Guide · Higher level
Applying for a higher care level
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).
- If care needs have increased, you can apply for a higher care level (Höherstufung) at any time. An informal letter is enough.
- For the reform, the application date counts: if the application arrives in 2026, the current, lower thresholds apply according to the draft.
- From 2027, care level 2 then requires 30 instead of 27 points, and care level 3 requires 50 instead of 47.5.
- For a higher care level, an assessment by phone or video is possible if you agree.
- The existing care level is kept if the application is unsuccessful. It can only go down if the person's condition has actually improved.
- The new thresholds apply to applications from 2027: care level 2 from 30, 3 from 50 points; 4 and 5 stay at 70 and 90.
- An application for a higher care level leads to a new assessment. How protected status applies in that case will only be settled by the law as passed. Get advice beforehand, for example from a local care support centre (Pflegestützpunkt).
When an application is worthwhile
Typical reasons are a hospital stay, a fall, advancing dementia or simply that much more help is needed in daily life than at the last assessment. Go through the areas with the detailed mode of our calculator and compare the result with the last assessment report.
How to apply
- A short letter to the care fund in German, requesting a new assessment and a higher care level. Make sure you can prove it arrived, e.g. by registered mail or fax.
- Prepare for the assessment: a two-week care diary, recent doctors' reports, the medication plan. How to prepare
- Check the decision: if the result is not right, you can object within one month. How to object
Higher care level and the 2027 reform
According to the draft, the rules on the day the application reaches the care fund apply. An application from 2026 is assessed under the current thresholds, even if the assessment only takes place in 2027. From 2027, new applications are assessed under the higher thresholds. If you are just above a current threshold, take this into account when planning.
| Target | until now | planned from 2027 |
|---|---|---|
| Care level 2 | from 27 | from 30 |
| Care level 3 | from 47.5 | from 50 |
| Care level 4 | from 70 | from 70 |
| Care level 5 | from 90 | from 90 |
Can the care level go down at a new assessment?
Only if the person's independence has actually improved. According to the draft, an existing care level must not be lost solely because of the new thresholds. If you are unsure, check with the calculator beforehand whether the need for help really has increased. More on protected status
Sources
- German Federal Ministry of Health: government draft of the care reform act (PNOG), 30 Sept 2026, Bundesrat document 587/26
- pflege-dschungel.de: what the cabinet draft means for care at home (30 Sept 2026)
- SGB XI: Section 33 (start of benefits), Section 37 (care allowance, advice visit), Section 44 (pension insurance for carers)
Frequently asked questions
How often can I apply for a higher care level?
At any time, if the need for help has changed. There is no fixed waiting period.
Which thresholds apply to my application?
According to the draft, those in force on the day the application reaches the care fund. Until the end of 2026, the current ones.
Will I lose my care level if the application is refused?
No. The existing care level stays as long as the person's condition has not actually improved.
When does the extra money start?
From the month in which the application for a higher care level arrived, backdated.