Guide · Application
How to apply for a care level in Germany: step by step
This guide is about the German statutory long-term care insurance (Pflegeversicherung). German terms are given in brackets so you can recognise them in letters from your care insurance fund (Pflegekasse).
- A phone call or an informal letter to the care insurance fund (Pflegekasse) counts as an application. The care fund is part of your health insurer.
- Benefits are paid from the month in which the application arrives, even if the decision comes later.
- For a first application, the Medical Service (Medizinischer Dienst) assesses the person at home; for privately insured people this is done by Medicproof.
- As a rule, the fund must decide within 25 working days. From January to April 2027 this deadline is to be suspended, according to the draft.
- For the reform, the application date counts: if the application arrives in 2026, the current thresholds apply according to the draft.
- According to the draft, the new thresholds apply to applications from 1 January 2027: care level 1 from 15, 2 from 30, 3 from 50 points.
- The need for help is to last at least six months “with high probability”, and care levels are to be time-limited more often.
- From January to April 2027, the 25-working-day deadline for the decision is to be suspended. Expect longer processing times.
Who can get a care level
A person needs care (is “pflegebedürftig”) if health problems mean they permanently need help in daily life, expected to last at least six months. What counts is not the diagnosis, but how independent the person still is.
In addition, the person must have been insured in the German long-term care insurance for at least two of the last ten years before the application; family insurance (Familienversicherung) also counts. This is important if you have only recently moved to Germany. The application is made by the person needing care or by someone with a power of attorney or legal guardianship.
Step 1: Apply
A phone call to the care fund is enough, but a short letter is safer. What matters is that you can prove when it arrived, for example by registered mail (Einschreiben), by fax with a transmission report or with a confirmation from the fund. The fund will then send you an application form, which you fill in and return. Letters from the fund will be in German.
Step 2: Use the free care advice
Once you have applied, you are entitled to free care advice (Pflegeberatung). The care fund must offer you an appointment within two weeks of receiving the application, at your home if you wish. Local care support centres (Pflegestützpunkte) can also help.
Step 3: The assessment
The Medical Service announces its visit in writing. For a first application the assessment always takes place in person, usually at home. It assesses independence in six areas of life. Good preparation often makes the difference. How to prepare
Step 4: Check the decision
The care fund sends its decision (Bescheid) in writing, usually together with the assessment report (Gutachten). It must decide within 25 working days of receiving the application. If the delay is the fund's fault, it pays €70 for every week or part of a week, without you having to apply for it. If the fund has asked for documents that are missing, the deadline is paused until they arrive.
If the care level does not match the actual need for help, you can object within one month. How to object
What changes in 2027
From 2027, more points are to be needed for care levels 1 to 3. According to the draft, the rules on the day the application reaches the care fund apply. From January to April 2027 the 25-working-day deadline is to be suspended, except in urgent cases. So expect longer waiting times; benefits are still paid retroactively from the month of the application. All changes of the reform
Sources
- German Social Code Book XI (SGB XI): Section 14 (definition of care need), Sections 18, 18a, 18c (assessment, decision deadline, extra payment), Section 33 (eligibility), Sections 7a/7b (care advice)
- Verbraucherzentrale NRW (consumer advice centre): objecting to a care level decision (as of 29 Apr 2025)
- Verbraucherzentrale: assessment by telephone (as of 2 Oct 2026)
- Medical Service (Medizinischer Dienst): assessment guidelines (Begutachtungsrichtlinien)
- Government draft of the care reform act (Pflegeneuordnungsgesetz), 30 Sept 2026 (application date, suspension of the decision deadline January to April 2027)
Frequently asked questions
When does the care fund start paying?
From the month in which the application reaches the care fund. If the decision takes longer, payments are backdated.
Does the assessment cost anything?
No. The application, the assessment and the care advice are free of charge.
Can I apply on behalf of my mother or father?
Yes, with a power of attorney or as their legal guardian. The applicant is the person who needs care.
We have only just moved to Germany. Can we apply?
Generally only after the person has been insured in the German long-term care insurance for at least two of the last ten years. Ask the care fund about your situation, as periods of insurance in other EU countries may count.
Can the care allowance be paid if the person lives in another EU country?
In many cases the care allowance (Pflegegeld) can continue to be paid within the EU, the EEA and Switzerland; in-kind benefits cannot. Ask the care fund before moving.