German Cabinet Approves Nursing Care Reform Bill Amid Criticism

The German federal cabinet approved a draft bill for the Nursing Care Reorganization Act on September 30, 2026, setting the stage for sweeping changes to the country's nursing care system. While the measure is not yet active law and remains subject to legislative debate, it outlines substantial restructuring, including new care budgets, stricter prerequisites for care grades, and billions of euros in savings.

Among the proposed changes, traditional nursing allowances and professional outpatient nursing services are slated to merge into comprehensive relief and service budgets. The monthly relief allowance of up to 131 euros for individuals in care grade 1 would be eliminated entirely. For those in care grades 2 through 5, a restricted community-based budget for approved everyday assistance would replace the current relief allowance, offering higher monthly sums depending on age but stripping away rollover capabilities and broad spending flexibility.

Additionally, the separate monthly allowance of up to 42 euros designated for disposable care products—such as disinfectant and disposable gloves—would disappear. Families utilizing these goods would be forced to finance them out of their general relief budgets. Critics note that individuals categorized under care grade 1 would lose up to 1,572 euros annually in dedicated assistance, leaving them to shoulder household help and supervision expenses independently.

The legislative proposal also establishes higher point thresholds and modified assessment rules for care grades 1 through 3, potentially creating tougher barriers for new applicants. At the same time, the government projects billions in savings through these alterations, alongside increased contributions from specific groups of insured individuals and new employer contributions for marginal employment arrangements, while canceling a previously scheduled performance increase for 2028.

In a separate development highlighting the significance of home care, the German Pension Insurance reminded citizens that informal caregiving can bolster statutory retirement benefits without requiring out-of-pocket contributions. According to guidance issued in October 2026, individuals who care for someone with at least care grade 2 at home for a minimum of ten hours per week across at least two days can accumulate pension credits.

The Federal Ministry of Health indicates that a full year of recognized caregiving can yield an additional monthly pension entitlement ranging between 7.34 and 38.85 euros, evaluated using the current pension value. Pension insurance funds transfer contributions directly into the system based on the care grade and the type of financial assistance received by the care recipient.

Retirement expert Peter Kosick emphasized the importance of these provisions, stating that care can strengthen personal old-age security if the care grade, time commitment, and employment status meet the required legal criteria. He advised caregivers to request the relevant questionnaire from the care fund to ensure their activities are fully documented and accounted for.