Since the 2017 long-term care reform, care levels have replaced the previous care grades in the German long-term care system. They form the basis for assessing how much support a person in need of care requires – regardless of whether the care is provided at home, in an outpatient setting, or in a residential care facility. The care levels range from 1 to 5 and are based on the degree of independence of the person requiring care, not solely on the time spent on care measures. The individual care levels and their differences are explained below.
Care level 1: Minor impairment of independence
Features:
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Minor limitations in independence or abilities
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Those affected occasionally need help, for example with personal hygiene, household management or mobility.
Example:
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An elderly person who is unsteady on their feet but largely able to manage on their own.
Services (selection):
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Care consultation
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Subsidies for care aids
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Relief amount (125 € per month)
Care level 2: Significant impairment of independence
Features:
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Daily support needs in multiple activities
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Often, help is needed with washing, dressing, or eating.
Example:
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A person with early-stage dementia or physical limitations
Services (selection):
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Care allowance: €332 per month
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Care benefits in kind: €760 per month
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Day and night care, respite care
Care level 3: Severe impairment of independence
Features:
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Significantly limited everyday skills
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Comprehensive assistance with personal hygiene, nutrition, and mobility is needed.
Example:
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A person with advanced dementia or severe physical disability
Services (selection):
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Care allowance: €573 per month
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Care benefits in kind: €1,431 per month
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Higher amounts for day care and short-term care
Care level 4: Most severe impairment of independence
Features:
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Serious limitations
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Almost complete dependence on outside help
Example:
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A bedridden person or someone with serious neurological conditions
Services (selection):
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Care allowance: €765 per month
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Care benefits in kind: €1,778 per month
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Extended care services and care aids
Care level 5: Most severe impairment with special requirements for nursing care
Features:
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Like care level 4, but with additional care requirements (e.g., special positioning, artificial nutrition)
Example:
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Coma patients, people on ventilators or people with severe multiple disabilities
Services (selection):
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Care allowance: €947 per month
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Care benefits in kind: €2,200 per month
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Comprehensive services in all areas of care
How is the classification carried out?
The assessment is carried out by the Medical Service (for those with statutory health insurance) or by Medicproof (for those with private health insurance). Six areas of life are evaluated using a points system, including mobility, cognitive abilities, self-care, and coping with illness-related demands.
Depending on the total score, the following care level results:
Care level |
Score |
1 |
12.5 – <27 |
2 |
27 – <47.5 |
3 |
47.5 – <70 |
4 |
70 – <90 |
5 |
90 – 100 |