Krankenversicherung a.G.
- NÜRNBERGER Krankenversicherung Aktiengesellschaft
- ottonova Krankenversicherung AG
- praenatura Versicherungsverein auf Gegenseitigkeit (VVaG)
- Provinzial Krankenversicherung Hannover AG
- R+V Krankenversicherung Aktiengesellschaft
- SIGNAL IDUNA Krankenversicherung a.G.
- SONO Krankenversicherung a.G.
- Süddeutsche Krankenversicherung a.G.
- UNION KRANKENVERSICHERUNG AKTIENGESELLSCHAFT
- uniVersa Krankenversicherung a.G.
- Versicherer im Raum der Kirchen Krankenversicherung AG
- vigo Krankenversicherung VVaG
- Württembergische Krankenversicherung Aktiengesellschaft
Source: BaFin company database, retrieved 18 September 2026. Insurers from other EU countries selling through a branch or without a German office are not included.
Legal basis and sources
Products and add-ons
Daily care allowance
A set amount per day depending on the care level, no receipts needed.
Care cost insurance
Refunds a percentage of the costs left after statutory benefits. Receipts required, so not suitable if relatives provide the care.
Care pension
A lifelong monthly pension from a life insurer once care is needed, with fixed premiums.
Pflege-Bahr
At least €10 own premium, €5 state subsidy, no health questions, waiting period up to five years.
Myth or truth
True or false?
Five things people say about this insurance. Guess first, then see the answer.
At care level 5, statutory care insurance pays the whole care home bill.
This is false.
False. It pays a fixed amount for care even at level 5. Room, meals and investment costs are always yours.
The longer you live in a German care home, the less you pay for care itself.
This is true.
True. The fund currently cuts the care share by 15 percent in year one, rising to 75 percent from year four. A reform proposed in 2026 would start the steps later.
Family members caring at home can get money from the care fund.
This is true.
True. From care level 2, a monthly care allowance goes to the person being cared for. It is meant to be passed on to relatives.
Premiums for private care insurance are fixed forever.
This is false.
False. Daily-benefit plans can rise when the costs of the tariff rise. Care annuities from life insurers are more stable.
People without children pay more for care insurance in Germany.
This is true.
True. From age 23, childless members pay a surcharge of 0.6 percentage points, and the employer does not share it. Parents with several children pay less.
Common mistakes
- Looking only at care home benefits and ignoring care at home
- Waiting until 60, when premiums are high and health may prevent acceptance
- Choosing a plan that pays only in Germany while planning to retire abroad
- Relying on Pflege-Bahr alone
- Agreeing a fixed allowance without indexation
Questions and answers
Frequently asked
Am I automatically in long-term care insurance in Germany?
Yes. Members of public health insurance are automatically in statutory care insurance, and private health insurance customers must take out private compulsory care insurance with the same benefits. The contribution is 3.6 percent of gross pay, 4.2 percent for people aged 23 or over without children.
What does statutory care insurance pay?
Fixed amounts per care level. In 2026 the monthly cash allowance for care at home ranges from 347 to 990 euros, and the contribution to a care home from 805 to 2,096 euros. Actual costs are usually much higher.
Will my children have to pay for my care?
Only if their gross income exceeds 100,000 euros a year. Below that, social welfare does not claim money from children. Your own assets and those of your spouse are used first.
What is Pflege-Bahr?
A state-subsidised daily care allowance. If you pay at least 10 euros a month, the state adds 5 euros. Insurers must accept everyone, but a waiting period of up to five years applies. Healthy people usually get better benefits from unsubsidised plans.
Does statutory care insurance pay if I move abroad?
The cash allowance continues within the EU, the EEA and Switzerland. Outside that area, statutory benefits generally stop. Private plans with worldwide cover continue to pay.
When should I take out private care insurance?
Between 30 and 50, while you are healthy. Premiums are lower and stay lower for longer. From the mid-fifties, starting premiums rise and pre-existing conditions lead to more rejections.
Does care insurance cover dementia?
Yes. Since 2017 cognitive impairment counts equally in the assessment of care levels, so dementia leads to a care level like physical limitations. Some private plans pay extra for dementia.
Who decides my care level?
For public insurance members, the Medical Service (Medizinischer Dienst), for private members an assessor from Medicproof. Most private top-up plans accept that assessment without their own examination.
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