The personal contribution for people in need of care continues to rise
For those in need of care, they must pay a contribution. With increased subsidies, politics tries to reduce this financial burden. However, this helps little: The self-paying contribution continues to rise according to current data.
For care-dependent individuals in nursing homes, self-paying contributions have further increased. As of July 1st, the average monthly cost in Germany was 2871 Euro from their own pockets. This is 211 Euro more than in the middle of 2023, as an analysis by the Association of Health Insurance Funds showed. The burdens continue to grow despite increased relief grants that depend on the length of stay. With the highest grant from the fourth year in the nursing home, the co-payment on average amounted to 1865 Euro per month. This is 91 Euro more than on July 1, 2023, according to the data.
The contribution includes the share for pure care and nursing. The nursing insurance only covers - unlike health insurance - a portion of these costs. For residents and residents in nursing homes, there are additional costs for accommodation, food, and investments in the facilities. For the first time, training costs were included in the evaluation as of July 1, which are also passed on by the nursing homes. However, these costs were also included in the comparison values from July 1, 2023, as it was explained in the data.
Since 2022, in addition to payments from the nursing insurance, relief grants have been provided, which were increased as part of a reform of the traffic light coalition on January 1, 2024. The contribution for pure care will therefore be 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 background for the still increasing contribution is mainly higher personnel costs for caregivers.
The increase in contributions could not be fully offset by the subsidies, as the data shows. As of July 1, the monthly cost for pure care in a nursing home was 1426 Euro on average nationwide - one year ago, it was still 1295 Euro with the then lower relief grant. According to the evaluation, accommodation and food in the nursing homes also became more expensive. Residents and residents had to pay an average of 955 Euro per month for this as of July 1, compared to 888 Euro in the middle of 2023.
The head of the Association of Health Insurance Funds, Ulrike Elsner, looked at the rising self-payment with regard to the increasing burden: "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 context of the Pflegereform announced by Federal Health Minister Karl Lauterbach.
The ministry will present a concept for the reform in the fall. It is intended to include a comprehensive package for more capacity in nursing staff, stronger prevention of care needs, and closing a financial gap - as the nursing insurance expects red numbers for 2024 and 2025. The first reform brought not only higher relief allowances for nursing homes but also a contribution increase on July 1, 2023.
Overall, there are still regional differences in contributions. The most expensive nursing home place in the first year of residence is currently in North Rhine-Westphalia with 3200 Euro per month and in Baden-Württemberg with 3180 Euro. The lowest self-contribution is in Saxony-Anhalt with 2373 Euro. According to the statements of the Replacement Insurance Association, the remuneration agreements of the nursing homes in all federal states were evaluated. The association includes, among others, the Techniker Health Insurance, Barmer, and DAK Health.
The lack of comprehensive long-term care insurance coverage in politics leaves a significant portion of healthcare system costs for care-dependent individuals to self-pay, leading to rising contributions. Despite the implementation of relief grants, these grants primarily depend on the length of stay in the nursing home, resulting in individuals still bearing a substantial financial burden for long-term care.
