Long-term care in Germany: how to apply for a care level

2 min read · 7 steps · Updated 3 October 2026

Long-term care insurance (Pflegeversicherung) is part of German social insurance. Everyone with statutory health insurance is in it automatically, and it pays part of the cost when a person can no longer manage daily life alone, because of age, illness or disability. Children can have a care level too.

This is general information, not legal advice. For your own case, speak to an advice centre.

Step by step

1. Check the conditions

   The need for help must be permanent, or last at least six months. The insured person must have paid contributions, or been insured through the family, for at least two of the last ten years.

   Done

2. Apply to the care fund

   The care fund (Pflegekasse) belongs to the health insurer. A phone call, an email or a short letter saying that you apply for care benefits is enough. Benefits are paid from the month of the application, so apply early. A relative can apply with a power of attorney.

   Done

3. Prepare for the home visit

   An assessor from the medical service comes to your home by appointment. Keep a diary for a week or two beforehand of every bit of help that is needed, and have doctor's letters, the medication plan and hospital reports ready. The person who helps most should be present.

   Done

4. Know what is assessed

   Six areas: mobility, mental and communication abilities, behaviour and psychological problems, self-care such as washing and eating, coping with illness and treatment such as medication, and organising daily life and social contact.

   Done

5. Receive the decision

   The care fund has 25 working days to decide. The letter names the care level: 1 for minor impairment of independence, up to 5 for the most severe.

   Done

6. Choose the kind of care

   Care at home by relatives or by a care service (outpatient), day or night care in a facility (semi-inpatient), or living in a care home (inpatient). The insurance pays a fixed amount for each, depending on the level. It covers only part of the cost.

   Done

7. Appeal if the level is too low

   If the application is refused, or the level seems too low, you can file an objection (Widerspruch) within four weeks of the letter. Ask for the assessment report and compare it with your diary.

   Done

Good to know

The insurance also pays for aids such as a walking frame, a wheelchair or a care bed with a prescription, and a monthly amount for supplies like gloves and disinfectant.

Everyone with a care level is entitled to free advice. Care support points (Pflegestützpunkte), the care fund and migration advice services help with forms.

Relatives who give care can get pension contributions paid, and time off work.

Related: health insurance in Germany and sick leave in Germany.

Rules, amounts and deadlines change. Check the official source named at the end before you act, and ask the office in your city, because procedures differ from town to town.

In short: Apply by phone or letter to the care fund of the health insurer, keep a care diary, home visit by an assessor, decision within 25 working days, care level 1 to 5, objection within four weeks.