The care reform 2023

On May 26th 2023, the Bundestag passed the Long-Term Care Support and Relief Act (PUEG) to reform long-term care insurance. According to the Federal Ministry of Health, it is planned to reform the statutory long-term care insurance in two steps. In the first step, the financial basis will be stabilised on July 1st 2023 in order to be able to implement benefit improvements from January 2024. This may lead to higher costs and an increased burden for some people. In the second step, all benefit amounts are to be noticeably increased as of January 1st in 2025. Especially people in need of care and their relatives are to benefit from this.

From the first of July 2023, long-term care insurance contributions will increase to cover the additional need of around six billion euros. At the same time, the care allowance will be increased by five percent from 2024. The law also provides for the introduction of a relief budget, which gives caregiving relatives more flexibility in short-term and preventive care.

Overview of the most important changes:

1. Long-term care allowances and outpatient benefits in kind: will be increased by five percent from January 1st in 2024.
2. Merging of short-term and preventive care in a relief budget: from January 1st 2024, parents of children in need of care with care level 4 or 5 can access a relief budget of up to 3,386 euros (then 3,539 euros from July 2025) per year. This budget includes money for short-term and preventive care. From first of July in 2025, this amount will be available to all family carers. The total amount of up to 3,539 euros can be used flexibly for both types of care. The benefits can be claimed directly after the care degree 2 has been determined, as the previous pre-care period of six months no longer applies.
3. Care support allowance: From January 1st 2024, employees can apply for up to ten working days of wage replacement benefit, the so-called care support allowance, for the care of close relatives. Previously, this was only possible once.
4. Increase of the relief allowances for nursing home costs: the relief allowances for co-payments in the nursing home will increase from January 1st 2024, staggered according to the length of stay:
   • from 5 % to 15 % at 0 – 12 Monaten
   • from 25 % to 30 % at 13 – 24 Monaten
   • from 45 % to 50 % at 25 – 36 Monaten
   • from 70 % to 75 % at more than 36 Monaten
5. Improved procedure for determining the need for long-term care: in future, the long-term care insurance fund must enclose the expert’s long-term care report and declare that the decision taken is comprehensible. If the expert’s report recommends aids, care aids or health prevention and rehabilitation measures, the long-term care insurance fund must offer these in the decision.
6. Extended access of caring relatives to preventive care and rehabilitation services: In the future, access of caring relatives to preventive care and rehabilitation services will be facilitated by expanding and developing the possibility of admitting the person in need of care to the caregiver’s inpatient preventive care or rehabilitation facility.
7. Contribution increases for insured persons: from July 1st 2023, contributions will increase for all insured persons:
   • Childless people pay 4% of their gross income into long-term care insurance
   • Parents pay a contribution rate of 3.4%, instead of 3.05% previously
   • Parents with several children are relieved from the second to the fifth child with a discount of 0.25 contribution rate points