Reform of long-term care insurance

The reform of long-term care insurance not only affects contributions, but also benefits in particular.

The first part of the long-term care insurance reform came into effect on July 1, 2023 and adjusted the contribution rates. While those without children now have to pay 0.6 % more, the contribution for parents is also based on the number and age of their children. From the second to the fifth child, parents receive a discount of 0.25 % on the regular contribution of 3.4 %.

However, this additional deduction only applies until the end of the month in which the respective child reaches the age of 25. In contrast to the list in the last newsletter, according to the final version of the law, only children under the age of 25 are eligible for the additional discount. As soon as at least 2 children are no longer under 25, the regular contribution for parents of 3.4 % applies again. The contribution scale thus looks like this:

• Childless: Employee contribution 2.30 %, total contribution 4.00 %

• Parents with max. 1 child under 25: Employee contribution 1.70 %, total contribution 3.40 %

• Parents with 2 children under 25: Employee contribution 1.45 %, total contribution 3.15 %

• Parents with 3 children under 25: Employee contribution 1.20 %, total contribution 2.90 %

• Parents with 4 children under 25: Employee contribution 0.95 %, total contribution 2.65 %

• Parents with at least 5 children under 25: Employee contribution 0.70 %, total contribution 2.40 %

In addition to the contributions, the benefits of long-term care insurance will also be significantly changed and in some cases significantly improved, even if the higher benefits fall well short of what would be desirable from the perspective of many of those affected. In addition, the benefit improvements will only take effect somewhat later than the contribution adjustments, namely on January 1, 2024, with further improvements from 2025. Here is an overview:

• Care allowance & benefits in kind: In order to strengthen home care, the care allowance and outpatient benefits in kind will be increased by 5% as of January 1, 2024.

• Care support allowance: From 2024, relatives can claim the care support allowance for up to ten working days per calendar year per person in need of care and is no longer limited to a one-off total of ten working days per person in need of care.

• Preventive & short-term care: On July 1, 2025, the benefit amounts for respite care and short-term care will be merged into a new joint annual amount for respite care and short-term care. With this so-called relief budget, benefits for respite care (previously up to €1,612) and short-term care (previously up to €1,774) can then be flexibly combined in home care for a total of €3,539. In addition, the previous six-month pre-care period before making use of respite care for the first time has been abolished, so that in future the benefits can be used as soon as at least care level 2 has been determined. For parents of children in need of care under the age of 25 with care degree 4 or 5, the relief budget will be available from January 2024 in the amount of €3,386 and will also increase to €3,539 by July 2025.

• Full inpatient care: As of January 1, 2024, the supplements paid by the long-term care insurance fund to those in need of care in nursing homes will be increased. The rates will rise from 5 % to 15 % for stays of up to 12 months, from 25 % to 30 % for stays of 13 to 24 months, from 45 % to 50 % for stays of 25 to 36 months and from 70 % to 75 % for stays of more than 36 months.

• Dynamized benefits: On 1 January 2025 and 1 January 2028, cash and non-cash benefits will be automatically dynamized in line with price trends. The federal government intends to draw up proposals for the long-term dynamization of benefits and their financing by the end of May 2024.

• Determination procedure: The complex and non-transparent regulations for determining the need for long-term care will be restructured and systematized so that procedural and benefit law content is separated from each other and presented more clearly. In addition, the possibility of a telephone assessment in certain situations will be created, which should relieve the burden on applicants and medical services.

• Prevention & rehabilitation: Access to preventive care and rehabilitation services for family caregivers will be made easier by extending and further developing the option of admitting the person in need of care to the caregiver's inpatient preventive care or rehabilitation facility.

• Working conditions: The working conditions for professional carers are to be improved through a series of measures, some of which are minor.