Care allowance: entitlement and application

Pflegegeld: Anspruch und Antragstellung

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Care Guide

Care allowance:

entitlement and

application

Those who require care and are cared for at home by relatives, friends, or acquaintances are entitled to care allowance. Statutory and private long-term care insurance providers grant this benefit. Various factors influence the amount of the care allowance.

Who can apply for long-term care benefits and where? What requirements must be met, and which other benefits can be combined? Under what circumstances is a reduction of the long-term care benefits possible? We have compiled answers to these and other questions about long-term care benefits for you here.

Care allowance 2

How to receive care allowance – and use it correctly

Care allowance is a social benefit. It is paid monthly by statutory and private health insurance companies to individuals who are recognized as needing care and are cared for at home by family members, friends, or acquaintances. The money is often used as financial recognition for the services provided by family caregivers. With the care allowance, the legislator has created an incentive for home-based care. The legal basis for the care allowance is Section 37 of the German Social Code, Book XI (SGB XI). This section precisely defines the amount, eligibility requirements, and intended use of the allowance.

Who is entitled to care allowance?

Who is entitled to

care allowance?

In order for people in need of care to be entitled to care allowance, various conditions must be met:

There must be an entitlement to benefits from statutory or private long-term care insurance. For statutory long-term care insurance, this means, according to Section 33 Paragraph 2 of the German Social Code, Book XI (SGB XI): Contributions to statutory long-term care insurance must have been paid for at least two years within the ten years preceding the need for benefits.
The person requiring care must have care level 2 or higher.
The requirements for home care must be met: The person in need of care is not cared for professionally by relatives, friends or other persons.

What levels of care are there?

What levels of

care are there?

Care levels indicate the level of care a person requires. Those needing care are assigned a care level from 1 to 5. Care level 1 indicates a low level of care, while care level 5 indicates the highest level. The care level forms the basis for entitlement to benefits from long-term care insurance. The higher the care level, the greater the specific benefits. Until 2017, the classification was based on care grades.

Have the care level determined

Have the care

level determined

The level of care required is determined by assessors from the Medical Service (MD, formerly MDK, the Medical Service of the Statutory Health Insurance). For private health insurance companies, this task is carried out by assessors from MEDICPROOF. To have the care needs assessed for oneself or a family member, an application from the person requiring care or their family member is necessary. After the application is submitted, a care assessment report is prepared by the MD or MEDICPROOF. A care level is confirmed if care is required continuously for at least six months. The care level is automatically reviewed and determined as part of an application for care allowance. A separate application for a care level review is not required.

Care allowance according to care level: Who gets how much

Care allowance

according to care level:

Who gets how much

The amount of care allowance for a person in need of care depends on their care level. The higher the care level, the more care allowance the person in need of care receives.

The following care allowance table illustrates this relationship:

Care level (PG) 1 – 0 Euros
Care level (PG) 2 – 347 euros
Care level (PG) 3 – 599 euros
Care level (PG) 4 – 800 euros
Care level (PG) 5 – 990 euros

The amount of long-term care allowance is regulated by law. These figures have been in effect since January 1, 2025, and are currently valid.

The amounts mentioned are maximum amounts. In individual cases, the care allowance may be lower. This is because other care-related benefits are deducted from the care allowance.

Long-term care benefits are the same throughout Germany. Those requiring care in Bavaria receive an additional monetary benefit. This southern German state grants a supplementary state long-term care allowance.

What can be paid for with care allowance?

What can be paid for

with care allowance?

Unlike other care benefits, the care allowance is not earmarked for a specific purpose. This means that the person receiving care can use the money freely – with one restriction: the care allowance must ensure care in their own home. Here are some examples of what people receiving care can do with the care allowance:

Rewarding family caregivers – For many family caregivers, a symbolic payment provides an incentive to take on home care. Furthermore, financial recognition expresses appreciation for the care provided.
Financing additional care or senior care on an hourly basis – The money can also be used to relieve the burden on family caregivers, for example by making use of care services. This allows family members to remain able to fulfill their caregiving responsibilities for longer, and gives those needing care the opportunity to live longer in their familiar surroundings.

Step by step to care allowance

Step by step to

care allowance

To receive care allowance, the person in need of care must submit an application. Furthermore, other requirements must be met: the care must be provided non-professionally by family members, friends, or other individuals in the home environment, and the person must have at least care level 2.

The application and approval process follows this procedure:

Submit an application to the long-term care insurance fund
Care assessment for the care level
The long-term care insurance fund processes and approves the application.

Those in need of care can apply for care allowance from their long-term care insurance provider. A simple letter is sufficient.

Once the application has been submitted, the next step is to determine the level of care required. For this, an assessor from the Medical Service or MEDICPROOF will evaluate the person in need of care in their home. The assessment is based on a questionnaire. The long-term care insurance provider must offer an appointment for the evaluation within 14 days of the application being submitted.

In the third and final step, the long-term care insurance provider processes the application. They have 25 working days to evaluate the care assessment. If the assessment confirms a care level of 2 to 5, the person in need of care receives care allowance.

Applying for care allowance

without a care level assessment

Applying for care

allowance without a

care level assessment

The level of care required is assessed individually during the application process. A care level does not need to be assigned at the time of application. This allows those in need of care to apply for care allowance without having a care level assigned. However, if the assessment confirms only care level 1 or no care level at all, there is no entitlement to care allowance.

Payout

Sometimes, care allowance payments may be reduced. This is especially true if home care is temporarily suspended. Typical situations include:

The person in need of care has to go to the hospital for an extended period of time – in this case, the long-term care insurance only pays the care allowance during the first four weeks in the hospital.
Temporary inpatient care is available when family caregivers are unavailable. In such cases, the long-term care insurance continues to pay 50 percent of the care allowance for up to eight weeks.
The family caregivers are taking advantage of respite care. For up to six weeks, they will receive 50 percent of their care allowance.

A care level classification comes with mandatory consultation appointments. There is no obligation to attend a consultation for care level 1. For care levels 2 and 3, a consultation is required every six months, and for care levels 4 and 5, every three months. If consultation appointments are missed, the care allowance may be reduced or even revoked.

A reduction in care allowance may also

occur in the case of a Combinations with

other care services are possible.

A reduction in care

allowance may also

occur in the case of a

Combinations with

care services

are possible.

Combine care allowance with other benefits

Combine care allowance

with other benefits

Care allowance can be combined with other care benefits. In this case, the additional benefits can lead to a reduction in the care allowance. This applies, for example, to in-kind care benefits, such as the services of an outpatient care provider. Depending on the percentage of in-kind care benefits used in a month, the care allowance will be reduced by that percentage. Example:

If a person in need of care uses 30 percent of their in-kind care benefits in a given month, their care allowance will be reduced by 30 percent accordingly. They will then receive only 70 percent of the regular care allowance for that month.

Care allowance and care benefits in

kind What are the differences?

Care allowance and

care benefits in kind

What are the

differences?

Depending on their care level, those requiring care are entitled to additional benefits from long-term care insurance besides their care allowance. These include, for example, in-kind care benefits or full-time residential care. In-kind care benefits can, for instance, cover additional outpatient care within the framework of home care. However, this reduces the care allowance. The more extensive the in-kind care benefits, the lower the care allowance will be.

Another benefit provided by long-term care insurance is the relief allowance. This allows those requiring care to finance additional support in daily life or at home – or even day care. The relief allowance is €125 per month, regardless of the care level. It is not paid out directly and is not offset against other benefits. It does not affect the amount of the care allowance. For this reason, those requiring care and their relatives should definitely take advantage of the relief allowance.

Care allowance - Conclusion

Care allowance

Conclusion

Care allowance is a form of support for people requiring care who are cared for at home. From care level 2 onwards, there is an entitlement to this benefit. The amount of the care allowance depends on the care level. Generally, those requiring care pass the care allowance on to their relatives as a token of appreciation for their caregiving. The care allowance can be combined with other benefits; however, this may result in reductions in the total amount.

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Pflegegeld: Anspruch und Antragstellung

Mit Blick auf eine gesunde und sichere Zukunft

Care Guide