Care Levels (formerly Care Stages) in Germany at a Glance

The introduction of care levels in Germany marked a significant change in long-term care insurance. They replaced the previous care stages and provide a more differentiated assessment of care needs.

Here you will find an in-depth insight into the world of care levels, including care levels 1, 2, 3, 4 & 5.

1. Introduction to Care Levels

2. Overview of Care Levels

3. Types of Benefits

4. Determining the Care Level

5. History of the Care System

The following guide is for informational purposes only and does not constitute legal advice

What are care levels (formerly care stages)?

In Germany, there is a care system based on care levels (often also called care stages). Care levels are five classification categories that define the care needs of individuals in Germany. They provide a differentiated assessment that takes into account both physical and mental impairments.

The Importance of Care Levels

Care levels are crucial for determining the care benefits a person receives. They influence how much care allowance or care services someone can claim and what type of support is available. The higher the care level, the more money or benefits are provided.

The following explains care levels 1, 2, 3, 4 & 5:

Care Levels 1, 2, 3, 4 & 5 (including Benefits & Allowances)

In Germany, care levels 1 to 5 are a central element of long-term care insurance, enabling a differentiated assessment of care needs. Each care level is associated with specific benefits and financial support, depending on the degree of impairment.

Care Level 1:

For people with minor impairments to independence. The focus here is on preventive measures and support in everyday life.

Benefits & Allowances for Care Level 1 (as of 2024)

Care Allowance

No entitlement

Care Services in Kind

No entitlement

Full-Time Residential Care

125 € per month

Day and Night Care

No entitlement

Respite Care

No entitlement

Short-term care

No entitlement

Relief allowance

125 € per month

Consumable care aids

up to 40 € per month

Technical care aids

Yes

Home emergency call

up to 25,50 € per month

Home adaptation

up to 4.180 €

Care advice/consultation

Yes

Care courses for relatives

Yes

Care support allowance

Yes

Shared housing supplement

214 € per month

Digital care applications (DiPA)

up to 50 € per month

Care level 2:

Significant impairments to independence. People in this category require regular support in daily life.

Benefits & money for care level 2 (as of 2024)

Care allowance

332 € per month

Care in kind

761 € per month

Full-time residential care

770 € per month

Day and night care

689 € per month

Respite care

1.612 € per year

Short-term care

1.774 € per year

Relief allowance

125 € per month

Consumable care aids

up to 40 € per month

Technical care aids

Yes

Home emergency call

up to 25,50 € per month

Home adaptation

up to 4.180 €

Care advice/consultation visit

Yes

Care courses for relatives

Yes

Care support allowance

Yes

Shared living group supplement

214 € per month

Digital care applications (DiPA)

up to 50 € per month

Care level 3:

Severe impairments. More extensive care services and more frequent professional care are required here.

Benefits & payments for care level 3 (as of 2024)

Care allowance

573 € per month

Care services in kind

1.432 € per month

Full-time residential care

1.262 € per month

Day and night care

1.298 € per month

Respite care

1.612 € per year

Short-term care

1.774 € per year

Relief amount

125 € per month

Consumable care aids

up to 40 € per month

Technical care aids

Yes

Home emergency call

up to 25,50 € per month

Home adaptation

up to 4.180 €

Care advice/advisory visit

Yes

Care courses for relatives

Yes

Care support allowance

Yes

Shared accommodation supplement

214 € per month

Digital care applications (DiPA)

up to 50 € per month

Care level 4:

Most severe impairments to independence. Individuals in this category require intensive care and support.

Benefits & money for care level 4 (as of 2024)

Care allowance

765 € per month

Care in kind

1.778 € per month

Full-time residential care

1.775 € per month

Day and night care

1.612 € per month

Respite care

1.612 € per year

Short-term care

1.774 € per year

Relief amount

125 € per month

Consumable care aids

up to 40 € per month

Technical care aids

Yes

Home emergency call

up to 25,50 € per month

Home adaptation

up to 4.180 €

Care consultation/assessment visit

Yes

Care courses for relatives

Yes

Care support allowance

Yes

Shared housing supplement

214 € per month

Digital care applications (DiPA)

up to 50 € per month

Care level 5:

This level is intended for people with exceptionally high care needs and offers the highest benefits.

Benefits & payments for care level 5 (as of 2024)

Care allowance

947 € per month

Care in kind

2.200 € per month

Full-time residential care

2.005 € per month

Day and night care

1.995 € per month

Respite care

1.612 € per year

Short-term care

1.774 € per year

Relief amount

125 € per month

Consumable care aids

up to 40 € per month

Technical care aids

Yes

Home emergency call system

up to 25,50 € per month

Home adaptation

up to 4.180 €

Care counselling/consultation visit

Yes

Care courses for relatives

Yes

Care support allowance

Yes

Shared housing supplement

214 € per month

Digital care applications (DiPA)

up to 50 € per month

Care allowance increase in 2025

After the 5 percent increase in the care allowance on 01/01/2024, in accordance with the Care Support and Relief Act (PUEG), a further increase in the care allowance is planned for 2025 eine. This increase amounts to 4.5 percent and is part of a continuous adjustment to price developments. The next regular adjustment after 2025 will then take place on 01/01/2028 geplant.

The expected care allowance amounts for 2025, based on the 2024 increase, are:

Care level 1: Still no entitlement to care allowance.
Care level 2: Increase from 332 euros (2024) to approximately 347 euros in 2025.
Care level 3: Increase from 573 euros (2024) to approximately 599 euros in 2025.
Care level 4: Increase from 765 euros (2024) to approximately 799 euros in 2025.
Care level 5: Increase from 947 euros (2024) to approximately 990 euros in 2025.

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Overview of types of care benefits

Care in Germany includes a wide range of benefits aimed at providing support to people in need of care and their relatives in various life situations. From financial assistance and technical support to specialised care services – the care system is designed to meet individual needs and improve the quality of life of those affected.

This overview presents the different types of benefits:

Care allowance

The care allowance is a financial support for people in need of care who are cared for at home by relatives or other non-professional carers. It is intended to recognise and support the care provided by these carers.

Care in-kind benefits

Care in-kind benefits are services provided by the long-term care insurance that can be used for professional care services. They cover the costs of home care by qualified personnel.

Full-time residential care

Full-time residential care refers to round-the-clock support in care homes. It is intended for individuals who require continuous care and assistance due to their need for care.

Day and night care

Day and night care are semi-residential forms of care, where individuals in need of care are looked after in a facility during the day or at night, but continue to live at home.

Respite care

Respite care comes into effect when the regular caregiver is temporarily unavailable due to holiday, illness, or other reasons. It enables the use of substitute care.

Short-term care

Short-term care is temporary full-time residential care that can be used, for example, after a hospital stay when home care is not yet ensured.

Relief allowance

The relief allowance is financial support for people in need of care, which can be used for additional care and relief services in everyday life, such as household-related services.

Consumable care aids

Consumable care aids are items that need to be replaced regularly, such as disposable gloves, disinfectants, or incontinence pads.

Technical care aids

Technical care aids are durable devices that make care easier or promote the independence of those in need of care, such as care beds or special chairs.

Home emergency call

A home emergency call system enables people in need of care to call for help quickly in an emergency. It usually consists of a transmitter carried by the person and a base station connected to an emergency call centre.

Home adaptation

Home adaptation includes measures to adapt the flat or house of a person in need of care to their requirements, such as installing a door in your existing bath or removing barriers, through „Tub out, shower in“.

Care advice and advisory visits

Care advice provides information and support on care topics, benefits, and application procedures. Advisory visits are legally required for recipients of care allowance and serve to ensure the quality of home care.

Care courses for relatives

Care courses for relatives provide practical knowledge and skills for home care. They offer support and guidance for family members providing care.

Care support allowance

The care support allowance is a financial benefit for employed persons who temporarily interrupt their work to care for a close relative in an acute care situation.

Shared housing supplement

The shared housing supplement is financial support for people in need of care who live in an ambulatory assisted shared housing group. It is intended to promote this communal living arrangement.

Digital care applications (DiPA)

Digital care applications (DiPA) are technological solutions such as apps or software that support people in need of care, relatives, and care staff in everyday care. They range from information and communication tools to applications for health management.

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How is the care level determined?

The classification into a care level is carried out by an assessment from the Medical Service of the Health Insurance (MDK). Various aspects are evaluated, such as mobility, cognitive and communication abilities, behaviour, self-care, handling of illness-related requirements, and organisation of daily life.

Insight into the history of the care system

The German care system has undergone significant development over the years, which has played a key role in the introduction of the current care levels.

From the beginnings to the care stages

Introduction of long-term care insurance: Long-term care insurance was introduced in Germany in the mid-1990s as part of social insurance. This was an important step to address the growing challenges of care needs in an ageing population.
Care stages as an initial measure: Originally, care stages were introduced to classify the need for care. This division into three stages (I, II and III) was mainly based on the time required for basic care and household support.

The transition to care levels

Need for a fairer assessment: The care stages primarily took physical limitations into account. Mental and psychological impairments, such as those occurring with dementia, were not sufficiently considered.
Introduction of care levels: With the Second Care Strengthening Act (PSG II), 2017 die care levels were introduced. This five-level classification provides a more comprehensive assessment of care needs by considering both physical as well as mental and psychological impairments.

Changes and innovations in care levels

The introduction of care levels also brought some important changes and innovations. These include:

Consideration of cognitive and psychological impairments: Unlike the previous care stages, the care levels take cognitive and psychological impairments into greater account.
New assessment tool (NBA): The NBA is a new system for assessing care needs, enabling a more holistic evaluation.
More flexible benefits: The care levels offer more flexible benefits that are better tailored to the individual needs of those requiring care.

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Frequently asked questions about care levels in Germany

What are care levels?

Care levels are five classification categories in the German long-term care insurance system that define a person’s need for care. They range from care level 1 for minor impairments to care level 5 for the most severe impairments.

Which care levels are there in Germany?

In Germany, there are 5 care levels (often also called care stages). The care level system helps to better meet the needs of people requiring care.

How are care levels determined?

The classification into a care level is carried out by an assessment from the Medical Service of the Health Insurance (MDK). Aspects such as mobility, cognitive and communication abilities, behaviour, self-care, and the organisation of daily life are evaluated.

Can I appeal if I disagree with the assigned care level?

Yes, you can appeal against the classification. In this case, a new review will be carried out by the MDK or another independent body.

What is the difference between care stages and care levels?

Care stages were the predecessors of care levels and focused mainly on physical impairments. Care levels provide a more comprehensive assessment, taking into account physical, mental, and psychological impairments.

What benefits are associated with each care level?

Each care level is associated with specific benefits, ranging from preventive measures and counselling services (care level 1) to comprehensive support and specialised care services (care level 5).

How can I apply for a care level?

You can apply for a care level by contacting your care insurance fund. They will then commission the MDK to carry out an assessment to determine your care needs.

Can care levels be adjusted?

Yes, care levels can be adjusted if the condition of the person in need of care changes. A new assessment is required for this.

What happens if my care needs change?

If your care needs change, you can request a reassessment of your care level. This may result in an upgrade or downgrade, depending on how your condition has changed.

Is there support for people who wish to apply for a care level?

Yes, there are various advisory centres and services that offer support with the application process. These include care support centres, social services, and specialised advisory firms.

How long does it take for a care level to be approved?

The time until approval of a care level can vary, but you will usually receive a decision within a few weeks after the assessment.

How do the 5 care levels differ in Germany?

The 5 care levels are divided as follows:

Care level 1: minor impairments.
Care level 2: considerable impairments.
Care level 3: severe impairments.
Care level 4: most severe impairments.
Care level 5: most severe impairments, with special requirements for care provision.

What is care level 1 in Germany?

With minor impairment of independence, you are classified as care level 1.

What is care level 2 in Germany?

With considerable impairment of independence, you are classified as care level 2.

What is care level 3 in Germany?

With severe impairment of independence, you are classified as care level 3.

What is care level 4 in Germany?

With most severe impairment of independence, you are classified as care level 4.

What is care level 5 in Germany?

With most severe impairment of independence and special requirements for care provision, you are classified as care level 5.

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