Nursing care allowance for self-organized care

Care recipients who are cared for at home and primarily by relatives or volunteers from their circle of friends and neighbors receive nursing care allowance. This long‑term care insurance benefit is a monthly payment and intended to help the care recipient to organize the required assistance with nursing care, support and household chores in a self-determined and independent manner.

The same conditions apply to people with private long-term care insurance as for statutory long-term care insurance. If they receive financial assistance, the nursing care allowance is reduced accordingly.

For care at home, two long-term care benefits are provided to finance the necessary care and support needs – the nursing care allowance and non-cash care benefits (care benefits in kind). The latter includes support from a professional care service that is settled according to the principle of non-cash benefits. The care service settles directly with the long-term care insurance provider without the insured persons having to advance the costs.

Care recipients can either choose one of the two benefits or a combination of both. They then receive both benefits on a pro rata basis: if, for example, they use 40 percent of the budget for non-cash care benefits, they will receive 60 percent of the nursing care allowance they are entitled to based on their individual care level. However, they cannot receive nursing care allowance and benefits for full-time residential care at the same time.

If the care needs are no longer being met by volunteer carers, for example because more and more support from professional nursing staff needs to be purchased or the carer is permanently ill or overworked, it is worth considering switching to non-cash care benefits or combination benefits. This can be done at any time.

Nursing advisors can help you to make the best choice for you.

The nursing care allowance is not considered as income, i.e. the care recipient does not need to pay tax on it. This also applies to carers who receive the nursing care allowance as recognition and not in the context of an employment relationship. The nursing care allowance is also paid in addition to other state benefits such as housing benefit or unemployment benefit II.

The nursing care allowance is a monthly, flat-rate amount that is transferred to the care recipient’s account at the beginning of the month.

The severity of the need for long-term care is a decisive factor for the amount of nursing care allowance. The higher the care level, the higher the monthly amount: 

• Care level 2: 332 euros 
• Care level 3: 573 euros  
• Care level 4: 765 euros 
• Care level 5: 947 euros  

As well as the nursing care allowance (or non-cash care benefits or a combination of the two), there are other benefits for care at home, for example, respite care, short-term care or day and night care and additional relief. Some of these benefits affect the amount of nursing care allowance.

Care recipients must pay for all other expenses themselves. If their income is too low for this, they can sometimes apply for help with care costs. 

Care recipients are only entitled to nursing care allowance if they meet the following requirements:

• There is a long-term care need with an assigned care level of 2 to 5.  
• The care is taking place at home.  
• The care is independently organized by the care recipient or their relatives. 

The nursing care allowance has to be requested from the care recipient’s long-term care insurance provider or private long-term care insurance provider. This can be done in writing or by telephone. The long-term care insurance provider will ask how care is to be ensured when the care level is applied for. It will send a form where the care recipient can select the desired benefits and specify the carer. This information will also be requested during the assessment.

It is possible to switch between nursing care allowance, non-cash care benefits or combination benefits at any time and with no transition period. A new care assessment is not usually required when switching between these benefits. 

The nursing care allowance is designed to provide assistance with nursing care, support and household chores. There are no other specifications as to how or for what the nursing care allowance is to be used. There is also no obligation to provide proof, e.g. in the form of receipts.

The care recipient is entitled to nursing care allowance and allowed to decide how it is to be used. It is often used to give relatives and other carers financial recognition. However, it is up to and must be discussed with the care recipient whether the nursing care allowance is used for this, to hire nursing support or home help or for other purposes.

Mandatory care review visits will regularly assess whether the care is being adequately ensured with the nursing care allowance. 

If care recipients use the nursing care allowance, professional nursing care staff regularly come to their home to give them advice on care. These mandatory care review visits are to ensure that care recipients are being cared for properly and that they get help promptly should they need it.

The aim of the care review visits is to continue to support care at home. They include: 

• Assessing the care situation. The topics addressed are the care of the care recipient, any heavy burdens on the carer and working together to find solutions for problems. The examination of certain parts of the body as part of this assessment is only carried out with the care recipient’s consent. 
• Assistance and practical nursing care support, for example, instructions on how to help someone get from their bed to a chair, or practical tips on aspects of care, such as body care, eating and drinking and incontinence. 
• Providing information, advice and support services for care recipients and their loved ones. This includes, for example, advice on training courses in care: what’s on offer is very comprehensive and ranges from instruction and information to training sessions and informal exchanges. The topics addressed include, for example, illness-specific care (care for dementia, stroke), physical and psychological stress for family carers and legal topics such as guardianship law. Some care courses can be done at home or online. 
• Advice on other support services: for example support from volunteer aid agencies, networks and self-help associations and advice on other long-term care insurance benefits, other welfare agencies and services and funding opportunities from federal states and municipalities. 
• Information on additional advisory services: for example, how housing can be made fully accessible. 

How many care review visits are compulsory? 

With nursing care allowance, advice on care is compulsory. If the advice is not used, the nursing care allowance can be reduced or even withdrawn in the event of a recurrence.

The higher the care level, the more frequently a nursing service comes to give home care advice: 

• Care levels 2 and 3: once every six months 
• Care levels 4 and 5: once every quarter 

For care recipients at care level 1 and care recipients who receive non-cash care benefits, advice on care is not compulsory. However, they are entitled to a care review visit at home every six months.

There are other long-term care insurance benefits for care at home. Some of them can affect the nursing care allowance: the amount is then reduced for a certain period of time or the entitlement is suspended.

These benefits can lead to reductions in the nursing care allowance: 

• Combination benefits: care recipients receive a proportionate nursing care allowance if non-cash care benefits are used at the same time. 
• Short-term care: half the nursing care allowance continues to be paid during the short-term care stay, for a maximum of eight weeks per calendar year.  
• Respite care: half the nursing care allowance continues to be paid, up to six weeks per calendar year.  
• If a person is staying in a full-time residential care facility for people with disabilities, it is possible to receive a proportionate nursing care allowance if some of the care also takes place at home. 

These benefits do not affect the amount of the nursing care allowance: 

• Additional relief 
• Semi-residential care (day or night care) 
• Care aids 

More information about the nursing care allowance and other benefits in full-time residential care facilities for people with disabilities can be obtained from the Complementary independent participation counseling center (EUTB).

Suspended entitlement

The entitlement to nursing care allowance is suspended whilst certain health insurance benefits are claimed, such as inpatient treatment in a hospital or a rehab center or when care at home is paid for by the health insurance provider. However, nursing care allowance will continue to be paid for the first four weeks.

More information about when the entitlement to care allowance is suspended can be obtained from your health and long-term care insurance provider.