Nursing Home Costs in Germany: What Insurance, Family and the State Pay

What a nursing home costs in Germany

A nursing home bill in Germany is split into three parts: the care-related personal contribution (pflegebedingter Eigenanteil), accommodation and meals (Unterkunft und Verpflegung), and facility investment costs (Investitionskosten), according to the consumer guide Pflege.de. Statutory long-term care insurance helps with the first part only; residents pay the other two in full themselves.

The nationwide average personal contribution reached €3,364 a month in July 2026, up €256 from a year earlier, based on figures from Germany's association of substitute health insurers (vdek) cited by the German benefits-information site Bürgergeld.org. Regional differences are large: the same vdek data puts Bremen highest at roughly €3,761 a month and Saxony-Anhalt lowest at about €2,891. The same vdek data, also reported by the consumer guide Pflege.de, puts the first-year average slightly lower in January 2026, at about €3,245, while the Cologne-based German Economic Institute (IW), cited by The Local in November 2025, had estimated the first-year average at €2,948 only months earlier — the three figures, taken together, point to costs rising through 2025 and 2026 rather than a single contradiction.

Pflege.de notes that within a given home, the personal contribution can shrink the longer a resident stays, because a statutory 'Leistungszuschlag' (performance subsidy) raises the insurance's share of the care-cost component over time.

What long-term care insurance actually pays

Pflegeversicherung is compulsory for everyone in Germany, whether insured through the statutory (GKV) or private (PKV) system, according to the insurance information site Private Health Germany. Benefits are paid according to one of five assessed care levels (Pflegegrade); level 1, the lowest, mainly gives access to support services rather than cash.

These figures, reported by Private Health Germany, correspond to the scale in force since 2024; under the government's 2026 reform plan a routine inflation adjustment due in 2028 has been cancelled, according to ver.di and the SPD-affiliated outlet Vorwärts, so the amounts are not expected to rise again before 2029. Even at Pflegegrad 5, the highest level, the nursing-home subsidy of €2,005 falls well short of total monthly costs of €3,000 to €5,000 that the same source cites for full residential care, leaving a gap the source estimates at roughly €2,500 a month on average.

When the welfare office (Sozialamt) steps in

If a resident's pension, savings and insurance benefits are not enough to cover the bill, they can apply to the local Sozialamt for 'Hilfe zur Pflege' (help with care costs), a form of social assistance, according to Bürgergeld.org. The same source stresses that this support starts only in the calendar month the application is filed — it is not paid retroactively for earlier months, so delaying the application can mean losing months of support permanently.

Family liability is limited. Under the Angehörigen-Entlastungsgesetz (Relatives' Relief Act), which the Federal Ministry of Labour and Social Affairs (BMAS) says took effect in December 2019, the income of adult children or parents is only taken into account by welfare authorities once it exceeds €100,000 a year, per person liable. Below that threshold, BMAS states, authorities may not pursue or demand a contribution from the relative's income at all.

The 2026 reform: what changes from 2027

On 30 September 2026 the federal cabinet approved a draft Pflegeneuordnungsgesetz (care reorganisation law), according to the government's own statement published by the Federal Government (Bundesregierung). It still needs approval from the Bundestag and Bundesrat before taking effect. The government says the bill is meant to stabilise the finances of the long-term care insurance fund — which it says otherwise faces deficits of more than €7.6 billion in 2027 and over €15 billion in 2028 — while holding the general contribution rate at 3.6%.

Planned new measures listed in the government statement include a right to professional, on-site care guidance for care-dependent people and their relatives, new 'social-space budgets' for people at Pflegegrad 2 and above, emergency bridging budgets for unexpected gaps in family care, and a digital overview tool called a 'care cockpit.'

A central demand from the Social Democratic Party (SPD) and the trade union ver.di — a 'Pflegedeckel' capping the care-related personal contribution in nursing homes at €1,500 a month — did not make it into the draft law, according to both verdi.de and the party-affiliated outlet Vorwärts. Instead, a separate nursing-structure commission is tasked with examining the cap and with aligning private and statutory insurance funding, and must report by the end of January 2027, according to Vorwärts.

Other provisions in the draft, as summarised by verdi.de and Vorwärts, include raising the contribution surcharge for childless insured people from 0.6 to 0.9 percentage points from 2027, raising the income ceiling used to calculate contributions, and ending the €131 monthly Pflegegrad-1 allowance in favour of nursing support services. The SPD says it blocked other proposed cuts, including a planned halving of the Pflegegeld cash benefit for care grades 2 and 3 and a wage freeze for care-sector staff.