Why the co-payment falls over time
Many people are shocked when they see the first bill from a nursing home. What many do not know is that the burden does not stay that high forever. Since 1 January 2022, the care fund has covered part of the care-related co-payment through the supplement under § 43c SGB XI — and this part grows the longer someone lives in the home. The percentages were raised in 2024.
The four stages
The law provides for four stages. People with care levels 2 to 5 receive a supplement on their care-related co-payment of:
1. 15% up to and including month 12
2. 30% from month 13
3. 50% from month 25
4. 75% from month 37
How the months are counted
What matters is how long someone has already been receiving full inpatient care benefits under § 43 SGB XI. Months in which benefits were received for only part of the month also count. So anyone who moves in on the 20th of a month has already "used up" that month.
Changing homes does not reset the count, because what matters is the receipt of benefits, not the individual facility. If you use the calculator for someone who has lived in a home for some time, enter the previous months under "Already in the home". The calculation then starts directly with the correct supplement rate.
What the supplement applies to — and what it does not
The supplement is granted exclusively on the care-related co-payment, i.e. the uniform facility co-payment (EEE) including the training levy. The following are not subsidised:
1. the costs of accommodation,
2. the costs of meals,
3. investment costs,
4. individually agreed additional services.
This explains why the total burden is still high even after three years. Read more about these cost blocks in the article on room, board and investment costs.
What the supplement means in euros
Let us assume a care-related co-payment of €2,088 before the supplement — roughly the federal average as of 1 July 2026. The care fund then additionally covers:
1. €313.20 per month in the first year,
2. €626.40 per month in the second year,
3. €1,044 per month in the third year,
4. €1,566 per month from the fourth year.
Over the first four years, the supplement thus adds up to around €42,600. The remaining care-related share falls from €1,774.80 in the first year to €522 from the fourth year.
Do you have to apply for the supplement?
No. The supplement is taken into account automatically: the care fund pays it directly to the home, and the home only bills you for the remaining co-payment. It is still worth checking the bill. Make sure the supplement is shown and that it actually increases after 12, 24 and 36 months.
Does the supplement also apply to care level 1?
No. The supplement is reserved for care levels 2 to 5. With care level 1, the care fund only pays a subsidy of €131 per month towards a stay in a home. Anyone moving into a home should therefore have it checked whether the care level still matches the actual situation.
Conclusion
The supplement is real relief that grows with every year in the home. However, it does not change room, board and investment costs. The nursing home cost calculator shows how your personal co-payment develops month by month — including a chart across all four stages.