German nursing home fees surge as reforms loom

A new analysis by the Association of Substitute Health Insurers shows that residents of German nursing homes are paying an average of €3,364 per month out of pocket in the first year of care – €119 more than at the start of the year and €256 higher than in July 2025. Regional differences are stark: Bremen tops the list at €3,761, followed by Saarland at €3,695, while Saxony‑Anhalt is the cheapest at €2,891.

The rise is driven mainly by higher personnel costs, as well as increased charges for accommodation, meals and facility investments. The coalition government is preparing a care‑reform that would limit future cost growth. Proposed measures include tiered reductions of the patient’s share of pure nursing costs – 15 % in the first year, 30 % in the second, 50 % in the third and 75 % from the fourth year onward – while extending the interval between each step from 12 to 18 months. The plan is expected to save the care funds about €2.6 billion next year.

Ulrike Elsner, head of the substitute‑insurers association, warned: “Es gab Nachholbedarf, und es ist richtig, dass Pflegekräfte gut bezahlt werden. Doch es kann nicht sein, dass das zu immer stärkeren Belastungen der Pflegebedürftigen führt.”

For residents whose finances are exhausted, the social‑welfare office can provide “Hilfe zur Pflege” once personal assets fall below €10,000, covering the remaining nursing‑home costs. The application requires extensive documentation of income, assets and the care‑home bill.