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How do I apply for a care grade (Pflegegrad) in Germany?

In short

To apply for a care grade (Pflegegrad) in Germany, call or write to the care insurance fund (Pflegekasse) at your health insurer. One sentence is enough. The Medical Service then assesses the person, and the fund must decide within 25 working days. Care allowance is EUR 347 to 990 a month and is paid from the start of the month you applied.

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How do I apply for a care grade (Pflegegrad) in Germany?

What it costs

What a care grade pays a month under German law in the version applying from 1 January 2025, still valid in 2026. Applying is free.

Example	Typical range
Care grade 2, care by family	EUR 347 care allowance a month
Care grade 3, care by family	EUR 599 care allowance a month
Care grade 4, care by family	EUR 800 care allowance a month
Care grade 5, care by family	EUR 990 care allowance a month
Care grades 1 to 5 at home, in addition	up to EUR 131 relief amount a month
Fund decides too late	EUR 70 per week started

Amounts under the German Social Code XI, as of October 2026.

If you use a home care service instead of the allowance, the in kind benefits are higher;

both can be combined.

Worked example

Mother, 82, needs help since January, application on 20 March

How the application date matters when the fund grants care grade 3 and the daughter provides the care.

Application by email	20 March
Benefits from	1 March, not January
Decision within 25 working days	end of April
Back payment March and April	2 × EUR 599 = EUR 1,198
Lost by applying late (January, February)	2 × EUR 599 = EUR 1,198

A phone call in January would have brought EUR 1,198 more. Apply as soon as help is needed for the long term.

The application: one sentence is enough

You do not need a form to apply for a care grade. Call your health insurer or write: Hiermit beantrage ich Leistungen der Pflegeversicherung (I hereby apply for long term care benefits). The care fund is part of your health insurer. A relative, neighbour or friend can apply for you if you give them authority.

The fund then sends a form. The date of your first call or letter counts, so do not wait for doctors' letters. An email or letter is easier to prove than a phone call; if you call, note the date and time.

To qualify, the person must have been insured in the German care insurance for at least two of the last ten years before applying, as a member or through family insurance.

How the care grade is worked out

An assessor from the Medical Service (Medizinischer Dienst) usually visits at home. What counts is not the diagnosis but how independently the person manages daily life. The result is a score from 0 to 100.

Self care such as washing, dressing, eating and using the toilet carries the most weight at 40 percent. Coping with illness and treatment counts 20 percent, mobility 10 percent, daily routine and social contact 15 percent, memory, behaviour and mental health together 15 percent.

Care grade	Total points	Care allowance a month
1	12.5 to under 27	no allowance, but up to EUR 131 relief amount
2	27 to under 47.5	EUR 347
3	47.5 to under 70	EUR 599
4	70 to under 90	EUR 800
5	90 to 100	EUR 990

Deadlines that work in your favour

The fund must decide in writing within 25 working days of receiving the application. If the person is in hospital, rehab, a hospice or receives outpatient palliative care, the assessment must happen within five working days. At home, with a relative on announced carer's leave, it is ten working days.

If the fund misses the 25 working days and the delay is its fault, it pays EUR 70 for every week started. The clock stops while the fund waits for documents it strictly needs, so send anything requested straight back.

Preparing for the assessor's visit

The most common reason for a care grade that is too low is a visit on a good day. Many older people do not want to appear weak and say they manage fine. A relative should be there and add what help is really needed. If German is not your first language, bring someone who can translate.

Keep a care diary for two weeks beforehand: who helps with what, when and for how long, including at night. Have the medication plan, doctors' letters, hospital reports and aids ready.

Wrong decision? File an objection

The assessment report is sent to you with the decision unless you object to receiving it. Check line by line whether it reflects what you described. Missing help is your starting point.

The objection must reach the care fund within one month of the decision being notified. One sentence is enough to keep the deadline; you can send reasons, the care diary and medical letters later. The objection costs nothing.

When an application does not make sense yet

If you only need help for a few weeks after an operation, you will usually not get a care grade, because the law requires a need expected to last at least six months. In that case, ask your health insurer first.

A care grade only covers part of the costs. In a nursing home a personal share remains that is often far above a pension. Anyone who wants to prepare for that has to do it before care is needed, because with a care grade a private top up policy is usually no longer available.

Step by step

Call or write to the care fund at the health insurer and apply for long term care benefits.
Note the date, fill in the fund's form and send it back signed.
Keep a care diary for two weeks and collect medical letters and the medication plan.
Have a trusted person present at the Medical Service visit.
Check the decision and report and object within one month if something is wrong.

Checklist

Application made, date noted
Care diary for at least two weeks, including nights
Medication plan, doctors' letters, hospital reports ready
List of aids such as walker, care bed, incontinence products
Relative present at the appointment, with translation if needed
25 working day deadline in the calendar, then claim EUR 70 a week
One month objection deadline after the decision noted

Common mistakes

Waiting for all medical reports before applying and losing months of benefits
Playing down difficulties during the assessor's visit
Not mentioning help at night or supervision needed with dementia
Accepting the decision unchecked and missing the one month objection deadline
Assuming the care grade covers nursing home costs

Questions and answers

Frequently asked

What does it cost to apply for a care grade?

Nothing.

Application, assessment and objection are free.

Who can apply?

The person needing care or someone with their authority, such as children,

a partner or a neighbour.

The form is signed by the person or their legal representative.

How long until the decision?

At most 25 working days from the application, so a little over five weeks.

In hospital or a hospice the assessment is faster.

Can I apply for a higher care grade?

Yes, at any time if the condition has worsened.

The process is the same as for the first application, including an assessment.

What does care grade 1 give?

No care allowance,

but up to EUR 131 a month relief amount for help in daily life,

plus advice and grants for adapting the home.

What if the fund misses the deadline?

It pays EUR 70 for every week started beyond the deadline if the delay is its fault.

Claim it in writing if it does not arrive automatically.

Do I need reasons when I object?

Not at once.

What matters is that the objection arrives within one month.

You can send the reasons later.

Sources

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