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Applying for a Pflegegrad (Care Level): Step by Step to a Decision

Updated on 05.07.2026 · Amounts verified against official sources (BMG/SGB XI) · Reading time approx. 7 minutes

Whether after a hospital stay or because things at home are gradually becoming too much: the Pflegegrad (care level) is the key to almost all benefits of Germany's long-term care insurance. Here is how to submit the application correctly — and avoid the typical mistakes.

1. Submit the Application — Immediately, Informally, Securing the Date

The application goes to the Pflegekasse (long-term care insurance fund — it is attached to the health insurance provider of the person in need of care). A phone call or an informal letter is enough: "I hereby apply for benefits from the long-term care insurance." Important to know:

2. The Assessment: How the Pflegegrad Is Determined

The assessment follows the Neues Begutachtungsassessment (NBA) (new assessment framework). What is evaluated is independence across six modules — not the diagnosis, but what the person can still manage on their own in everyday life:

ModuleWeighting
1. Mobility10 %
2. Cognitive & communication abilities15 % (the higher value counts)
3. Behavior & psychological issues
4. Self-care (washing, dressing, eating …)40 %
5. Coping with illness & therapy20 %
6. Everyday life & social contacts15 %

The points (0–100) determine the Pflegegrad: from 12,5 points Pflegegrad 1, from 27 Pflegegrad 2, from 47,5 Pflegegrad 3, from 70 Pflegegrad 4, from 90 Pflegegrad 5.

Tip: Many people in need of care put on their best face when the assessor visits (a "good day"). Keep a care diary (Pflegetagebuch) for 1–2 weeks beforehand and be present at the appointment — describe everyday life honestly, including the bad days.

3. Decision, Money, and Deadlines

Organize care together — with Liova

The Pflegegrad check in Liova walks you through the six NBA modules for a realistic self-assessment — and the integrated care diary provides the evidence for the assessment and any appeal.

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Frequently Asked Questions

How long does it take until the Pflegegrad is approved?

The Pflegekasse must generally decide within 25 working days of receiving the application. If it delays the decision without good reason, a delay penalty can become due for each week (or part thereof) of delay.

From when does the Pflegegrad apply?

Retroactively from the month in which the application was submitted. That is why you should apply as early as possible — an informal phone call or a two-line letter to the Pflegekasse is enough to secure the date.

What happens during the assessment by the Medizinischer Dienst?

An assessor usually visits the person in need of care at home and evaluates their independence in six areas of life (Neues Begutachtungsassessment, NBA). This produces a score between 0 and 100 points, which determines the Pflegegrad.

Can I appeal against the decision?

Yes, within one month of receiving the decision — informally and without any obligation to state reasons (the reasoning can be submitted later). A well-kept care diary is the strongest piece of evidence in the appeal procedure.

How much Pflegegeld is paid in 2026?

For home care provided by relatives: Pflegegrad 2: 347 €, Pflegegrad 3: 599 €, Pflegegrad 4: 800 €, Pflegegrad 5: 990 € per month. The amounts remain unchanged in 2026; the next adjustment is planned for 2028.