How much does a home care service cost in Germany and what does insurance pay?

What a home care service (ambulanter Pflegedienst) costs in Germany depends on the services you agree and on the prices the provider has negotiated with the care insurance funds in its federal state. From care grade 2, long-term care insurance covers up to €796, €1,497, €1,859 or €2,299 a month as benefits in kind (Pflegesachleistung) and settles the bill directly with the service. You only pay what goes beyond that. Medical treatment care, such as changing dressings, is paid by health insurance instead, subject to a statutory co-payment.

What care insurance pays for a home care service

Benefits in kind under § 36 SGB XI are a monthly maximum. They only apply to approved services with a care contract (Versorgungsvertrag). There are no benefits in kind at care grade 1, but the relief amount can be used for certain services.

Care grade	Benefits in kind per month	Relief amount per month
1	-	€131
2	€796	€131
3	€1,497	€131
4	€1,859	€131
5	€2,299	€131

Our guide to care grades explains which grade brings which entitlements. These amounts have applied unchanged since 1 January 2025.

How home care services set their prices

Every approved service concludes a remuneration agreement (Vergütungsvereinbarung) with the care insurance funds and the social welfare authority under § 89 SGB XI. The prices in it are the same for everyone, whether insurance or you pay. The law allows three models:

• Service packages (Leistungskomplexe): fixed prices for typical visits, such as help with washing, eating or housework, regardless of the time actually taken.
• Time-based fees: billing by the time required.
• Individual items: only in exceptional cases.

Most services add flat fees, for instance for travel. Because the framework is negotiated state by state, prices and package names vary considerably, so there is no nationwide price per visit. Always ask for the provider’s current price list.

Cost information and the care contract

Before signing and whenever anything changes significantly, the service must normally inform you in writing about the expected costs (§ 120 SGB XI). The care contract lists the type, content and scope of services with a price per item or package. If services exceed the insurance maximum, the provider may charge you no more than the agreed prices for the extra. You can terminate the contract at any time without notice.

Who pays for what

Cost item	Who pays	Note
Personal care, support, help in the home	Care insurance up to the benefits-in-kind amount	remainder is your share
Treatment care (e.g. dressings, compression stockings)	Health insurance under § 37 SGB V	doctor’s prescription, co-payment from age 18
Own share above the maximum	You	relief amount partly usable
Investment costs, training surcharge	charged separately depending on the state	ask for them in the quote

Treatment care through health insurance

Home nursing care (häusliche Krankenpflege) is prescribed by a doctor. Health insurance pays it on top of care insurance, so it does not reduce your benefits-in-kind budget. Adults pay 10 % of the costs plus €10 per prescription, limited to the first 28 calendar days in each calendar year (§ 37 SGB V with § 61 SGB V).

Items charged separately

In some federal states, services bill investment costs or a surcharge that funds nursing training separately. Whether this is allowed, and how much, depends on state law and the provider’s agreement. Ask for these items to be shown in the quote.

Worked example with an assumed bill

The figures below are not a market price but an assumed value to show the principle. Mrs M. has care grade 3. Her service’s monthly bill for care and household help is assumed to be €1,700.

Item	Amount
Home care bill (assumed)	€1,700.00
Benefits in kind, grade 3	€1,497.00
Remaining own share	€203.00
of which refundable via relief amount (not for personal care)	up to €131.00

At care grades 2 to 5 the relief amount (Entlastungsbetrag) cannot be used for help with personal care, such as washing, but it can be used for household help or companionship. The invoice shows which items are which. See our guide to the relief amount.

If the bill is below the maximum, you receive a proportional care allowance instead. If Mrs M. uses 60 % of her benefits in kind (€898.20), she receives 40 % of the care allowance, which is €239.60. Our guide to benefits in kind and the combination benefit explains the details. You can work out your own figures with the care benefits calculator.

Keeping costs under control

1. Clarify needs: note which tasks genuinely need help and how often.
2. Get several quotes: ask two or three services for a written cost estimate.
3. Compare packages: check what each package includes, not just the price.
4. Check the bill: compare the monthly invoice with the service record you or your family sign.
5. Use the remaining budget: up to 40 % of the benefits-in-kind amount can be converted for recognised everyday support services.

If you cannot afford the own share in the long run, ask the local social welfare office (Sozialamt) to assess help with care costs (Hilfe zur Pflege). Questions for the first meeting are in our checklist for choosing a home care service, and you can find providers near you in the home care directory.

Planned reform

With the Care Reorganisation Act (PNOG, cabinet draft of 30 September 2026), the government plans changes from 2027. The law has not yet been passed. Until it is enacted, today’s rules and amounts apply.

This article is general information and does not replace individual care or legal advice.