Higher own shares - Additional payments for nursing home care continue to rise
For care-dependent individuals in nursing homes, self-payable contributions have further increased. As of July 1st, the average monthly cost in a nursing home across Germany was 2,871 Euro from one's own pocket. This is 211 Euro more than in the middle of 2023, as an analysis by the Association of Statutory Health Insurance Funds showed.
With the highest subsidy starting from the fourth year in the nursing home, the self-payment on average amounted to 1,865 Euro per month. This is 91 Euro more than on July 1, 2023, according to the data available from the German Press Agency.
The self-payment includes the contribution for pure care and nursing. The nursing insurance covers - unlike health insurance - only a part of these costs. In addition to care and nursing costs, there are costs for accommodation, food, and investments in the facilities for nursing home residents.
For the first time, training costs were included in the analysis as of July 1st. However, these costs were also included in the comparison values from July 1, 2023, as it was explained.
Subsidies are intended to reduce costs
Since 2022, in addition to payments from the nursing insurance, there have been relief subsidies, which were increased as part of the coalition reform from January 1, 2024. The self-payment for pure care will therefore amount to 15% instead of the previous 5% in the first year in the nursing home, 30% instead of 25% in the second year, 50% instead of 45% in the third year, and 75% instead of 70% from the fourth year. The reason for the still increasing self-payment is mainly higher personnel costs for caregivers.
The increase in self-payments could not be fully compensated by the subsidies, as the data shows. According to the analysis, the cost of pure care in the first year in a nursing home across Germany was now 1,426 Euro per month on average - a year ago, it was 1,295 Euro with the then lower relief subsidy. The analysis also showed that accommodation and food costs in nursing homes had risen. On July 1, residents had to pay an average of 955 Euro per month for this, compared to 888 Euro in the middle of 2023.
The head of the Association of Statutory Health Insurance Funds, Ulrike Elsner, commented on the increasing self-payment: "The fact that it is so high is also due to the fact that the states are ignoring their responsibility." The assumption of investment costs by the states - as originally planned - would relieve nursing home residents by an average of 490 Euro per month. In addition, it is the responsibility of the state to cover training costs. This should be addressed in the Pflegereform announced by Federal Health Minister Karl Lauterbach (SPD).
The Ministry plans to present a concept for the reform in the fall. It should include a comprehensive package for more capacity in the nursing workforce, stronger prevention of care dependency, and closing a financial gap - because the nursing insurance expects red numbers for 2024 and 2025. A first reform brought, in addition to higher relief subsidies for nursing home places, a contribution increase on July 1, 2023.
Differences among the federal states
In total, there are regional differences in additional payments. Currently, the most expensive place to live in the first year of residence is in North Rhine-Westphalia with an average of 3,200 Euro per month and in Baden-Württemberg with 3,180 Euro. The lowest contribution is in Saxony-Anhalt with 2,373 Euro.
According to the statements of the Replacement Insurance Association Health Funds, compensation agreements with nursing homes in all federal states have been evaluated. The association includes, among others, the Techniker Krankenkasse, Barmer, and DAK-Gesundheit.
- People in need of care in nursing homes across Germany are required to make additional self-payments, with the average monthly cost in North Rhine-Westphalia and Baden-Württemberg reaching 3,200 Euro and 3,180 Euro respectively, as the German Press Agency reported.
- While subsidies are intended to reduce these costs for care-dependent individuals, the head of the Association of Statutory Health Insurance Funds, Ulrike Elsner, criticized that the states have not assumed their responsibility, which could alleviate the burden by 490 Euro per month.
- In Berlin, the average self-payment for pure care in the first year of residence in a nursing home is 1,426 Euro per month, an increase from the 1,295 Euro in the middle of 2023 due to higher personnel costs for caregivers.
- Own contribution to care in nursing homes can be quite substantial, as shown in the data, with residents in Berlin paying an average of 955 Euro per month for accommodation and food costs, in addition to the pure care and nursing expenses.
