Automatically translated version. The German original is authoritative; all amounts and legal references are unchanged. Zur deutschen Fassung.
What Does “24-Hour Care” Really Cost?
A caregiver who lives in the household is, for many families, the last alternative to a nursing home. The market for it is large, confusing — and full of offers that are too good to be legal. Here is the honest calculation: what it costs, what the Pflegekasse (long-term care insurance fund) and the tax office contribute, and how to recognize reputable providers.
Let’s Be Clear First: Nobody Works “24 Hours”
The common term is misleading: working-time law and the minimum wage also apply in private households. What is actually meant is “Betreuung in häuslicher Gemeinschaft” (live-in care in a shared household) — a caregiver lives in the household and provides defined working and on-call hours, with breaks and days off. In 2021 the Bundesarbeitsgericht (Federal Labor Court) ruled that on-call time must also be paid at minimum wage. Since 01.01.2026 the statutory minimum wage has been 13,90 € per hour — that is the arithmetical floor of every reputable calculation.
The Three Models Compared
| Model | How it works | What to watch for |
|---|---|---|
| Entsendemodell (posted-worker model, the most common) | The caregiver is employed by a company in their home country (often Poland/Eastern Europe) and posted via a German placement agency; rotation usually every 2–3 months. | Always inspect the A1-Bescheinigung (A1 certificate proving social insurance coverage); contract with clear tasks/hours. |
| Arbeitgebermodell (employer model) | You employ the caregiver yourselves, with full social insurance. | Full employer obligations (payroll, vacation, dismissal protection) — the cleanest but most demanding solution. |
| Selbstständigen-Modell (self-employment model) | The caregiver formally works on their own account. | High risk of bogus self-employment (Scheinselbstständigkeit): anyone living in the household and working under instructions is de facto employed — back payments of contributions hit you as the client. |
The Honest Cost Calculation
Reputable agency offers (posted-worker model) are typically around 2.500 to 5.000 € per month on the market — depending on German language skills, qualifications, and the extent of on-call hours; on top of that come free board and lodging (a room of their own) and usually arrival/departure costs. This range is a market orientation, not an official figure. You can sanity-check the floor yourselves: just 40 hours a week × the minimum wage of 13,90 € already comes to over 2.400 € in gross wage costs — plus social contributions, agency margin, and travel. Offers well below this threshold cannot arithmetically be legal.
What the Pflegekasse and the Tax Office Contribute
- Pflegegeld (care allowance): 347 € (PG 2) to 990 € (PG 5) per month — it is paid for care at home and can be used freely for the live-in caregiver.
- Verhinderungspflege (respite care): up to 3.539 €/year — e.g. to bridge the changeover between caregivers or for additional relief.
- Entlastungsbetrag (relief amount): 131 €/month for recognized support services.
- Tax: 20 % of the labor costs, up to 4.000 € per year, deducted directly from your tax liability (§ 35a EStG) — payment must be made cashless to the provider’s account, and keep the invoices.
- The bottom line, depending on the Pflegegrad (care level), is usually 1.500–3.500 € out of pocket per month (orientation).
Checklist: Recognizing a Reputable Provider
- ✅ The A1 certificate of every posted caregiver is presented without being asked
- ✅ Transparent contracts under German law: tasks, working/on-call hours, days off, notice periods
- ✅ Guaranteed replacement if the caregiver falls ill or drops out
- ✅ Invoice + cashless payment (also because of § 35a!)
- ❌ Dumping prices below the minimum-wage logic, cash payment, pressure to sign quickly
Organize care together — with Liova
Whether it’s a live-in caregiver, a care service, or family members taking turns: in Liova you coordinate everyone involved with shared tasks, appointments, and a medication plan — and the caregiver can be included as a “Guest (caregiver)” with restricted access.
Try free for 14 daysFrequently Asked Questions
Is “24-hour care” even legal?
Yes — but nobody may actually work 24 hours. What is legal is “Betreuung in häuslicher Gemeinschaft” (live-in care in a shared household) with regulated working, on-call, and rest hours. In 2021 the Federal Labor Court clarified that on-call time of foreign caregivers must also be paid at the German minimum wage. Offers that are arithmetically far below that only work with unpaid labor — stay away.
Does the Pflegekasse pay a dedicated subsidy for 24-hour care?
No, there is no dedicated “24-hour pot”. Financing runs through the normal benefits: Pflegegeld (347–990 € depending on the Pflegegrad), Verhinderungspflege (up to 3.539 €/year, e.g. to bridge the caregiver changeover), the Entlastungsbetrag (131 €/month) — and the tax reduction under § 35a EStG.
How much do I get back through taxes?
For household-related employment/services — which includes care in your own household — you receive 20 % of the labor costs as a direct deduction from your tax liability, at most 4.000 € per year (§ 35a EStG). Important: only for cashless payment to the provider’s account; cash payment is lost for tax purposes.
How do I recognize disreputable providers?
Warning signs: prices well below the arithmetical minimum-wage floor, cash payment requested, no A1 certificate for the posted caregiver, “self-employed” caregivers who de facto live in the household around the clock and work under instructions (risk of bogus self-employment — back payments hit you as the client), no replacement in case of illness/absence, and contracts without German law/place of jurisdiction.
Are there cheaper alternatives?
Often yes: the combination of an outpatient care service (via the Pflegesachleistung, the care in-kind benefit), day/night care (its own budget of 721–2.085 €/month), support workers paid via the Entlastungsbetrag, and family. For many situations that is enough — round-the-clock presence pays off above all with nighttime care needs or advanced dementia.
Sources (official)
- § 35a EStG — Tax reduction for household-related services (20 %, max. 4.000 €)
- BMAS: Minimum wage rises to 13,90 euros on 1 January 2026 (press release)
- § 37 SGB XI — Pflegegeld and advisory visits
- § 39 SGB XI — Verhinderungspflege (entitlement, 8 weeks, relatives rule)
- § 45b SGB XI — Entlastungsbetrag
- Federal Ministry of Health: Benefit entitlements of insured persons in 2026 (PDF, as of 11.12.2025)