Hidden care poverty is a complicated term. Hundreds of thousands of people in need of care in this country have very real financial problems – and not just those who have to pay for the costs of a nursing home. But many from the much larger group of people who are cared for at home. A new study on care poverty commissioned by the General Association of Parity shows that that around 300,000 people in need of care in poverty in Germany do not receive any help Care
received even though they would be entitled to this benefit.
Around 4.9 million people in Germany are currently cared for at home. The study authors estimate that at least around 390,000 of them would be eligible for care assistance. In fact, only around 76,000 received this benefit – in other words: more than 80 percent of those in need of care at risk of poverty who are entitled to social benefits do not receive it. These numbers were determined by a team led by legal scientist and nursing expert Thomas Klie from the non-profit AGP Social Research Institute in Freiburg. The institute emerged in 1989 from a research focus at the Evangelical University of Freiburg and researches nursing and care.
For the study, official figures on care assistance actually paid were evaluated, differentiated according to home care and inpatient accommodation. In order to estimate how many people at home would actually be entitled, a model calculation with so-called basic security data is used. These are data sets from which income and housing costs can be used to determine whether someone would be entitled to social benefits. Non-utilization results from the difference between this estimate and the cases actually approved.
You must apply for care assistance from the social welfare office and prove that your own resources and those of the statutory care insurance fund are not sufficient to cover the care costs. There has been a lot of discussion in the public debate recently the increasing personal contributions in nursing homes
discussed. However, only the minority of all those in need of care live in a retirement or nursing home; the vast majority are cared for at home and by relatives, outpatient care services and nursing staff who live with them. So-called 24-hour care in particular is very expensive, but outpatient care services also require high out-of-pocket costs.
Who only has a small legal pension and no other income, often cannot get by with the benefits of the nursing care insurance fund. The amount depends on the level of care. In 2026, the care allowance will be between 347 euros (grade two) and 990 euros (grade five) per month. If you use a care service instead, you can take advantage of so-called care benefits in kind – around twice as much money is available for this. Both can be combined, but the entitlement to benefits in kind will then be correspondingly lower. In addition, all those in need of care receive a relief allowance of up to 131 euros per month, for example for help with the household or other support in everyday life.
But for many people that is not enough money. This is shown by an exemplary average case: Ms. Meyer is 80 years old, she lives alone in a small town in North Rhine-Westphalia and has care level four. Her children live in Berlin and Munich and can only look after them temporarily on weekends. She needs help with washing and dressing, tidying up and cleaning, and warming up meals. A nursing service comes morning and evening.
Thousands of euros of personal contribution also for home care
For these two daily missions According to the Association of Replacement Insurance Funds (vdek), the costs are on average between 2,600 and 3,300 euros per monthdepending on the service and scope of services. In this example we take the average of 2,900 euros. There are also other expenses such as help around the house, around two to three hours per week. In the example, this costs 320 euros per month. The nursing care insurance relief amount (131 euros per month) can cover part of this if a recognized provider is used. The pensioner has to raise the rest privately. A home emergency call costs around 35 euros per month, and she also commissions a shopping service that costs a good 60 euros per month.
Overall, the care-related costs add up to 3,315 euros per month. However, the care insurance fund only pays a maximum of 1,859 euros per month in care benefits in kind. If you subtract the relief amount of 131 euros, that leaves 1,325 euros that Ms. Meyer has to pay out of her own pocket.
In our example, we assume that Ms. Meyer has an income from a widow’s pension and her own pension of 1,500 euros net per month. This corresponds to an average widow’s pension and the average statutory pension for a West German woman of her age. After deducting her own contribution, she is left with 175 euros for all other living costs: rent, heating costs, electricity, clothing, food, insurance, medication and trips to the doctor.