From the outside, the route to a care level looks complicated — in fact it consists of four manageable steps. One thing matters above all: submit the application early and prepare well for the assessment.
Who can apply for a care level?
Anyone who depends on support in everyday life on a lasting basis — expected to last at least six months — can apply for a care level. This is not only about physical limitations: dementia, mental illness and cognitive impairments are taken into account as well.
The application is usually submitted by the person in need of care themselves. Where that is not possible, family members can take over with a power of attorney. If a legal guardian has been appointed, that person submits the application within the scope of their responsibilities.
Step 1: Submit the application to your care insurance fund
Your care insurance fund is responsible — it sits within the health insurance fund of the person in need of care. Anyone with private insurance should contact their private compulsory care insurance provider.
The application does not have to follow any particular form. A phone call is enough, as is a short written note or the fund's online form. One sentence will do:
"I hereby apply for benefits from the care insurance scheme."
What matters is the date of receipt. Benefits are granted from the month in which the application was received — even if the assessment only takes place weeks later. Anyone who hesitates is giving away money. The fund will send you the detailed forms afterwards.
Step 2: Prepare for the assessment
After the application, the care insurance fund commissions an assessment. For people with statutory insurance this is carried out by the Medical Service (MD), and for privately insured people by the company Medicproof. The assessor will get in touch to propose a date for a home visit.
Keep a care diary
The most important preparation is a care diary. Over one to two weeks, note down which activities require support and how long that support takes — washing, dressing, eating, medication, going to the toilet, accompaniment to appointments.
It sounds like a lot of work, but it is decisive. Many applications are graded too low because only a snapshot of everyday life is visible during the appointment. A diary makes visible what would otherwise go unnoticed.
Don't play anything down
Many people in need of care want to show their best side during the appointment — understandable, but counterproductive. Describe everyday life as it really looks on an average day, including bad days.
Don't go through it alone
Ask a family member to be present at the appointment. Someone who provides care every day can add situations that would otherwise go unmentioned. Also have medical reports, medication plans and any disability pass ready.
Step 3: These six areas are assessed
The assessment follows a standard procedure used across Germany. What is assessed is how independently a person manages their everyday life — not which diagnoses they have. Six areas feed into the result with different weightings:
- Mobility — getting up, walking, climbing stairs, moving around the home
- Cognitive and communication skills — orientation, memory, understanding conversations
- Behaviour and psychological problems — restlessness at night, anxiety, aggression
- Self-care — personal hygiene, dressing, eating and drinking; this area carries the most weight
- Coping with illness- and treatment-related demands — medication, dressings, doctor's appointments
- Organising everyday life and social contacts — structuring the day, maintaining contacts
The individual assessments produce a score between 0 and 100. The higher the score, the higher the care level — from care level 1 for minor impairment up to care level 5 for the most severe impairment with special demands on nursing care.
Step 4: The decision
The care insurance fund decides in writing. As a rule, a deadline of 25 working days from receipt of the application applies to processing. If the fund misses this deadline without adequate reason, a surcharge may become payable for each week of delay begun.
The decision states the care level that has been determined. Also request the full assessment report — you have a right to it. Only with that report can you understand how the points were arrived at.
If the decision is lower than expected, or the application is rejected, you can lodge an appeal. The deadline for this is one month from receipt of the decision.
What you are already entitled to from care level 1
Many people do not know that even the lowest care level triggers entitlements. These include, among others:
- consumable care essentials worth up to €42 a month — such as disposable gloves, disinfectant and bed pads
- a contribution towards a home emergency call system
- grants for measures that improve the living environment, such as a barrier-free bathroom conversion
- free care courses for family carers
Frequently asked questions
From when do I receive benefits?
Do I have to apply in writing?
Who applies if the person cannot do it themselves?
What does the assessment cost?
We'll handle the application for you
First application, upgrade or appeal: we prepare the paperwork, deal with your care insurance fund and guide you through the procedure — free of charge for you as an insured person.
This article offers general orientation and does not replace individual advice. The statutory provisions of SGB XI and the decision of your care insurance fund in each individual case are what count.