Preparing for the assessment by the Medical Service

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 · 4 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).

What is assessed

The Medical Service (Medizinischer Dienst) looks at six areas of life: mobility, cognitive and communication skills, behaviour and psychological problems, self-care, coping with illness and treatment, and daily life and social contacts. For each activity, what counts is whether the person manages it independently or how much help is needed. This produces a score from 0 to 100. How the score is calculated

Preparing in the two weeks before

• Keep a care diary: every evening, note what help was needed, how often and for how long. 14-day care diary
• Have documents ready: recent doctors' and hospital reports, the medication plan, a list of aids, a severe disability card (Schwerbehindertenausweis) if you have one, and the care records of the home care service.
• Fill in the questionnaire: the Medical Service often sends a questionnaire in advance (in German). Mention restlessness, anxiety or confusion there, even if you are not asked about it directly.
• Assess yourself first: go through the areas with the detailed mode of our calculator, so you know in advance where the points come from.

On the day of the assessment

• Be there: many people who need care pull themselves together during the visit and say they can manage everything alone. Family members can describe daily life more realistically.
• Describe an ordinary day, not the best one. Also mention nights, falls, incontinence and forgetfulness, even if it is uncomfortable.
• Show rather than tell: where appropriate, let the person get up from the armchair without helping.
• Ask if something has been misunderstood, and sum up the key points again at the end.
• Language: the assessment is held in German. If the person needing care or you do not speak much German, bring someone you trust to translate.

Assessment by phone or video

For some applications, such as a request for a higher care level, the Medical Service can offer a structured phone or video interview. This is only possible with your consent, and a home visit always takes priority if you ask for one. It is not possible for a first application, for an objection or for children under 14, among other cases.

After the appointment

You will usually receive the assessment report (Gutachten) with the decision. If it is missing, ask the care fund for it. Compare it with your care diary: are the details for each activity correct? If not, an objection is often worthwhile. How to object

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