Berlin. The contribution rate will probably remain at 3.6 percent. Nursing care insurance will still be more expensive. The reason for this is higher surcharges that the cabinet decided on Wednesday as part of the care reform. Employees and employers face additional costs while benefits are reduced.
Because the federal government urgently needs money for long-term care insurance. According to calculations by the Ministry of Health, at least 7.6 billion euros will be missing next year. The coalition would still like to avoid a contribution increase for everyone. Instead, it turns several smaller adjustment screws - sometimes with significant consequences for individual groups.
For employees without children, the surcharge for long-term care insurance will increase by 0.3 percentage points next year. It is levied from the age of 23. Together with the general contribution rate, this results in a new total contribution of 4.5 percent. An increase of 0.2 percentage points was originally planned. With a gross salary of 3,000 euros, an employee pays around nine euros more per month; with 5,000 euros it is 15 euros.
It becomes even more expensive for people with higher salaries. The reason is the shift in the contribution assessment limit, i.e. the salary amount up to which contributions to long-term care insurance are due. It will rise from the current 5,812.50 euros per month to 6,375 euros in the coming year, so the care contribution will be calculated on the basis of a higher salary in the future.
In part, this is a regular adjustment depending on wage developments; the 300 euro increase comes from the reform. For a person without children with a salary above the new limit, their own care contribution increases from around 140 to 172 euros per month.
There is also a new surcharge for certain couples. From 2028, employees will pay an additional 0.52 percentage points if their spouse or partner is insured through them without paying contributions. With a gross salary of 4,000 euros, that amounts to just under 21 euros per month.
Excluded from this are couples who live with a child who is younger than twelve years old or whose co-insured partner looks after a relative who is in serious need of care. Even couples who are past retirement age or who need care in everyday life do not have to pay the surcharge.
The health insurance companies criticize the higher surcharges. “With today's decision, those who pay contributions will be placed an additional burden,” said Technik health insurance company boss Jens Baas after the cabinet decision. He calls on the federal government to take on more responsibility and to finance tasks for society as a whole more through taxes. He is alluding to benefits that are described as non-insurance-related, such as unemployment insurance contributions for nursing staff or pension contributions for caring relatives.
For example, if an employee's salary is at the new limit, the employer pays almost ten euros more per month. In Saxony, the employer's share of nursing care insurance is set by a special rule and is different.
From 2028, mini-jobbers will also become more expensive for employers. Then they pay nursing care insurance contributions for the first time, which should amount to 3.6 percent of their salary. For a mini-job with 600 euros per month, that's almost 22 euros extra. A lower rate of 1.5 percent applies to mini-jobs in private households.
Health economist David Matusiewicz from the FOM University sees a fundamental shift behind the individual measures: “In sum, the reform shifts the financing of long-term care insurance more towards higher earned incomes, those insured without children, spouses and life partners who were previously insured without contributions, and employers of mini-jobbers.”
The agreed benefit cuts initially affect people who now receive care level 1. The relief amount of 131 euros per month will be canceled. So far they have been able to use this to pay for help with household chores or childcare. Anyone who already receives the amount will continue to receive the amount.
Overall, the nursing assessment should become stricter, in which the medical service checks how well a person can still manage their everyday life on their own and how much help they need. The threshold values that determine what level of care someone needs should be adjusted. It should also be possible to limit this classification more frequently. The coalition expects this to reduce the number of people in need of care. According to the Federal Minister of Health, the number of people receiving care has increased from two to six million over the past 20 years.
Some initially planned cuts are not part of the reform. This means that the care allowance for people who now receive care level 2 or 3 remains stable from the first month. An earlier draft had envisaged paying only half in the first three months.
The coalition also made cuts for nursing home residents. Originally, the waiting period until the next level of relief was supposed to be extended by six months. The coalition canceled this change, as announced weeks before by Federal Health Minister Carsten Linnemann (CDU). “We do not compromise on the pensions of family carers because they are the unsung heroes of our society,” he said.
This does not inspire much confidence among the German Federation of Trade Unions. “The subsequent changes to the Care Act do not change the disappointing course – a cuts program remains a cuts program,” explains board member Anja Piel. She also criticizes the fact that fundamental decisions are being postponed and, among other things, calls for capped personal contributions. These are costs that those in need of care have to pay out of their own pocket when staying in a home.
New support offers are also planned. From 2029, specialists will accompany those in need of care at home and advise relatives. If the person who normally provides care is no longer available, the long-term care insurance will temporarily pay for an outpatient service or short-term care. Certain services can also be used more flexibly.
Nevertheless, there remains a deficit of a good 1.25 billion euros. A commission is to develop proposals on how it can be completely closed, which is due to begin its work next week. Your job is to find further savings opportunities and develop reforms that will stabilize the long-term care insurance finances.
