Germany’s cabinet approved a long-term care insurance reform bill on September 30, 2026. If parliament passes the long-term care insurance reform, you’ll pay higher care insurance contributions from 2027 if you don’t have children. Some people who get care at home would also lose a €131 monthly allowance.
Germany’s Long-Term Care Insurance Fund Is €7.6 Billion Short for 2027
Germany’s long-term care insurance fund is set to run about €7.6 billion short in 2027. If nothing changes, that gap grows past €15 billion by 2028.
Long-term care insurance changed between 2005 and 2025:
- People receiving long-term care benefits: 1.95 million to about 6 million
- Annual long-term care insurance costs: €17 billion to €70.4 billion
Health Minister Carsten Linnemann (CDU) confirmed the cabinet’s approval of the long-term care insurance reform bill. He called care support “a central task of our solidarity community.”
NOTE: The long-term care insurance reform is a cabinet-approved draft, not yet law. The bill still needs Bundestag and Bundesrat approval before taking effect.
#1 Childless Members Pay a Higher Long-Term Care Insurance Surcharge From 2027
If you have no children, your supplementary care insurance surcharge rises from 0.6% to 0.9%. The higher surcharge takes effect January 1, 2027.
Take a gross salary of €4,500 a month. On that salary, the higher surcharge raises your monthly care insurance contribution from about €108 to €121.50. Check your first 2027 payslip to make sure the new 0.9% surcharge is applied.
The extra revenue from the higher surcharge helps close the long-term care insurance fund’s 2027 shortfall.
#2 The Long-Term Care Insurance Income Ceiling Rises by €300 for Higher Earners
The income ceiling for care insurance contributions is going up by €300 a month. Right now, the ceiling sits at €5,812.50. The health insurance ceiling goes up by the same €300.
If you earn above €5,812.50 a month, more of your income will count toward care insurance contributions, so your monthly care insurance deduction goes up.
#3 Co-Insured Spouses Pay a New 0.52% Long-Term Care Insurance Surcharge From 2028
Co-insured spouses pay a new 0.52% care insurance surcharge from January 1, 2028. Until now, co-insured spouses were covered for free through their partner’s insurance.
Two groups are exempt from the spousal surcharge:
- Caregiving relatives
- Parents of disabled children
Ask your care insurer (Pflegekasse) whether you qualify for the spousal surcharge exemption.
#4 Minijob Workers Start Paying Into Care Insurance
The long-term care insurance reform brings marginal employment (Minijobs) into care insurance contributions. Minijob contributions are expected to bring in about €1.4 billion a year.
Care Level Assessments Get Stricter and Care Level 1 Loses the €131 Allowance
The long-term care insurance reform makes assessments for care levels 1 through 3 stricter. If you already hold a care level, you keep your current care level.
The long-term care insurance reform also scraps the €131 monthly support allowance for care level 1 home care. The €131 allowance cut affects anyone currently claiming the allowance.
WARNING: If your household relies on the €131 care level 1 allowance, budget for its removal. Stricter assessment criteria may also make new care level 1 claims harder to get approved.
Five More Changes in the Long-Term Care Insurance Reform
The long-term care insurance reform also includes:
- A “Check-up 60+” screening
- A “rehabilitation before care” principle
- A digital Pflege-Cockpit platform for managing care benefits
- Care benefit levels that rise automatically with inflation from 2029
- €1.6 billion from the government for digitalizing care facilities
