Can I take out private long-term care insurance with an existing care grade?
In short
Can I take out private long-term care insurance with an existing care grade? As a rule, no. Even the state-subsidised Pflege-Bahr excludes anyone who receives or has received care fund benefits. If you hide the care grade, the insurer can withdraw from the contract. Instead, make full use of the care fund, for example 347 to 990 euros of care allowance a month.
What remains without private care insurance and what cover for relatives costs, 2026.
Example
Typical range
Care allowance, care grades 2 to 5
347 to 990 euros a month
Relief amount in all care grades
131 euros a month
Daily care allowance for relatives, starting at 30
around 40 euros a month
Daily care allowance for relatives, starting at 50
around 100 euros a month
Pflege-Bahr for healthy relatives
from 15 euros a month including the 5 euro subsidy
Premium examples for strong policies from published market examples, without later adjustments.
The worked example is an indicative figure from quoting practice.
Worked example
Mother with care grade 2, daughter aged 48
The mother has just been assessed. It is too late for her to take out a policy, but not for her daughter.
Mother's care allowance
347 euros a month
Mother's relief amount
131 euros a month for recognised help
Private care insurance for the mother
no longer possible
Daily care allowance for the daughter, starting at 48
about 80 to 100 euros a month
The mother receives 478 euros a month from the care fund. The daughter insures herself while she is healthy, because every year of waiting makes the premium higher.
Why a policy with a care grade fails
Private long-term care insurance is meant to cover the risk of needing care in the future. With an existing care grade (Pflegegrad) that risk has already happened. For the insurer there is nothing left to calculate, because a claim is as good as certain.
That is why care policies ask about need for care and about illnesses that often lead to it. With a care grade, insurers will as a rule decline. This also applies to care grade 1, because it is an officially assessed need for care.
Route
With an existing care grade?
Why
Daily care allowance or care annuity
as a rule no
health questions about need for care
Pflege-Bahr
no
legal exclusion after receiving benefits
Group policy through the employer
rarely, depends on the contract
the group terms decide
Policy taken out before the care grade
yes, it pays
cover was running when care became necessary
The Pflege-Bahr does not help either
The state-subsidised Pflege-Bahr must accept every adult without a health check. But the law expressly excludes anyone who, before taking it out, received or receives benefits from the care fund as a person in need of care.
So if you already get care allowance, the relief amount or other benefits, the Pflege-Bahr is closed to you as well.
Hiding the care grade is no solution
Leaving the care grade out of the application breaches your duty of disclosure. The insurer can then withdraw or terminate, and you get nothing when you claim. The premiums you paid are lost.
At the latest when you claim, the insurer sees from the care fund's decision since when the care grade exists. An application made shortly after the assessment stands out immediately.
What you can do now
Use the statutory benefits fully: care allowance or a nursing service, 131 euros relief amount, up to 3,539 euros a year for respite and short-term care, 42 euros for consumables and up to 4,180 euros per home adaptation. If your condition worsens, apply for a higher care grade.
If pension and savings are not enough, the social welfare office pays care support (Hilfe zur Pflege). Children only have to contribute if their annual income exceeds 100,000 euros.
Insure your relatives in good time
A care case in the family shows what care costs. For partners and children, now is the right time for private long-term care insurance, while they are healthy. At 30 a strong policy costs around 40 euros a month, at 50 around 100 euros.
Anyone who already had a policy before the care grade should report the care grade immediately. Whether premiums stop during a claim depends on the policy terms.
Step by step
Check whether an older policy exists and report the care grade there.
Claim all care fund benefits, including the relief amount and consumables.
Apply for a higher care grade if needs increase.
If money is short, ask the social welfare office about care support.
Insure partners and children now, while they are healthy.
Checklist
No application with a hidden care grade
Existing policies checked for benefits
Relief amount and respite care used
Higher care grade applied for if needed
Cover for relatives requested
Common mistakes
Hiding the care grade and paying premiums for nothing
Counting on the Pflege-Bahr although benefits are already paid
Letting statutory benefits such as the relief amount expire
Putting off your own cover as a relative
Questions and answers
Frequently asked
Does this apply to care grade 1 too?
Yes.
Care grade 1 is an assessed need for care;
insurers will as a rule decline and the Pflege-Bahr is excluded.
What if the care grade has only been applied for?
State the pending application if asked.
Hiding a pending application is just as risky as hiding a care grade.
Can I increase an existing policy?
Voluntary increases usually require new health questions and then fail.
What automatic increases do during a claim is set out in your policy terms.
Are there group policies without questions?
Some employers have group policies without a health check.
Whether an existing care grade is excluded depends on the specific contract.
Who pays if the money is not enough?
The social welfare office with care support.
Children only contribute if their annual income exceeds 100,000 euros.
