Nursing home: how much does it cost? | NDR.de – Guide

According to the Federal Statistical Office, around five million people in Germany are in need of care. Around four out of five people in need of care are cared for at home, and around a million live in nursing homes. Moving into a nursing home and leaving your home and surroundings is difficult for most old people. Added to this are worries about the financial burden and the fear of not being able to afford the place in a home. The costs, especially for nursing staff, but also for accommodation and food, have risen sharply and are clearly reflected in the personal contribution of those in need of care.

Care reform: Higher contributions to care insurance, more state benefits

With the The federal government wants to respond to rising costs with nursing care reform, which will be implemented in two stages until 2025. The package of measures is intended to improve nursing training and relieve the burden on those in need of care and their relatives. In a first step, both nursing care insurance contributions and state subsidies were increased. The general contribution rate for nursing care insurance has increased from 3.05 percent to 3.4 percent of gross income. There are surcharges or deductions on the contribution, which depend on whether and how many children the insured person has and how old they are. In addition, state subsidies for care services have increased increased, including in inpatient care. The consumer advice center gives one Overview of the changes.

How much is the co-payment in a nursing home?

There is no fixed price for a place in the home. Each operator calculates the costs for his house himself, but must have them approved by the nursing care insurance companies and the social authorities. Although the care insurance funds pay subsidies towards the costs of care, those in need of care still have to dig deeper into their pockets. According to the Association of Replacement Funds (vdek), in 2023 they had to pay an average of 2,576 euros per month if they were cared for in a nursing home for up to twelve months. That is 165 euros more than last year. Those in need of care who stayed in the home for more than twelve months had to pay an average of 2,370 euros (plus 187 euros). For more than two years it was 2,095 euros (plus 140 euros) and for more than three years it was 1,750 euros (plus 79 euros).

Nursing home costs vary across federal states

In addition to the pure care costs, the costs for a place in a home also include costs for accommodation, food and other additional costs. The amounts sometimes differ significantly between the federal states: While those in need of care in Saxony-Anhalt paid an average of 2,016.85 euros per month for a place in a home in the first year in 2023, in Saarland it was 2,980.80 euros.

Nursing insurance covers part of the costs depending on the level of care

A nursing home bill is made up of many items.

The actual costs for a place in a nursing home are significantly higher than the out-of-pocket cost. To cover the costs of care, the care insurance funds pay monthly benefits to the operator, which are based on the care needs of the resident – from care level 1 to 5, from mild to severe. According to the will of the legislature, people with care level 1 should, if possible, not live in inpatient care. If you still want it, you will have to pay a significantly higher contribution; the fund will only contribute 125 euros. For care level 2 it is already 770 euros and for intensive care at level 5 it is even 2,005 euros per month.

Nursing care insurance provides subsidies for your own contribution depending on the length of stay

The costs for a place in a home consist of care and support costs, accommodation, food and investment costs. Those in need of care must pay for their own accommodation, meals and investment costs in the home. They contribute to the high costs of nursing staff with what is known as their own contribution. Since the beginning of 2022, the nursing care funds have been granting subsidies for this personal contribution, which are staggered depending on the length of stay in the home. The following applies: the longer a person in need of care lives in the home, the lower their own contribution becomes. Since January 1, 2024, the following applies: in the first year it is 15 percent, in the second 30 percent, in the third 50 percent and after three years 75 percent. This means that the care insurance companies only cover a larger part of the costs for the pure care and support services from the third year onwards in the nursing home.

How is the personal contribution made up?

Home operators must break down the costs for residents in their calculations. A sample calculation for the national average financial burden of a person in need of care:

• As part of the care and support costs, a “facility-specific contribution” (EEE) is charged. It applies to all residents with care levels 2 to 5 at the same amount and averaged 1,377 euros in 2023.
• A further 921 euros were added for accommodation with additional costs and food.
• In third place are “investment costs”. This includes expenses for the maintenance and modernization of buildings and technical systems, such as the renovation of common areas or the renovation of bathrooms. On average, residents had to pay an additional 485 euros per month.

The personal contribution amounts to 2,783 euros per month (2022: 2,468 euros). However, with the nursing care insurance fund’s subsidy of 15 to 75 percent towards your own contribution (EEE), the amount is reduced depending on the length of stay. If the home trains nursing staff, a “training surcharge” of around 50 euros is added to the cost calculation.

Price increases in the home cause your own contribution to increase

Nursing home costs are rising regularly. Operators must apply for, justify and approve a planned increase from the supervisory bodies. The principle is that the increase and the future price must be reasonable. The operators must announce, explain and justify the increase to residents in a timely manner. If you do not want to agree, you can terminate the contract with the home. Since the additional payments from the nursing care insurance fund are a fixed amount depending on the level of care, any increase will initially be fully reflected in the residents’ own contribution. But even with the subsidy from the nursing care insurance funds, the personal contribution is higher than before.

An example: A resident has care level 3. She pays a monthly contribution (EEE) of 1,377 euros out of her own pocket, and the care fund pays a further 1,262 euros as a fixed amount to the home operator, depending on the level of care. If this increases the personal contribution by 100 euros, the resident pays 1,477 euros, but the nursing care fund’s fixed amount does not increase. The nursing care insurance company only pays the percentage subsidy, which is staggered according to the length of stay, on top of the higher personal contribution.

Compare nursing home costs

Prices also vary widely between homes in the same state and region. It therefore makes sense to compare offers and prices in good time. The information portal “Pflegelotse” from vdek provides a nationwide overview of nursing homes and their prices. Also the “Care Navigator” from the health insurance company AOK provides information about facilities nationwide.

Nursing homes should not be confused with retirement homes, residences or similar facilities. While in nursing homes the focus is on care, in retirement homes it is assisted living. Old people there often live very independently in small flats or apartments. The prices and services can be freely designed and be correspondingly high.

Who pays the home costs if the pension is not enough?

Not all those in need of care can afford an average contribution of up to 2,411 euros per month for a place in a home. If your own reserves have been used up to a maximum of 10,000 euros, The social welfare office will cover the remaining costs. However, it checks whether children can pay for their parents. However, you are only obliged to pay maintenance if you Annual gross income exceeds 100,000 euros. Those in need of care can also have one Receive a subsidy towards housing costs.

Further information

1 min

The personal contribution is now around 2,270 euros per month. The increased relief surcharge does not cover the costs. 1 min

7 mins

Investment costs are often added to the monthly amount for a place in a nursing home. What is appropriate? 7 mins