What does Germany’s care reform mean for you?

After months of debate, the Federal Cabinet agreed on a draft of the “Care Reorganisation Act” on Wednesday, which lays out the government’s plan for a reform of Germany’s long-term care insurance policies.

The reforms are primarily aimed at closing a large financial gap in funding for long-term healthcare, estimated at around eight billion euros in the coming year.

Federal Health Minister Carsten Linnemann, of the conservative Christian Democratic Union (CDU) which heads the black-red government coalition, says the changes represent a “first important step” toward stabilising Germany’s care system.

According to Linnemann, savings are necessary to bring the finances into balance. But for many residents and workers in the country, the concrete impacts will be higher care insurance contributions.

Here’s a look at what the proposed care reform means for you.

Higher contributions for the childless…

Under the Care Reorganisation Act (Pflegeneuordnungsgesetz), the care insurance contribution surcharge for childless persons will increase by 0.3 percentage points to 0.9 percent.

The general base contribution rate, however, remains stable at 3.6 percent.

In total this raises the contribution rate for workers who don’t have children to 4.5 percent from the start of 2027.

Note that the base contribution rate is split between employers and employees — each side pays 1.8 percent, amounting to 3.6 percent in total toward care insurance. (Except in the state of Saxony where employees pay a base rate of 2.3 percent.) 

The childless surcharge is paid solely by the employees.

…and for co-insured spouses

Another surcharge introduced by the act would apply to co-insured spouses or civil partners.

This surcharge amounts to 0.52 percent.

Exceptions are in place for the parents of children with disabilities, or for those who are caring for relatives.

Increased contribution assessment ceiling

For higher income earners, the reform also amounts to slightly higher contribution costs.

The contribution assessment ceiling for long-term care insurance will be raised by €300 euros per month — a bit less than was initially planned.

The current limit is set at €5,812.50 per month, or €69,750 per year. Care insurance contributions are applied to gross income up to this amount. Everything earned above this ceiling is free from contributions.

Contributions also from mini-jobs

Starting next year, the reform would see contributions to long-term care insurance also taken from salary for mini-jobs.

This is expected to bring in €1.4 billion in revenue annually.

Until now, mini-jobs have remained entirely free of social security contributions by definition.

READ ALSO: Will Germany scrap the ‘mini-job’?

Changes for professional care workers

For healthcare professionals, nurses and state in elderly care, the reform brings in or adjusts policies to try and address labour shortages and reduce the burdens put on employees in the care work sector (Pflegefachkräfte).

Care professionals are to be given more authority to directly engage in certain medical interventions, such as some specialised wound treatments or diabetes care, without requiring explicit doctor authorisation.

This comes alongside a reduction in some daily documentation requirements meant to reduce bureaucracy.

In addition, care assistant training is to be standardised nationally and care worker organisation are to receive formal statutory representation in federal healthcare policy decisions.

And for people who care for relatives 

For those who care for their own family members at home, long-term care insurance will continue to pay their pension insurance contributions, contrary to what had initially been proposed.

Also families with children in need of care will have access to a special budget of up to €300 per month, which is intended to finance support in everyday life, including individual helpers recognised by care insurance companies.

For people receiving care

Changes are to be made to how care levels are assessed, which may affect what benefits or services patients qualify for.

According to reporting by Tagesschau, the health ministry has been vague about what exactly will be changed, but says that care levels one to three should be assigned “more precisely” in future.

For level one patients, the relief contribution, valued at €131 per month for home care, is to be abolished.

More proactive prevention for elders

The draft law does aim to focus more efforts toward preventative health measures.

To this end, insured people aged over 60 will be entitled to an early detection examination called ‘Check-up 60+’, aimed at identifying health risks at an early stage.

What’s next?

With the Care Reorganisation Act now approved by the cabinet, it is set to go to the German legislature (Bundestag and Bundesrat) for further discussion and/or approval.

This process could potentially bring further changes to aspects of the reform, and can be expected to continue through late autumn.

The government aims to have the law passed and adopted so that changes can start from the beginning of 2027.

While this draft law would bring some significant monetary policy changes and tweaks to certain care benefits, lawmakers had initially wanted to tackle a bigger structural reform.

That debate, however, has been postponed due to major disagreements between the conservative (CDU/CSU) and centre-left (SPD) camps in the federal government.

According to Health Minister Linnemann, the cabinet is to decide on the schedule for this next week. An expert committee is expected to present proposals by the end of January 2027.