Pflegegrad

What is a Pflegegrad?

A Pflegegrad (care level) is Germany's classification of how much long-term care support a person needs. The system has five grades, from 1 (minor impairment of independence) to 5 (severely impaired with specialised care requirements). The legal basis is SGB XI, Germany's long-term care insurance code.

Everyone insured under Germany's mandatory care system has the same five grades. It does not matter whether you are in the GKV or the PKV: a Pflegegrad assigned by a medical assessment gives the same benefit structure, though different organisations administer the payout.

How the assessment works

Assessment uses the NBA, Neues Begutachtungsassessment, introduced in 2017 to replace the older three-tier system. It measures ability to live independently across six modules, with each module weighted to produce a final score on a 100-point scale.

The six modules:

1. Mobility (10 % weight), ability to move around, change position, climb stairs 2. Cognitive and communicative abilities (15 %, combined with #3), orientation, understanding, decision-making 3. Behavioural and psychological challenges (15 %, combined with #2), the higher of the two scores counts 4. Self-care (40 %), washing, dressing, eating, toileting, continence 5. Disease-related requirements (20 %), managing medication, therapies, medical appointments 6. Everyday life and social contact (15 %), daily structure, contact with others

The combined score places the person into one of the five grades. Higher points = higher grade = more benefits.

Who does the assessment

• GKV members: Medizinischer Dienst (MD, formerly MDK)

• PKV members: MEDICPROOF, a private agency that operates to the same legal standards

The assessment is free, takes place in the person's home, and usually lasts 1-2 hours. A formal report is produced and sent to the insurer, which then issues the official Pflegegrad decision.

What each grade pays

Benefits scale with the grade. The SGB XI defines monthly amounts for:

• Pflegegeld, home-care allowance paid to family members or informal caregivers

• Pflegesachleistung, professional home care (ambulante Pflege)

• Tages- und Nachtpflege, day or night care

• Kurzzeitpflege and Verhinderungspflege, short-term or substitute care

• Stationäre Pflege, long-term residential care

• Entlastungsbetrag, €131/month in 2026 for support services (available from Pflegegrad 1 upwards; unchanged since 2025, next statutory increase scheduled for 1.1.2028)

Pflegegrad 1 receives the Entlastungsbetrag (monthly relief allowance) and limited additional support. Pflegegrades 2-5 receive escalating home-care allowances and professional-care budgets.

Exact monthly euro amounts are adjusted by law periodically, most recently through the Pflegeunterstützungs- und -entlastungsgesetz (PUEG, 2023) and subsequent updates. Always check the current rates with the Krankenkasse (statutory health-insurance fund) or MEDICPROOF before planning around specific figures.

Why the Pflegegrad matters even if you are young

Long-term care is often mentally filed under "later life", but accidents, strokes, severe illness, and congenital conditions produce Pflegegrad assessments across every age group. The system applies equally to a 28-year-old after a traffic accident and a 78-year-old with dementia. Everyone in Germany's mandatory insurance carries the same entitlement.

For new PKV members, the practical takeaway: when you sign a PKV full-cover contract, you automatically take out a Pflegepflichtversicherung (PPV) alongside. The PPV is the private mirror of the statutory Pflegeversicherung. Premiums are calculated by age at entry (like the PKV), benefits match the statutory scale by law.

When statutory benefits do not cover real cost

Statutory Pflegegrad payouts rarely cover the full real cost of long-term care. Residential care fees often exceed the statutory Pflegesachleistung several times over. This gap is the argument for a Pflegezusatzversicherung, a supplementary policy that pays a flat euro amount per Pflegegrad, on top of the statutory (or PPV) benefit.

See the Krankenzusatzversicherung entry for more detail on the supplementary options.