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Apply for care assistance

Sozialamt · When the long-term care insurance fund (Pflegekasse) is not enough

In personEarly

Long-term care insurance is not full cover – it pays fixed grants, not the actual costs. In a care home, there is therefore usually a substantial personal contribution left to pay: the care-related share, accommodation and meals, investment costs and often a training levy. If your pension and assets are not enough to cover it, care assistance under social assistance law (Hilfe zur Pflege) steps in under §§ 61 ff. of Book Twelve of the Social Code (SGB XII) – from the Sozialamt (social welfare office), not from the Pflegekasse.

Everything in this entity is subject to a proviso that § 2 SGB XII puts in one sentence: “Social assistance is not granted to anyone who can help themselves, above all by using their own labour, income and assets” – and just as little to anyone “who receives the required benefit from others, in particular from relatives or from the institutions of other social benefits”. Social assistance is the last safety net. Almost everything else follows from this: that income and assets are examined, that other benefits take precedence, and that a refusal often does not mean “you are not entitled to anything”, but “another body pays for that”.

For care, that means specifically: first come the benefits of the Pflegekasse, then your own income and your assets, then, where applicable, maintenance claims – and only after that, care assistance. It fills the gap; it is not the foundation.

The worry about burdening one’s own children with an application keeps more people away from basic income support than any refusal does. § 94 Abs. 1a SGB XII largely removes its basis: recourse is only taken against children and parents if their annual income exceeds €100 000 – and that applies per person liable for maintenance. The second part is decisive, and hardly anyone knows it: “It is presumed that the income of the persons liable to provide maintenance … does not exceed the annual income threshold”. The Sozialamt therefore does not routinely ask about the children’s income; it needs concrete indications to rebut the presumption. This does not apply to benefits under Chapter Three for minor children.

Last updated27 August 2026
Legal basis§ 61 SGB XII · § 66a · § 94 Abs. 1a · § 2
VerificationChecked against gesetze-im-internet.de (consolidated version)
Written and reviewed byAndrés Sánchez Botta
Independent information page: we are not the Sozialamt, not an authority and not a paid advisory service — we do not submit applications on your behalf. All information comes from official sources and is explained here in simple terms; the competent body is always authoritative. Not legal advice. Whether and to what amount an entitlement exists depends on the individual case. All information without guarantee. We are neither lawyers nor tax consultants: we document administrative procedures and check the information against the official source — that is information, not legal or tax advice.
Competent bodySozialamtNot the Pflegekasse
Order of precedenceSubsidiary§ 2 SGB XII
Recourse against childrenFrom €100,000With statutory presumption
ApplicationAs early as possibleOnly limited retroactive effect
Required documents

What you need

The notice (Bescheid) on the Pflegegrad

Basis. If no care grade (Pflegegrad) has been established yet, apply to the Pflegekasse for one in parallel – do not wait until it has been granted, because care assistance does not have unlimited retroactive effect.

Cost estimate or care home invoice

With each item shown separately: the care-related personal contribution, accommodation and meals, investment costs, training levy. Only then can it be checked which part remains uncovered – and only the care-related share is reduced by the benefit supplement (Leistungszuschlag) from the Pflegekasse.

Evidence of income and assets

Pensions, interest, accounts, life insurance policies, property. Because of the subsidiarity principle, the examination here is more thorough than for other benefits. Do not dispose of anything prematurely – § 90 Abs. 2 SGB XII protects several items, and subsection 3 contains a hardship rule.

For home care: proof of need

Invoices from the care service, prescriptions, proof of additional support. Care assistance exists not only in care homes – also at home, if the benefits of the Pflegekasse do not cover the actual need.

Information about children only when asked

Because of the presumption in § 94 Abs. 1a, the office does not routinely ask about the children's income. Do not submit it unasked – that invites an examination which the law does not provide for.

Step by step

How to proceed

  1. 1

    Apply early, not once the money is gone

    Care assistance is not paid retroactively without limit while the care home invoice keeps running. Submit the application as soon as it becomes apparent that your pension and assets will not permanently cover the personal contribution – not only once the account is empty.

  2. 2

    Clarify the Pflegegrad in parallel

    Without a Pflegegrad, the Pflegekasse pays nothing, and without its benefits the gap is larger than necessary. If no procedure is under way yet, apply for the Pflegegrad at the same time – a deadline of 25 working days applies there, and €70 per week is payable if it is exceeded.

  3. 3

    Have the invoice itemised

    Request a breakdown that shows the care-related personal contribution, accommodation and meals, investment costs and training levy separately. Without this separation, neither the benefit supplement from the Pflegekasse nor the remaining gap can be calculated properly.

  4. 4

    Make full use of the Pflegekasse benefit supplement

    It significantly reduces the care-related personal contribution according to the duration of residence – 15% in the first year, then 30, 50 and 75%. Earlier periods in a care home count towards this. What the Pflegekasse covers, the Sozialamt does not have to cover; so check there first.

  5. 5

    Name claims that take precedence

    Beihilfe (the state subsidy for civil servants towards medical and care costs), private long-term care insurance, accident insurance, claims against the person who caused the harm, pensions. The office asks about these because the subsidiarity principle requires it – and because some of these benefits are considerably higher.

  6. 6

    Have your assets assessed instead of disposing of them

    Not everything has to be used up. Protected items include, among others, an appropriate owner-occupied house property and cash assets of up to €10,000 per person; § 66a SGB XII additionally protects up to €25,000, but only to the extent that this amount comes from your own economic activity during the period you receive the benefit.

  7. 7

    Request the notice in the event of refusal

    In writing, with a calculation. Common points of dispute are the treatment of income, the valuation of assets and the question of appropriateness. The period for lodging an objection (Widerspruch) is one month; social associations provide advice free of charge.

Fee information

Costs and payment

Who pays which partPflegekasse, your own means, then the Sozialamt
ApplicationFree of charge
FirstBenefits of the Pflegekasse
ThenYour own income and assets
Protected assets in general€10,000.00 per person
Additionally under § 66aUp to €25,000, only from economic activity
Recourse against childrenOnly above €100,000 annual income

Everything on these pages is subject to a proviso that § 2 SGB XII puts in one sentence: “Social assistance is not granted to anyone who can help themselves, above all by using their own labour, income and assets” – and just as little to anyone “who receives the required benefit from others, in particular from relatives or from the institutions of other social benefits”. Social assistance is the last safety net. Almost everything else follows from this: that income and assets are examined, that other benefits take precedence, and that a refusal often does not mean “you are not entitled to anything”, but “another body pays for that”.

For care, this means a fixed order: first the Pflegekasse pays its grants – which do not cover the full costs – then your own income and assets must be used, and only the remaining gap is borne by the Sozialamt. With regard to assets, the general rule applies first: § 90 Abs. 2 SGB XII protects certain items, including an appropriate owner-occupied house property, and the corresponding implementing regulation sets €10,000 per person for cash assets. In addition there is § 66a SGB XII, which is often shortened to “€25,000 of protected assets for care assistance” – in fact it protects this amount only “insofar as this amount was acquired wholly or predominantly as income from self-employed and employed activity of the person entitled to benefits during the period of receiving the benefit”. It is therefore about savings from one's own work during the period of receipt, not about a generally higher level of protected assets; anyone who reads the figure without this condition is planning wrongly. The worry of burdening one's own children with an application keeps more people from claiming basic income support than any refusal. § 94 Abs. 1a SGB XII largely removes that basis: recourse is taken against children and parents only if their annual income exceeds €100 000 – calculated per person liable to pay maintenance. The second part is decisive, and hardly anyone knows it: “It is presumed that the income of the persons liable to pay maintenance … does not exceed the annual income limit”. The Sozialamt therefore does not routinely ask about the children's income; it needs concrete indications to rebut the presumption. Benefits under Chapter Three paid to minor children are excluded from this rule.

Good to know

Important notes

Long-term care insurance is not full cover. It pays grants; the personal contribution remains and is the reason for this benefit.

The Sozialamt is responsible, not the Pflegekasse. Two different institutions with two different applications.

Apply early. Benefits are paid retroactively only to a limited extent, while the care home invoice keeps running.

Recourse against children only comes into consideration from €100 000 annual income – with a statutory presumption that the limit is not exceeded.

The €25,000 under § 66a is tied to a condition: it protects only what comes from your own economic activity during the period of receiving the benefit.

Make full use of the Pflegekasse benefit supplement first. It reduces the care-related personal contribution by 15 to 75% depending on the duration of residence.

Care assistance is also available at home, not only in a care home – if the benefits of the Pflegekasse do not cover the need.

Do not dispose of assets before receiving advice. A policy surrendered too hastily cannot be retrieved.

Avoid these mistakes

Common mistakes

Waiting until your savings are used up. The benefit does not have unlimited retroactive effect, and the care home invoice keeps running.

Submitting the application to the Pflegekasse. The Sozialamt is responsible; the detour costs weeks during which the invoice remains unpaid.

Not applying at all out of concern for the children. The presumption under § 94 Abs. 1a argues against this, and the limit is €100 000 per child.

Planning with €25,000 of protected assets. This limit only applies to savings from your own economic activity during the period of receipt.

Accepting a care home invoice without separately itemised items. Without a breakdown, the gap cannot be calculated properly.

Overlooking the Pflegekasse benefit supplement. What it covers, the Sozialamt does not have to cover – and earlier periods in a care home count towards this.

Frequently asked questions

Questions and answers

When do I need care assistance?

When the benefits of the Pflegekasse and your own means do not cover the cost of care. Long-term care insurance is deliberately designed as partial cover: it pays fixed grants – in a care home, between €805 and €2,096 a month depending on the Pflegegrad – not the actual costs. What remains is the personal contribution: the care-related share, accommodation and meals, investment costs and often a training levy. If your pension and assets are not enough to cover this, care assistance under §§ 61 ff. SGB XII applies – from the Sozialamt. Incidentally, it is available not only in a care home but also for home care, if the actual need exceeds the benefits of the Pflegekasse.

Do my children have to pay for the care home?

As a rule, no. § 94 Abs. 1a SGB XII allows recourse against children and parents only if their annual income exceeds €100 000 – calculated per person liable to pay maintenance. And the law adds: “It is presumed that the income of the persons liable to pay maintenance … does not exceed the annual income limit.” The Sozialamt therefore does not routinely ask about your children's income and needs concrete indications to rebut the presumption. This rule is why the widespread fear of “Elternunterhalt” (maintenance support for parents) is now largely unfounded – but it still keeps many families from a legitimate application.

How much in assets may I keep?

There are two levels, and they are often confused. The general rule is in § 90 SGB XII: subsection 2 protects certain items – among others an appropriate owner-occupied house property –, and the implementing regulation sets €10,000 per person for cash assets; subsection 3 contains a hardship rule. In addition there is § 66a SGB XII with an amount of up to €25,000 – but only “insofar as this amount was acquired wholly or predominantly as income from self-employed and employed activity … during the period of receiving the benefit”. It therefore protects savings from your own work during the period of receipt, not a generally higher level of assets. Anyone who reads the €25,000 without this condition is planning wrongly.

When should I submit the application?

As soon as it becomes apparent that your pension and assets will not permanently cover the personal contribution – not only once the account is empty. Care assistance is not paid retroactively without limit while the care home invoice keeps running month after month; any arrears that accrue then remain with the person in need of care or with those who co-signed the care home contract. Work out early how long your assets will last, and submit the application in good time before that point. The application can be made informally; documents can be submitted afterwards. Also seek advice before disposing of assets – some of them are protected.

Is care assistance also available at home?

Yes. Although it is most often applied for in connection with a care home, it is not limited to that: it also comes into consideration for home care if the actual need exceeds the benefits of the Pflegekasse – for example because a higher level of care-in-kind benefit is needed than the amount provided for the Pflegegrad, or because more intensive support is required. People with Pflegegrad 1 or without a Pflegegrad may also be eligible under certain conditions if there is a care need. Enclose invoices from the care service and medical documents, and describe the need specifically – that is the core of the examination.

What does the Pflegekasse have to do with it?

It takes precedence. Because of the subsidiarity principle in § 2 SGB XII, the Sozialamt first examines whether and to what extent the Pflegekasse pays – and what it covers, the Sozialamt does not have to cover. It is therefore worth claiming everything available there: the correct Pflegegrad (an upgrade is possible at any time, with no waiting period), the benefit supplement, which reduces the care-related personal contribution in a care home by 15, 30, 50 or 75% depending on the duration of residence, and the remaining benefits such as care aids and improvements to the living environment. Only the gap that remains after that is the subject of care assistance. The two applications run separately, and with different institutions – submit them in parallel.

Will my house have to be sold?

Not automatically. § 90 Abs. 2 SGB XII protects an appropriate owner-occupied house property; what is appropriate depends on size, layout, value and the number of occupants and is assessed on a case-by-case basis – there is no generally applicable figure in square metres. It becomes more difficult if the person in need of care lives permanently in a care home and no longer occupies the house: then it may in principle have to be used, although subsection 3 contains a hardship rule, for example if relatives continue to live there. It is also possible to grant the benefit as a loan secured in the Grundbuch (land register), instead of requiring a sale. Be sure to seek advice here before you arrange anything.

What if the application is refused?

Request a written official notice (Bescheid) with a calculation and lodge an objection within one month. The most common points of dispute can be challenged specifically: the treatment of income – check whether earmarked benefits were wrongly included –, the valuation of assets including the hardship rule under § 90 Abs. 3, and the question of the appropriateness of the care home costs. Free support is offered by social associations, care support centres and independent advice centres; for legal advice from a lawyer, Beratungshilfe (advisory assistance for people on low incomes) may be available, with a personal contribution of €15.00. It is important to observe the one-month period – if necessary with one sentence and a statement of reasons submitted later.

Related official procedures

Care home
What the Pflegekasse pays
€805–€2,096
Basic income support in old age
Often to be applied for in parallel
€563 + accommodation costs
Integration assistance
For disability, SGB IX
On application

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