The nursing care reform 2027 is a legislative project, not yet settled law. The Federal Cabinet adopted the draft Nursing Care Reorganisation Act (Pflegeneuordnungsgesetz) on 30 September 2026, and the Bundestag and Bundesrat have not yet decided. This hub shows what already applies, what the draft contains and where the individual articles are.
Short answer: The Cabinet adopted the Nursing Care Reorganisation Act on 30 September 2026. The Bundestag and Bundesrat still have to approve it (last updated: November 2026). The government bill provides for a higher childless surcharge from 1 January 2027: 0.9 instead of 0.6 contribution points. The contribution rate for long-term care insurance has been 3.6 percent since 1 January 2025.
The most important points at a glance
- The Nursing Care Reorganisation Act has been adopted by the Cabinet. The Bundestag and Bundesrat have not yet decided.
- The long-term care insurance contribution rate has been 3.6 percent since 1 January 2025 (BMG status: 14 September 2026).
- The draft provides for a higher surcharge for childless members from 1 January 2027: 0.9 contribution points instead of 0.6 so far (government bill of 30 September 2026, not yet adopted).
- A surcharge for co-insured partners from 2028 is under discussion. Details are in the article on the partner surcharge (in German).
- According to the draft ordinance, the contribution assessment ceiling for health and long-term care insurance is set to rise to 6,375 euros per month in 2027.
Which contribution rates apply today and in 2027?
The table separates law in force from the draft bill. The figures may still change during the legislative process.
| Rule | Value | Status date | Status |
|---|---|---|---|
| Long-term care contribution rate | 3.6 percent | since 1 Jan 2025 | law in force (BMG, 14 Sep 2026) |
| Childless surcharge so far | 0.6 contribution points, total 4.2 percent | since 1 Jul 2023 | law in force from age 23 |
| Childless surcharge from 2027 | 0.9 contribution points, total 4.5 percent | from 1 Jan 2027 under the government bill (Bundesrat Drucksache 587/26) | Cabinet draft, legislative process under way, not adopted |
| Contribution assessment ceiling, health and long-term care 2027 | 6,375 euros per month | ordinance draft, Cabinet 7 Oct 2026 | Bundesrat approval still pending |
What does long-term care insurance cost students?
Students pay the long-term care contribution alone. The contribution basis in 2026 was 855 euros per month, and the amount depends on whether the childless surcharge applies (as of 1 January 2026, GKV-Spitzenverband).
| Situation | Contribution per month | Status date |
|---|---|---|
| Without surcharge (with a child, or up to age 23) | 30.78 euros | 1 Jan 2026 |
| Childless from age 23 (4.2 percent) | 35.91 euros | 1 Jan 2026 |
Assumption: the contribution basis stays at 855 euros and the total rate for childless members rises to 4.5 percent. This gives about 38.48 euros per month (855 times 0.045), which is 2.57 euros more than today.
What changes for care allowances, the social-area budget and the relief amount?
The draft changes benefit structures. Until a law is passed and promulgated, the current entitlements remain in place. Which benefits the draft contains and which are still open is covered in Pflegegeld 2027: Was sich ändert und was noch offen bleibt (in German), Sozialraumbudget in der Pflege: Was 175 Euro im Monat ersetzen (in German) and Entlastungsbetrag Pflege: Wofür er bis 2026 genutzt werden kann (in German).
What does the reform mean for relatives who provide care?
For relatives who provide care, two questions matter: which entitlements they have today and which will change. The application process is described in Pflegegrad beantragen: Ablauf, Fristen und Begutachtung (in German), and time off work in Pflegezeit: Freistellung im Job für pflegebedürftige Angehörige (in German). Changes from the reform are not yet decided in the draft.
Why do childless members pay a surcharge?
The surcharge applies to members without children from the month after they turn 23. Members up to the end of their 23rd year are exempt. The constitutional background is covered in Pflegeversicherung und Kinderlosigkeit: Die verfassungsrechtliche Lage (in German).
Why the legislative status matters for you
A Cabinet decision is a proposal by the Federal Government. The Bundestag and Bundesrat can still change the text before it is promulgated. For your planning, only the adopted and promulgated wording counts. Figures from the draft are a guide until then, but not a basis for binding decisions.
A short example shows how little a tenth of a point can make. Assumption: contribution basis 855 euros per month. Each contribution point then equals 8.55 euros per month, or about 103 euros per year. A tenth of a point equals about 0.86 euros per month, or about 10 euros per year. The planned increase of the childless surcharge by 0.3 points equals about 2.57 euros per month, or about 31 euros per year.
Frequently asked questions
Does the nursing care reform 2027 already apply?
No, not yet. The Cabinet has adopted the draft. The law only takes effect once the Bundestag and Bundesrat approve it and it is promulgated. Status: November 2026.
When does the childless surcharge increase?
The draft sets 1 January 2027. Whether that date holds depends on the legislative process. The government bill raises it by 0.3 points to 0.9 points (BMG press release of 30 September 2026, Bundesrat Drucksache 587/26 of 9 October 2026). The draft bill of 5 June 2026 still named 0.7 points, a figure that has been superseded.
What does a childless student pay from age 23?
In 2026 it is 35.91 euros per month, based on a contribution basis of 855 euros and 4.2 percent. Students pay the long-term care contribution alone.
What does the reform mean if I do not need care yet?
Then the contribution matters most. The surcharge for childless members already applies from age 23. Those who want to plan ahead will find notes in Pflegevollmacht für junge Erwachsene: Wann sie sinnvoll ist (in German).
Where can I find the current legislative status?
On the websites of the Federal Government and the Federal Ministry of Health, and in the Bundestag documents. The adopted text is always the authoritative version, not a draft.
What to do now
- Check your long-term care contribution notice to see whether the childless surcharge applies.
- Follow the legislative status until the Bundestag and Bundesrat have decided.
- Read the articles in this group that match your situation, for example on care levels, care leave or parental maintenance.
- If you have questions about your protection, personal advice helps. More on this is on the page How we work.
All articles on this topic
The articles in this group are arranged by subtopic. Links point to the German versions.
Reform und Gesetzgebung
- Pflegegeld 2027: What is planned and what is still open
- Sozialraumbudget in der Pflege: Was 175 Euro im Monat ersetzen (in German)
- Verhinderungspflege und Kurzzeitpflege 2027: Was sich zusammenlegen soll (in German)
- Pflegekommission: Welche Strukturreform bis Mitte 2027 kommen soll (in German)
- Entlastungsbetrag Pflege: Wofür er bis 2026 genutzt werden kann (in German)
- Pflegeunterstützungsgeld und Familienpflegegeld: Was 2027 geplant ist (in German)
Beiträge und Kinderlose
- Care contribution 2027: what employees and employers pay
- Partnerzuschlag Pflegeversicherung 2028: Was mitversicherte Partner zahlen (in German)
- Pflegeversicherung mit Kindern: Beitragsabschlag einfach erklärt (in German)
- Pflegeversicherung und Kinderlosigkeit: Die verfassungsrechtliche Lage (in German)
Pflegegrad, Beratung und Leistungen
- Pflegegrade 1 bis 5: Welche Leistungen zu welchem Grad gehören
- Pflegegrad beantragen: Ablauf, Fristen und Begutachtung (in German)
- Care courses for relatives: free training for carers
- Pflegeberatung: Anspruch auf Beratung für Familien (in German)
Pflege im Alltag, Beruf und Familie
- Elternunterhalt bei Pflegeheim: Was Kinder tatsächlich zahlen müssen (in German)
- Pflegezeit: Freistellung im Job für pflegebedürftige Angehörige (in German)
- Pflegedienst oder Pflegegeld: Was Angehörige wählen sollten (in German)
- Rentenbeiträge für pflegende Angehörige: Was 2027 gilt (in German)
- Pflegevollmacht für junge Erwachsene: Wann sie sinnvoll ist (in German)
Privat vorsorgen und steuerlich absetzen
- Pflegetagegeld: Was es zahlt und für wen es passt (in German)
- Pflegezusatzversicherung mit Gesundheitsfragen: Was man angeben muss (in German)
- Pflegekosten steuerlich absetzen: Was das Finanzamt anerkennt (in German)
Related reading
- Health insurance 2027: what changes for insured members and students
- Pflegeversicherung mit Kindern: Beitragsabschlag einfach erklärt (in German)
- Care contribution 2027: what employees and employers pay
Sources: Federal Government, Nursing Care Reorganisation Act, Cabinet decision of 30 Sep 2026; Federal Ministry of Health, press release on the cabinet decision of 30 September 2026 (in German); Bundesrat, Drucksache 587/26, government bill (9 October 2026, in German); BMG, childless surcharge (status 14 Sep 2026); GKV-Spitzenverband, fact sheet on calculation parameters for contribution law (as of 1 Jan 2026).
Last updated: November 2026. This guide is general information, not individual advice.
