Care costs in 2026: This is how high the out-of-pocket expenses will be in nursing homes
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Care costs in 2026: This is how high the out-of-pocket expenses will be in nursing homes
Digital innovations - Tax-optimized investments - Individual consulting
Costs of care in 2026: The actual expenses for a place in a nursing home
Personal contribution, long-term care insurance benefits, and the financial gap that families themselves have to close.
In 2026, a nursing home place will cost an average of over €5,000 per month nationwide. Of this, you will be responsible for an average of €3,245 per month in the first year of nursing home care, as statutory long-term care insurance only covers a portion of the cost. The remaining costs must be borne by the individual, their spouse, and, if applicable, their children. In this article, I will calculate the long-term care costs for 2026: what benefits the long-term care insurance provides, how large the actual care gap will be, and which type of insurance is recommended for which individual situation.
Care costs 2026: The amount of the out-of-pocket expenses in nursing homes
The Association of Substitute Health Insurance Funds annually determines the out-of-pocket costs that residents of nursing homes must bear. In January 2026, the average out-of-pocket contribution in the first year of residence amounted to €3,245 per month. This represents an increase of €261 compared to the previous year, which equates to a rise of approximately nine percent. By comparison, the costs in 2022 were around €2,200. The reasons for this are well-known and persist: collectively bargained wages for staff, general price increases, and investment costs that are not adequately subsidized by numerous federal states.
It should be noted that the co-payment is not a single item. Rather, it is made up of four components, which are subsidized to varying degrees:
- Facility-specific uniform co-payment (EEE): The care-related portion, which all residents of a facility pay regardless of their care level. Only this item is subsidized by the long-term care insurance fund.
- Accommodation and meals: The nationwide average is approximately €1,046 per month. You will bear this cost permanently and in full yourself.
- Investment costs: The portion of the building and furnishings that the facility is allowed to pass on. The long-term care insurance fund does not provide a subsidy for this either.
- Additional services: Hairdressing, foot care, single room supplement or special meals will be charged separately.
Since 2022, the long-term care insurance fund has granted a supplementary benefit that increases with the length of stay: 15 percent in the first year, 30 percent in the second, 50 percent in the third, and 75 percent from the fourth year onward. This supplement applies exclusively to the EEE (Extended Endowment for Residential Care). Accommodation, meals, and investment costs remain entirely your responsibility. Therefore, while your out-of-pocket expenses decrease over the years, they still average well over €2,000 per month even after four years.
For your own planning, this means in particular: Don't calculate with a monthly amount, but with a timeframe. Even a moderate out-of-pocket expense quickly adds up to a six-figure sum over several years. Therefore, for financial planning, the question of the expected duration of care is more important than the monthly price of a single facility.
Furthermore, there are considerable regional differences. The difference between the cheapest and most expensive federal states is more than €1,000 per month. Anyone planning to care for a parent should check the prices of the specific facility and not calculate based on the national average.
Which services will be covered by statutory long-term care insurance in 2026 and which will not?
The statutory long-term care insurance is intentionally designed as a partial benefit. It covers fixed amounts per care level, not the actual costs incurred. The contribution rate remains unchanged at 3.6 percent of gross income in 2026; childless individuals aged 23 and over pay 4.2 percent. The contribution assessment ceiling increased to €5,812.50 per month on January 1, 2026; those earning above this amount consequently pay significantly more.
Those with private health insurance pay for private long-term care insurance separately. Insurers significantly increased premiums at the beginning of the year, by an average of around six percent for those eligible for government subsidies and by about 16 percent for all other policyholders. The benefits themselves are identical to those of statutory long-term care insurance, as they are legally defined. The difference, therefore, lies solely in the premium, not in the coverage provided.
For full-time inpatient care, the long-term care insurance fund covers fixed benefit amounts, for example, 805 euros for care level 2, 1,319 euros for care level 3, 1,855 euros for care level 4, and 2,096 euros for care level 5. These amounts fall far short of covering the costs of care in a nursing home, which, mathematically speaking, results in a care gap of approximately 3,200 euros.
Another aspect is crucial for planning: 2026 is a year for updates. Benefit amounts were last increased on January 1, 2025, and will remain unchanged. The next regular adjustment according to Section 30 of the German Social Code, Book XI (SGB XI), is not scheduled until January 1, 2028. Meanwhile, nursing home costs continue to rise steadily. Therefore, the care gap is not widening due to a reform, but simply due to the passage of time.
Home care: care allowance, benefits in kind and relief allowance
Approximately four out of five people requiring care receive their care at home. In this area, the amounts will remain unchanged from the previous year in 2026: Care allowance amounts to €347 for care level 2 and rises to €990 for care level 5, while in-kind benefits for outpatient care services range from €796 to €2,299. In addition, there is a monthly relief allowance of €131 for all care levels, as well as a combined annual budget of €3,539 for respite and short-term care, which, for the first time in 2026, can be used flexibly throughout the entire calendar year.
Home care is on average less expensive than a nursing home placement, but by no means free. A home care service with multiple daily visits, a live-in caregiver, or a barrier-free bathroom renovation quickly exceeds the benefits provided. And the most significant cost factor never appears in any billing: the reduced or completely abandoned employment of family caregivers, which later also negatively impacts their own retirement savings.
If you foreseeably need to organize the care of a relative, I recommend a factual cost breakdown before making decisions regarding living arrangements or working hours.
Who will cover the costs if pensions and savings are insufficient?
If the pension is insufficient, a clear order of priority applies. First, the current income of the person requiring care is considered, followed by their assets, except for a small protected amount. Even owner-occupied property is only protected within narrow limits once it is no longer used. Only after this process does social assistance for care, provided by the social welfare office under Book XII of the German Social Code (SGB XII), become available. It is estimated that approximately one-third of all nursing home residents rely on this assistance.
The situation is particularly burdensome for married couples, as the income and assets of both partners are factored into the calculation. The partner living at home must therefore contribute proportionally to the financing before social assistance is granted. For children, the Family Relief Act has brought significant relief: they are only required to contribute to parental support if their gross annual income exceeds €100,000. This limit applies individually to each child and is not added to the income of the respective spouse.
One frequently overlooked aspect concerns gifts. Anyone who transfers assets to children and becomes dependent on care or needs assistance within ten years may have to reclaim the gift in accordance with Section 528 of the German Civil Code (BGB). Therefore, anticipated inheritance and long-term care provisions should be considered in joint planning.
Before transferring a property or restructuring assets, the impact on potential future care needs should be carefully calculated.
Long-term care insurance 2026: Three models at a glance
A private long-term care insurance policy precisely covers the difference between the benefit amount provided by the statutory long-term care insurance and the actual costs incurred. Three models have become established on the market, differing in terms of payout logic, flexibility, and premium stability.
Long-term care daily allowance insurance
This insurance provides a contractually agreed daily or monthly payment in the event of needing care, the amount of which is tiered according to the level of care required. The use of the money remains unrestricted. This is the most flexible option, as it can also finance care provided by family members or a professional caregiver. I recommend paying attention to the tiered benefit structure in the lower care levels, any automatic adjustments to compensate for rising costs, and whether the insurer offers a premium waiver in the event of a claim.
Long-term care insurance
Reimbursement of documented costs is typically provided as a percentage of the remaining costs after the long-term care insurance fund has made its initial payment. The advantage lies in the close link to actual expenses. However, a disadvantage is that benefits for care provided by family members are often limited, and documentation is still required.
Long-term care insurance
It provides a lifelong pension in the event of needing long-term care and combines this coverage with a savings component. While premiums are higher, they are more stable in terms of calculations, and a portion of the capital is preserved. For individuals with existing assets who wish to avoid premium adjustments in old age, this represents a serious option.
In addition, there is the government-subsidized long-term care insurance (Pflege-Bahr). Those who contribute at least ten euros per month receive a five-euro supplement per month, amounting to 60 euros annually. The advantage lies in the waiver of a health check, making it attractive for individuals with pre-existing conditions. However, the disadvantages should be noted: a waiting period of up to five years and a level of benefits that, on its own, does not close the coverage gap. It can be useful as a supplement or combined policy, but rarely as the sole source of coverage.
For tax purposes, contributions to supplemental long-term care insurance are considered other precautionary expenses. In practice, however, this deduction often proves ineffective for employees, as the maximum amount is already exhausted by contributions to mandatory health and long-term care insurance. I therefore advise against factoring in the tax advantage as a fixed expense.
The premium is primarily determined by the age at which the policy is taken out. Calculations by the rating agency Assekurata show that a 25-year-old can fully insure herself against nursing home care costs of around €2,000 per month for approximately €38 per month. Those who only take out a policy at age 60 pay significantly more, assuming they even pass the health assessment. This is precisely where many prospective policyholders misunderstand: long-term care insurance is not just for retirees, but a decision for those in middle working life.
When is independent advice on care costs advisable?
Consultation isn't equally beneficial in every life situation. Specifically, it's advisable in four scenarios. First, if you're between 40 and 60 and coverage is still affordable. Second, if a parent already requires care and it needs to be clarified what costs the family will face and which benefits haven't yet been utilized. Third, if real estate or substantial assets are involved, because transferring ownership, protected assets, and the risk of needing care must be considered together. And fourth, if you already have a supplemental long-term care insurance policy whose benefits level has never been reviewed since its inception.
As an independent lawyer, I compare the rates of several companies and calculate the gap for your specific situation, instead of working with averages. If you want to know what your existing contract actually covers in the event of needing long-term care, have it reviewed as part of my contract check.
Conclusion: Long-term care costs in 2026 can be planned, but only with sufficient lead time.
The figures for 2026 are clear. The average out-of-pocket cost for nursing home care in the first year is €3,245 per month and is continuing to rise, while long-term care insurance benefits are frozen until at least 2028. This gap is therefore growing without any political intervention. Those who want to close it have three options: their own capital, private long-term care insurance, or the willingness to use assets and real estate in an emergency. All three options are legitimate, but only the consciously chosen one protects relatives from unpleasant surprises. The best time to make this decision is while you are healthy and the options are still open.
Frequently Asked Questions (FAQ)
What will the out-of-pocket costs for nursing home care be in 2026?
On average across Germany, residents pay €3,245 per month out of their own pockets during their first year of stay. This represents an increase of €261 compared to 2025. With increasing length of stay, this amount decreases due to supplementary payments from the long-term care insurance fund, but remains above €2,000 on average. Depending on the specific federal state and facility, the actual amount can be considerably higher or lower.
Why does the out-of-pocket expense increase even though the long-term care insurance fund provides subsidies?
The benefit supplements apply exclusively to the facility-wide co-payment for care. You are still responsible for the full cost of accommodation, meals, and investment expenses. Because nursing home costs are rising faster than the subsidies are being implemented, your co-payment will continue to increase. Furthermore, the benefit amounts from the long-term care insurance fund will remain unchanged in 2026.
What will the long-term care insurance contribution rate be in 2026?
The contribution rate remains unchanged at 3.6 percent of the gross income subject to contributions and is split between employer and employee. Childless individuals aged 23 and over pay a surcharge of 0.6 percentage points, bringing the total to 4.2 percent. The rate is reduced on a sliding scale for each additional child. The contribution assessment ceiling in 2026 is €5,812.50 per month.
Will there be an increase in long-term care benefits in 2026?
No. The benefit amounts were last increased on January 1, 2025, and will remain unchanged in 2026. The next regular adjustment, according to Section 30 of the German Social Code, Book XI (SGB XI), will not occur until January 1, 2028. The care allowance will therefore continue to range between €347 for care level 2 and €990 for care level 5.
Are children obligated to pay for their parents' care costs?
Only in exceptional cases. Since the Family Relief Act, children are only obligated to contribute to their parents' support if their gross annual income exceeds €100,000. This limit applies individually to each child, and the spouse's income is not taken into account. If the income is below this threshold, the social welfare office covers the uncovered costs as part of long-term care assistance.
Will the owner's home be sold to cover care costs?
As long as the person requiring care or their spouse lives in the property, it is usually protected. If the owner permanently moves into a nursing home and the house remains unoccupied, it can be classified as an asset that can be liquidated. In practice, this could involve renting, selling, or taking out a loan secured by a mortgage. A transfer to children can be reclaimed within a period of ten years.
Which supplemental long-term care insurance policy is the best fit?
This depends on your goals and budget. Daily care allowance is the most flexible option, as the payout is unrestricted. Long-term care cost insurance covers documented costs and is suitable for exclusively professional care. Long-term care annuity insurance is characterized by stable premiums and asset accumulation, albeit with higher premiums. I recommend comparing different insurers, as the benefit levels vary considerably across the different care levels.
Is the Pflege-Bahr a worthwhile investment?
The subsidized plan offers a monthly allowance of five euros for a minimum personal contribution of ten euros and waives the health check. For individuals with pre-existing conditions, it often represents the only access option. Disadvantages include a waiting period of up to five years and a limited level of coverage. It is insufficient as a sole form of protection, but can be a useful component of a combined plan.
At what age does it make sense to take out long-term care insurance?
The earlier you take out a policy, the more cost-effective it is, as the premium depends significantly on your age at entry and is calculated over the entire contract term. Between the ages of 40 and 55, coverage can usually still be obtained at reasonable premiums, and the health check is generally successful. From the age of 60 onward, both the premium and the risk of rejection increase considerably. Those who already have a care level classification are no longer eligible for conventional policies.
When is independent advice on long-term care planning advisable?
This is especially important when several factors coincide: personal assets, real estate ownership, family members with foreseeable care needs, or an existing contract with unclear benefits. A consultation identifies the individual coverage gap and compares the rates of different companies. This is crucial because the conditions for care levels 2 to 4 differ significantly, and this is precisely the area where most claims arise.
