The five degress of care

Care degrees are a classification used in the German care system to assess people’s care needs. Care degrees are used to show the individual care needs of people. Long-term care insurance benefits are granted according to this classification. They were introduced in 2017 when the Second Care Strengthening Act (PSG II) came into force and replaced the care levels that had applied until then.

Which care degrees are there?

There are five degrees of care, which are based on the degree of independence or impairment in everyday life:

  • Care degree 1: Slight impairment of independence
  • Care degree 2: Considerable impairment of independence
  • Care degree 3: Severe impairment of independence
  • Care degree 4: Most severe impairment of independence
  • Care degree 5: Most severe impairment of independence with special requirements for nursing care

What services are available?

Depending on the degree of care, insured persons are entitled to different benefits from the long-term care insurance. The amount of benefits depends on the individual care needs and is determined on the basis of the approved care degree. Basically applies the higher the care degree, the higher the cash benefits or benefits in kind:

Care services Care degree 1 Care degree  2 Care degree  3 Care degree  4 Care degree 5
Care allowance (monthly) 316 € 545 € 728 € 901 €
Care benefits in kind (monthly), 724 € 1.363 € 1.693 € 2.095 €
Day and night care (monthly) 689 € 1.298 € 1.612 € 1.995 €
Short-term care
1.774 € 1.774 € 1.774 € 1.774 €
Prevention care (annual) 1.612 € 1.612 € 1.612 € 1.612 €
Full-stationary care (monthly) 770 € 1.262 € 1.775 € 2.005 €
Care and relief services (monthly) 125 € 125 € 125 € 125 € 125 €
Intended for consumption (monthly) up to 40 € up to 40 € up to 40 € up to 40 € up to 40 €
Home emergency call
25,50 € 25,50 € 25,50 € 25,50 € 25,50 €
Housing adaptation
(per total measure)
4.000 € 4.000 € 4.000 € 4.000 € 4.000 €
Residential group allowance (monthly) 214 € 214 € 214 € 214 € 214 €


How do you get a care degree?

In order to obtain a care degree, the first step is to submit an application to the health insurance fund. The long-term care insurance then commissions the Medical Service with the so-called assessment. In this process, various areas such as mobility, cognitive and communicative abilities, behavior and psychological problems as well as self-care and coping with illness- or therapy-related requirements are assessed. Points are awarded per module on the basis of a catalogue of questions. The total points of all modules, weighted according to a special system, decide on the classification into the corresponding care degree.

Increase care level: Application for an upgrade

If the health situation deteriorates further and more care is needed, an application for a higher level of care should be submitted to the long-term care insurance. It is not necessary to go through the five degrees of care step by step. If the physical or mental impairment progresses quickly, care degrees can also be skipped.

Care degrees for children:

Children in need of care can also receive a care degree. In general, the same requirements apply as for adults – but there are a few special features:

  • Children under 18 months of age: Infants and toddlers under 18 months of age are considered to be in need of natural care, as even healthy children of that age need all-round care from their parents. Therefore, they are always classified one care level higher in the care assessment.
  • Children under the age of eleven: When assessing the need for long-term care, different standards apply to children under the age of eleven than to adults. Since many abilities and independence develop in children over the years, the degree of need for care in children is determined by comparison with children who have developed according to their age.

Care degree for dementia

Dementia describes a degeneration of the brain that often progresses gradually. The disease results in deficits in the cognitive, emotional and social areas. Since cognitive and psychological impairments are included in the assessment of the degree of need for care, dementia patients are just as entitled to benefits from long-term care insurance as persons who are predominantly restricted in their mobility, depending on their impairment or need for support. If a written diagnosis of dementia is available, this is often already sufficient for care degree 2.

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