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What to know about Germany’s long-term care insurance hikes

Germany has agreed on a controversial long-term care reform that will see people - especially those without children - pay more towards insurance.

A care worker helping a patient in Germany.
A care worker helping a patient in Germany. Photo: picture alliance/dpa | Sebastian Gollnow

What is care insurance and who pays it?

All workers in Germany pay compulsory care insurance, or Pflegeversicherung, throughout their working lives and as pensioners. 

At the moment, the contribution rate for employees with children is 3.05 percent of their salaries or pensions, while people without pay 3.4 percent. As a rule, the employer pays half the contributions for long-term care insurance.

Freelancers can also choose to pay voluntary care insurance, though they generally have to bear both the employer and employee portions of this.

READ ALSO: What foreigners need to know about old age care in Germany

Those who pay care insurance have access to financial support with social care in their old age, or whenever they need it. 

How are contributions changing?

According to the law passed by the government in the Bundestag and approved by state leaders in the Bundesrat on Friday, long-term care insurance will go up in Germany. 

From July, people with children will pay 3.4 percent of their gross income for long-term care, up from 3.05 percent (although it will depend on how many children people have – more on that below). At the same time, the additional fee for childfree people will be increased from 0.35 to 0.6 percentage points to a total of 4 percent of their gross income.

Why are contributions going up?

According to Federal Health Minister Karl Lauterbach of the Social Democrats, the increase is needed because of rising costs. The reform he’s drawn up is intended to provide financial security for long-term care insurance until 2025.

The hike in contributions should bring in additional revenue of about €6.6 billion per year. But if this is not enough, the law also contains a decree authorisation for the federal government to further adjust the contribution rate.

READ ALSO: What you need to know about the complicated world of German insurance

It is viewed by some as controversial that people without children have to pay more than mothers and fathers. 

However, the Federal Constitutional Court ruled in 2001 that a premium increase for people without children is allowed.  

German Health Minister Karl Lauterbach SPD

German Health Minister Karl Lauterbach (SPD) speaks at an event run by the Social Affairs Association in Berlin. Photo: picture alliance/dpa | Christophe Gateau

The reasoning behind this is that people who are not raising children have a lower financial burden than those who do, and those with children may rely on care insurance in older age less than childless people because their children are likely to foot some of the care (or help with bills). 

What else is changing?

The government’s law also implements a ruling by the Federal Constitutional Court that parents with several children should be relieved from paying too much in long-term care insurance.

Parents’ contributions will decrease with the number of children they have. From the second to the fifth child under 25, they will pay 0.25 contribution rate points less per child.

Meanwhile, the care allowance for those in need of care at home, which was last increased in 2017, is to be raised by 5 percent at the beginning of 2024. Subsidies for inpatients at care homes are also to go up next year.

From 2024, support for people who are temporarily unable to work due to the care needs of a relative will also be expanded. In future, relatives will be able to claim the care support allowance for up to 10 working days per care case per calendar year.

What’s changing with pensions?

The Bundesrat on Friday also passed a pension increase. For the second year in a row, there will be a hike for the 21 million pensioners in Germany.

In western Germany, the payments will increase by 4.39 percent and in eastern states by 5.86 percent.

For a monthly pension of €1,000, pensioners in the west will see about €44 more, while those in eastern German states will see around €60 extra per month.

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HEALTH

Klinik-Atlas: How to use Germany’s new hospital comparison portal

The German government has launched a ‘Bundes-Klinik-Atlas’ which provides information on services and treatment quality at almost 1,700 hospitals throughout Germany. Here's what you need to know.

Klinik-Atlas: How to use Germany's new hospital comparison portal

Whether you’re a foreign resident or a local, it can be tricky to navigate hospital care in Germany. 

Now the German government has launched a new nationwide ‘Klinik-Atlas’ aimed at making it easier for people to compare different services in hospitals. 

If a patient needs care at a hospital or clinic, such as a knee operation, cancer treatment or to get their tonsils out, they can look through the state-run comparison portal to compare the services offered and their quality. The portal is intended to help patients make a decision on where they want to access care. 

It was launched on Friday May 17th and so far includes details on 1,700 hospitals throughout the country. 

Why has the Klinik-Atlas been launched? 

The German government believed there was a need to get more information on hospitals out there to the public. 

Health Minister Karl Lauterbach, of the Social Democrats (SPD), said comprehensive information on how to find good care is now more accessible to everyone with the new portal. 

He said that transparency was needed in view of the 16 million hospital treatments that take place in Germany per year and the 500,000 new cancer patients per year alone. Most patients are unsure which clinic or hospital is best suited for their treatment, he added. 

Compared to existing information portals, the Klinik-Atlas is particularly unique in the way it prepares data for patients, Lauterbach said: “With just a few clicks, they can compare clinics and find the best clinic in their area for the treatment they need.”

READ ALSO: Which of Germany’s hospitals are among the ‘world’s best’?

Patients can see and assess hospitals side by side instead of having to “hop from clinic to clinic”, added Lauterbach. He called it “clear guide” to help people sift through the maze of health care. 

However, there’s been a mixed reception to the project, with hospitals raising some concerns.

How does it work exactly?

One thing to keep in mind is that the site, which is located at www.bundes-klinik-atlas.de, is only in German, but it is fairly simple to use. 

– On the site you can see a map with all the clinics in your area, as well as the number of beds they have and treatments they offer. Each clinic is scored on the quality of its care. The score is based on the number of patients per nurse, taking into account the severity of the cases. Lower values equate better scores in this case.

A sign at a Charité Campus points to the Central Emergency Department.

A sign at the Berlin Charité points to the Central Emergency Department. Photo: picture alliance/dpa | Sebastian Gollnow

– You can also enter your place of residence and an illness or a very specific treatment in the portal. The system offers search suggestions if you don’t know the specialised term. According to the ministry, 28,000 treatment and 13,000 disease definitions are stored.

– There is a kind of speedometer display to help patients categorise their cases. The ‘faster’ you go, so to speak, i.e. the further the needle moves to the right, the better. For the time being, there are two speedometers – for the number of annual cases of a treatment and for the number of nursing staff in the hospital. The speedometers have five coloured elements to which the needle can point – from ‘very few’ to ‘very many’ cases, for example. 

What else can you find out?

A comparison shows that there are “huge differences within a very small area”, said Lauterbach. For example, there are 48 hospitals in Berlin and the surrounding area that perform bowel cancer operations, but only 18 of them are certified as specialist centres.

In the case of severe bowel disease in children, there are clinics that perform more than 70 operations a year, while others only perform four.

It is not the case that large clinics are automatically always ‘the winners’. There are also small clinics that are extremely specialised.

The portal is to receive its first update in a few weeks’ time and will then include complication rates for treatments. Figures on the number of specialised doctors will follow.

The information will be updated regularly, according to the Institute for Quality and Transparency in Healthcare, which is coordinating the implementation. At the moment the data is lagging, featuring case numbers from 2022. The information comes from several sources, including clinics and health insurance company invoices.

READ ALSO: How could Germany solve its worsening GP crisis?

How’s the reaction so far? 

According to the ministry, there were more than five million hits in the first three hours of the comparison launching, with some page views also experiencing a brief hitch due to the volume of traffic. 

But not everyone is for it. The German Hospital Federation said the portal does not provide patients with any additional information and even adds more bureaucracy to hospitals’ workloads. The hospital sector recently expanded its own online overview portal. The Deutschen Krankenhaus Verzeichnis’ or ‘German Hospital Directory’, which has existed since 2002, was updated to include more search functions. 

The German Patient Protection Foundation said that people want to know about the range of services and quality. “But the ‘hospital atlas’ lacks crucial information,” said CEO Eugen Brysch. “The quality of patient management in the clinic is not recorded.”

The German Social Association welcomed the comparison site, but added: “It remains to be seen how great the added value for patients really is.”

READ ALSO: How Germany is planning to save its ailing hospitals 

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