What Is Care Allowance in Germany?
Care allowance (Pflegegeld) is a monthly cash benefit provided by the German statutory long-term care insurance (Pflegeversicherung) to people who require regular assistance with everyday activities. The benefit is paid directly to the care recipient, who typically passes it on to family members or other informal caregivers as recognition for their unpaid care work. The legal foundation is found in sections 37 and 38 of the Social Code Book XI (SGB XI), which governs all aspects of long-term care insurance in Germany.
Unlike professional care benefits (Sachleistungen), which are paid directly to licensed care services, the care allowance gives families maximum flexibility. The recipient can use the money freely, whether to compensate a family caregiver, hire a neighborhood helper, or cover care-related household expenses. This flexibility is one of the main reasons that roughly two-thirds of all care recipients in Germany opt for the cash benefit rather than professional care services.
The care allowance system is closely tied to the care level classification (Pflegegrad). Since the major reform of 2017, Germany uses five care levels instead of the old three-tier system. Each care level corresponds to a specific degree of impairment in independence, measured through a standardized assessment tool called the NBA (Neues Begutachtungsassessment). The higher the care level, the greater the impairment, and the higher the monthly care allowance.
Care Allowance Amounts by Care Level 2026
The 2026 care allowance rates reflect the most recent adjustments to account for rising costs of living. Care Level 1 does not include a cash allowance or professional care benefits, but it does provide access to the monthly relief amount and other supplementary services. Starting from Care Level 2, the monthly care allowance amounts are as follows: Care Level 2 receives 332 euros per month, Care Level 3 receives 573 euros, Care Level 4 receives 765 euros, and Care Level 5 receives 947 euros per month.
These amounts are fixed by law and do not vary by region or individual circumstances. They are paid tax-free and do not count as income for social welfare or unemployment benefit purposes. The care allowance is paid for as long as the care level classification remains valid and care is provided in a home setting. If the care recipient moves to a residential care facility, the care allowance is replaced by institutional care benefits.
It is worth noting that the care allowance amounts are significantly lower than the corresponding professional care benefit amounts. For example, at Care Level 3, the care allowance is 573 euros while professional care benefits amount to 1,432 euros. This difference reflects the fact that professional care services are more expensive to deliver, but it also means that families relying solely on the care allowance may find the amount insufficient to cover all care-related costs.
Professional Care Benefits (Sachleistungen)
Professional care benefits are the alternative to the cash care allowance. Instead of receiving money directly, the care recipient uses licensed ambulatory care services (ambulante Pflegedienste) to provide professional care at home. The care insurance pays the care service directly, up to the maximum amount for the relevant care level.
The 2026 professional care benefit amounts are: Care Level 2 receives up to 761 euros per month, Care Level 3 up to 1,432 euros, Care Level 4 up to 1,778 euros, and Care Level 5 up to 2,200 euros. Care Level 1 does not receive professional care benefits but may use the relief amount for approved services.
Professional care services include personal hygiene assistance, mobility support, meal preparation, medication management, and other activities of daily living. The care recipient can choose which services they need, and the care service bills the insurance directly. If the actual cost of services used in a given month is less than the maximum amount, the unused portion is not paid out as cash.
Combined Benefits (Kombileistung)
The combined benefits option (Kombileistung) under section 38 SGB XI allows care recipients to mix cash allowance and professional care services. This is particularly useful for families where a relative provides the majority of care but professional support is needed for specific tasks such as bathing, wound care, or medication management.
The calculation works on a percentage basis. If the care recipient uses 40 percent of their professional care benefit budget for a care service, they receive the remaining 60 percent of their care allowance as a cash payment. For example, at Care Level 3 with a professional care budget of 1,432 euros and a care allowance of 573 euros: using 40 percent of professional care (572.80 euros) leaves 60 percent of the care allowance (343.80 euros) as a cash payment. The total monthly benefit in this scenario is 916.60 euros, which is higher than either the pure cash allowance (573 euros) or using professional care alone.
Finding the optimal ratio between professional care and cash allowance is one of the most important financial decisions for care families. Our calculator includes a combined benefit optimizer that shows the total benefit amount at every possible ratio, helping families identify the split that maximizes their total monthly benefits.
Additional Benefits Beyond the Monthly Allowance
Beyond the monthly care allowance or professional care benefits, German care insurance provides several additional benefits that many families overlook. The relief amount (Entlastungsbetrag) of 125 euros per month is available to all care levels, including Care Level 1. It can be used for day care, night care, short-term care, ambulatory care services for household support, or recognized everyday support services. Unused amounts can be carried forward within the calendar year and used until June 30 of the following year.
Care consumables (Pflegehilfsmittel zum Verbrauch) cover disposable items such as gloves, disinfectant, bed protectors, and face masks, up to 40 euros per month. Technical care aids such as hospital beds, wheelchairs, and bath lifts are provided on loan or with a small co-payment of 10 percent (maximum 25 euros per item). These benefits are available regardless of whether the care recipient chooses cash allowance or professional care services.
The home modification subsidy (Wohnraumanpassung) provides up to 4,000 euros per measure for accessibility improvements such as stair lifts, walk-in showers, widened doorways, or ramps. If multiple care recipients live in a shared household, the subsidy can reach up to 16,000 euros. This is a one-time subsidy per measure, but new measures can be funded if the care situation changes significantly.
Respite Care and Short-term Care
Respite care (Verhinderungspflege) provides replacement care when the primary family caregiver is temporarily unavailable due to vacation, illness, or personal commitments. From Care Level 2, an annual budget of 1,612 euros is available. This can cover care by another family member, a neighbor, or a professional care service. The prerequisite is that the primary caregiver has been providing care for at least six months before claiming respite care.
Short-term care (Kurzzeitpflege) is available when temporary residential care is needed, for example after a hospital stay or during a crisis. The annual budget is 1,774 euros from Care Level 2. An important feature is that unused respite care budget can be transferred to short-term care, increasing the short-term care budget by up to 1,612 euros to a maximum of 3,386 euros. Conversely, up to 806 euros of unused short-term care budget can be transferred to respite care.
During respite care of up to six weeks per year, the care allowance continues to be paid at 50 percent for the first 28 days. During short-term care of up to eight weeks per year, the care allowance is also paid at 50 percent. These rules ensure that families are not financially penalized for taking necessary breaks from caregiving.
The NBA Assessment System
The Neues Begutachtungsassessment (NBA) is the standardized assessment tool used to determine care levels in Germany. It replaced the old system of measuring care needs in minutes with a comprehensive evaluation of independence across six life domains. The assessment is carried out by trained assessors from the Medical Service (Medizinischer Dienst, formerly MDK) during a home visit.
The six modules of the NBA are: Module 1 (Mobility) with a weight of 10 percent, Module 2 (Cognitive and communicative abilities) and Module 3 (Behavioral and psychological issues) which share a combined weight of 15 percent (only the higher-scoring module counts), Module 4 (Self-care) with the highest weight of 40 percent, Module 5 (Managing disease-related demands) at 20 percent, and Module 6 (Organizing daily life and social contacts) at 15 percent.
Each module evaluates specific activities on a scale from independent to fully dependent. The weighted scores are combined into a total score between 0 and 100 points. Care Level 1 requires 12.5 to under 27 points, Care Level 2 requires 27 to under 47.5 points, Care Level 3 requires 47.5 to under 70 points, Care Level 4 requires 70 to under 90 points, and Care Level 5 requires 90 to 100 points.
How to Apply for Care Benefits
To receive care benefits, you must first apply for a care level classification with your care insurance fund (Pflegekasse), which is part of your statutory health insurance. The application can be submitted informally by phone, letter, or email. Many insurance funds also offer online application forms. Once the application is received, the insurance fund commissions the Medical Service to conduct an in-home assessment.
The Medical Service assessor visits the care recipient at home and evaluates their independence across the six NBA modules. The assessment typically takes 60 to 90 minutes. It is strongly recommended to have a family member or other person familiar with the daily care routine present during the assessment. The assessor produces a report with a recommended care level, and the insurance fund issues a decision, usually within four to six weeks of the application.
If the care level assigned is lower than expected, the care recipient can file an objection (Widerspruch) within one month of receiving the decision. The objection should be in writing and include specific reasons why the assigned level does not reflect the actual care needs. In many cases, a second assessment is ordered, and a significant number of objections result in an upgraded care level.
Maximizing Your Benefits
Many German families leave substantial benefits unclaimed because they are unaware of all available entitlements. Studies suggest that the average family uses only about 60 percent of the benefits they are entitled to. The most commonly overlooked benefits are the monthly relief amount, care consumables, and the home modification subsidy.
To maximize your benefits, start by understanding the full range of services available at your care level. Use the combined benefit option if you can, as it typically yields a higher total monthly amount than either pure cash allowance or pure professional care. Apply for the relief amount and set up a care consumables subscription (Pflegebox) to ensure you receive the full 40 euros per month. If any home modifications would improve the care situation, apply for the subsidy before starting the work.
Keep detailed records of all care activities, as this documentation supports applications for higher care levels and helps during reassessments. Review your care situation annually, because care needs often increase over time and a higher care level may be warranted. Finally, take advantage of free care counseling services (Pflegeberatung) offered by the care insurance funds, which can help identify additional benefits and services you may be eligible for.
Conclusion
The German care allowance system provides a comprehensive framework of financial support for people with care needs and their families. From monthly cash benefits and professional care services to respite care, short-term care, and home modification subsidies, the range of available benefits is extensive. Understanding the care level system, the NBA assessment process, and the various benefit options is essential for maximizing the support you receive. Our care allowance calculator helps you determine your entitlements quickly and accurately, but for complex situations or disputes about care level classification, professional care counseling is always recommended.