German care reform 2027: all changes at a glance

As of 18 Oct 2026 · Based on the government draft of the German care reform act (Pflegeneuordnungsgesetz) of 30 Sept 2026, not yet passed · Pflegestand editorial team · 5 min read

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).

Where does the law stand?

The German federal cabinet adopted the draft care reform act on 30 September 2026. According to the timetable, the Bundestag is to hold its final vote on 11 December and the Bundesrat on 18 December. Until the law enters into force, the current rules apply. Individual figures may still change during the process. We update this guide after every step.

New point thresholds for the care level

The Medical Service (Medizinischer Dienst) will still assess independence in six areas and award up to 100 points. What is new are the thresholds at which a care level is reached:

In addition, the scoring system itself is to be adjusted. The draft expects fewer people to be newly assessed as a result. The exact changes will only be certain once the law is passed; we will then build them into the calculator.

Application date and protected status

The rules in force on the day of the application are to apply. An application that reaches the care insurance fund in 2026 is therefore assessed under the current thresholds, even if the assessment only takes place in 2027. An informal letter or phone call counts as an application.

Anyone who already has a care level is not to lose it just because of the new thresholds. It can still be lowered if the person's condition actually improves. However, the protection does not cover every benefit, for example not the relief amount at care level 1. More on protected status

The new budgets at a glance

• Care supplies: the separate allowance of up to €42 a month (the “care box”, Pflegebox) is to be abolished. Consumables are to be paid for in future out of the care allowance.
• Relief amount: from care level 2, the €131 is to become the local support budget (Sozialraumbudget) of €175 a month (€300 for people under 25), but with stricter rules on its use.
• Respite and short-term care: instead of the joint annual amount of €3,539, there is to be a bridging budget (Überbrückungsbudget) of up to €2,285 a year. Privately organised replacement care is to be paid from the monthly care allowance in future.
• People without children: the extra contribution to the care insurance is to rise from 0.6 to 0.9 percentage points.

What this means in practice

If you receive care allowance today and also use the care box, you will have slightly less available at care levels 2 and 3:

A plan in the first draft from June to halve the care allowance in the first three months after the assessment is no longer included in the government draft.

Longer waiting times in early 2027

From January to April 2027, the rule that the care insurance fund must decide within 25 working days is to be suspended, except in urgent cases. Benefits are still paid from the month in which the application arrived.

What you can do now

1. Use our care level calculator to estimate which care level is realistic under the old and new rules.
2. Use the protected-status check to see what changes for your family.
3. If care needs have increased, applying for a higher care level (Höherstufung) may make sense. A template letter helps.
4. Keep a care diary before every assessment. It makes the real need for help visible. Our 14-day care diary is free to print.

Sources

• German Federal Ministry of Health: government draft of the care reform act (Pflegeneuordnungsgesetz, PNOG), 30 Sept 2026, Bundesrat document 587/26
• AOK legislation monitor (Gesetzesmonitor), PNOG timetable, as of 7 Oct 2026
• Section 15 SGB XI with Annexes 1 and 2 (current assessment system)
• Diakonie Deutschland: benefits of the long-term care insurance 2026

Frequently asked questions