Germany’s Federal Ministry of Health published a draft law on June 4, 2026, to overhaul the country’s long-term care insurance (gesetzliche Pflegeversicherung). The law, called the Pflegeneuordnungsgesetz (PNOG), is scheduled to take effect on January 1, 2027, with some measures taking effect in 2028.
NOTE: This is a referral draft (Referentenentwurf), not a final law. The Bundestag has not yet voted on it. Further changes are possible before it passes.
Why Germany’s long-term care insurance is in financial trouble
The long-term care insurance system faces a serious shortfall. Without reform, the system is projected to run a deficit of €7.6 billion in 2027 and €15.4 billion in 2028.
The number of people officially recognized as requiring care has grown sharply to nearly six million. One of the main reasons is that the criteria for recognizing care needs were relaxed in 2017.
Without action, contribution rates would have to rise sharply for everyone. The draft law tries to close the gap through a combination of higher contributions, lower benefits, and structural changes.
9 key changes proposed in the long-term care insurance reform
#1 Higher contribution base
From January 1, 2027, long-term care insurance contributions will no longer be calculated up to the contribution assessment ceiling (Beitragsbemessungsgrenze). But up to the compulsory insurance threshold (Versicherungspflichtgrenze) of statutory health insurance.
The Beitragsbemessungsgrenze is €69,750 per year (€5,812/month), and the Versicherungspflichtgrenze is €77,400 per year (€6,450/month) in 2026. Moreover, the Versicherungspflichtgrenze could rise to around €84,000 (€7,000/month) in 2027.
Projected additional revenue: €1.6 billion in 2027.
#2 Higher surcharge for childless individuals
If you are over 23 and have no children, the childless surcharge (Kinderlosenzuschlag) rises from 0.6 to 0.7 percentage points above the standard rate. That adds roughly €6–7 per month for those earning at or above the contribution threshold.
Your employer needs to know how many children you have to apply the correct rate. This becomes more important under the new rules.
#3 Surcharge for partners covered under your health insurance for free
From January 1, 2028, if your partner is currently co-insured under your public health insurance plan for free (beitragsfreie Familienversicherung), you will pay an additional 0.52 percentage points. At the compulsory insurance threshold, that is roughly €35 more per month.
Exceptions apply: the surcharge is waived if your partner cares for a family member with at least care level 2 (Pflegegrad 2) for at least 10 hours per week across at least two days per week in a home setting.
Children remain contribution-free under family insurance.
#4 Employer contributions for mini-jobbers
Employers of mini-jobbers (Minijobber) will be required to pay long-term care insurance contributions. Previously, mini-job employment was exempt.
#5 Relief allowance partially cut
The relief allowance (Entlastungsbetrag) of €131 per month for people with care level 1 (Pflegegrad 1) will be eliminated. For care levels 2 and 3 (Pflegegrad 2 und 3), the allowance will be halved for the first three months after a care level is awarded.
From 2028, people with care level 1 will instead receive a new form of regular care support (Pflegeunterstützung).
#6 Stricter criteria for care levels 1–3
The criteria used to classify someone as having care level 1, 2, or 3 will become stricter. Since 2017, more lenient standards have been applied than those recommended by research.
#7 Lower pension contributions for home caregivers
If you care for a relative at home and reduce or stop working to do so, the long-term care insurance currently pays pension contributions on your behalf. Under the draft, these payments will be reduced to 70% of their current level. Your future pension will be lower as a result.
#8 Slower-increasing nursing home subsidies
Long-term care insurance pays a supplement (Leistungszuschlag) toward your share of nursing home costs. This supplement currently increases by 15% every 12 months, rising to 75% from the fourth year onward.
Under the draft, the supplement will increase every 18 months instead. In practice, this means you will pay several hundred euros more per month during the second and third years of residence, before the supplement catches up.
Average out-of-pocket nursing home costs in Germany are already over €3,200 per month in the first year.
#9 Inflation adjustment from 2028
From 2028 onward, long-term care insurance benefits will be adjusted annually in line with inflation. This is a positive change for those receiving care.
Your parents’ home might have to be sold to pay the long-term care bills
Under current rules, a home is treated as a protected asset (Schonvermögen) for someone receiving care. It does not have to be sold before the social welfare office (Sozialamt) steps in to cover care costs.
The protection is strongest when a spouse or other relative still lives in the home. However, if you move permanently into a nursing home and no one else lives in your home, the house may need to be liquidated before social welfare steps in.
Many families currently get around this by transferring the home to their children as an early gift (Schenkung). Under current law, the Sozialamt can only reclaim gifts made within the past ten years.
CDU politician Stegemann has called this an “inheritance protection program at the expense of the general public” and proposed extending this clawback period. The current draft does not include this change.
Your children may have to pay more in parental support
Since 2020, children only have to contribute to parental care costs (Elternunterhalt) if their gross annual income exceeds €100,000. This threshold covers all income: salary, capital gains, and rental income.
Reducing this threshold is being discussed to limit how high contribution rates rise. The Federal Court of Justice has ruled that adult children can keep at least €2,650 per month for themselves before any parental support obligation applies.
