Does German long-term care insurance pay for 24-hour care?
In short
Does German long-term care insurance pay for 24-hour care? Not as a benefit of its own. You can use the care allowance (Pflegegeld) of 347 to 990 euros a month for it, plus up to 3,539 euros a year for respite care. A legally employed live-in carer costs about 2,800 to 3,500 euros a month, so most of the bill stays with you.
Costs of a live-in carer and German care insurance benefits for 24-hour care at home, 2026.
Example
Typical range
Live-in carer, employed or posted
about 2,800 to 3,500 euros a month
Care allowance, care grade 3
599 euros a month
Care allowance, care grade 5
990 euros a month
Respite and short-term care combined
up to 3,539 euros a year
Tax reduction for care and support services
20 percent, up to 4,000 euros a year
Carer costs as stated by the Verbraucherzentrale, without agency fees, travel, board and lodging.
Benefit amounts unchanged since 2025.
The worked example is an indicative figure from quoting practice.
Worked example
Care grade 3, carer posted by an agency
The mother lives alone, her daughter lives 200 kilometres away. This is the monthly bill.
Live-in carer including contributions
3,200 euros
Board, lodging and travel share
about 250 euros
Care allowance, care grade 3
minus 599 euros
Respite care for the carer's holiday
up to 3,539 euros a year
About 2,850 euros a month remain, more than 34,000 euros a year. A daily care allowance policy paying 1,500 euros in care grade 3 would cover just over half.
What care insurance contributes to 24-hour care
German long-term care insurance (Pflegeversicherung) does not pay for care around the clock. It pays benefits by care grade (Pflegegrad), and some of them can be used for 24-hour care at home. The most important is the care allowance, which you may spend as you see fit.
If a nursing service also comes in, for example to help with washing in the morning, the care allowance is reduced by the share of the service budget you use. You are bound to that split for six months.
Benefit
Amount 2026
Usable for 24-hour care?
Care allowance, care grades 2 to 5
347 to 990 euros a month
yes, free to use
Nursing service in kind (Sachleistung)
796 to 2,299 euros a month
only for approved nursing services, not for the carer
Relief amount (Entlastungsbetrag)
131 euros a month
only for recognised services and everyday support offers
Respite and short-term care
up to 3,539 euros a year
for replacement care when the main carer is unavailable
Consumable care aids
42 euros a month
yes, for gloves and disinfectant
What a live-in carer really costs
According to the German consumer advice centre (Verbraucherzentrale), a full-time carer from Eastern Europe costs about 2,800 to 3,500 euros a month including minimum wage and social contributions. Agency fees, travel, phone and internet, board and lodging usually come on top.
There are three models: you employ the carer yourself, a foreign company posts the carer to you, in which case ask to see the A1 certificate, or the carer works self-employed. The third model is often close to bogus self-employment and is only recommended with caution.
One carer cannot legally work 24 hours
24-hour care by a single person is not legal in Germany. On working days the average may not exceed eight hours, and the week may not exceed 48 hours. Full-time carers are entitled to at least 24 days of holiday a year.
Plan a care mix instead: family, a nursing service for personal care and the live-in carer for daily life. The respite care budget helps when the carer or the family carer goes on holiday.
When 24-hour care makes more sense than a care home
In a German care home residents pay on average 3,364 euros a month themselves in the first year. A live-in carer at 2,800 to 3,500 euros, minus the care allowance, can cost about the same or less, especially in care grades 4 and 5 with 800 or 990 euros of allowance.
24-hour care at home does not work well if constant medical help is needed at night or there is no private room for the carer. In that case a care home or shared care flat is often the more honest solution.
Where private care insurance closes the gap
A daily care allowance policy (Pflegetagegeld) pays a fixed amount per care grade with no proof of spending. That fits 24-hour care, because a live-in carer is not a cost that a care cost policy would reimburse.
You do not need extra cover for 24-hour care if your pension and savings can cover a gap of roughly 2,000 to 3,000 euros a month for years. Once a care grade exists, you will usually not get a new policy.
Step by step
Apply for a care grade, or for a higher one if needs have grown.
Decide whether care allowance alone or combined with a nursing service fits better.
Choose the employment model and ask for the A1 certificate if the carer is posted.
Agree working hours, days off and holiday cover in writing.
Keep invoices for your tax return and claim respite care with receipts.
Checklist
Care grade 2 or higher in place
Private room for the carer
Contract with minimum wage and clear working hours
A1 certificate on file for posted carers
Holiday and sickness cover arranged
Six-monthly advisory visit for the care allowance booked
Common mistakes
Planning one person for 24 hours, seven days a week
Using self-employed carers without checks and risking bogus self-employment
Letting the respite budget and relief amount expire
Thinking about private care insurance only once care is needed
Questions and answers
Frequently asked
Does the care fund pay the carer directly?
No.
You receive the care allowance and pay the carer yourself.
In-kind benefits only go to approved nursing services.
Is there money for 24-hour care with care grade 1?
Hardly.
Care grade 1 has no care allowance, mainly the 131 euro relief amount for recognised services.
Can I use respite care for the carer?
For replacement care when the main carer is on holiday or ill.
The fund reimburses proven costs up to the joint annual budget of 3,539 euros.
Can I deduct the costs from tax?
For care and support services in the household, income tax is reduced by 20 percent of the costs,
up to 4,000 euros a year.
Is 24-hour care cheaper than a care home?
Often similar.
In a care home residents pay 3,364 euros on average,
at home 2,800 to 3,500 euros for the carer minus the care allowance, plus extras.
