How is a care level applied for?

The claim goes to the long-term care fund attached to the health insurer of the person in need of care. It can be filed informally, by phone or in writing, and an authorised representative may file it too. Timing matters: benefits are granted from the point of claim, and where the claim is filed later, from the beginning of the month in which it is filed (**Section 33 SGB XI**). The fund then orders the assessment; the order goes out within three working days of the claim arriving, in secured electronic form (**Section 18 SGB XI**). Approval, level and duration of benefits are decided by the care fund on the basis of the assessment report in the individual case.

What is rated during the assessment?

What is rated is independence, not the diagnosis. For that, the insured person is to be examined in their own living environment (**Section 18a SGB XI**). The rating is carried out across six modules with fixed weightings: mobility at **10 percent**, cognitive and communicative skills together with behaviour at **15 percent**, self-care at **40 percent**, coping with illness- and therapy-related demands at **20 percent**, and structuring everyday life and social contacts at **15 percent** (**Section 15 SGB XI**). Activities outside the home and household management are recorded but are not separately taken into account in the arithmetical determination of the care level (**Section 18a SGB XI**).

Which care level results from how many points?

The total score runs from 0 to 100 and is translated into five levels: from 12.5 to under 27 total points care level 1, from 27 to under 47.5 care level 2, from 47.5 to under 70 care level 3, from 70 to under 90 care level 4 and from 90 to 100 care level 5 (**Section 15 SGB XI**). Of the modules cognitive and communicative skills and behaviour, only the higher weighted value counts. In the initial assessments of 2025 care level 2 was recommended most often, in **34.5 percent** of cases, followed by care level 1 with **29.0 percent** (Medizinischer Dienst Bund).

What can relatives do if the decision is lower than expected?

The first step is to look at the assessment report, which is usually enclosed with the decision letter unless the claimant has objected (**Section 18c SGB XI**). It shows which point values were awarded per module. If everyday details are missing, such as support during the night, that is the starting point for an appeal within the deadline named in the legal remedies notice. Support is available from the statutory care counselling, to which there is an entitlement even where a claim has been filed and there is a recognisable need for help and advice (**Section 7a SGB XI**). That a second look is worthwhile is shown by the claims seeking a higher level: an upgrade was recommended in **69 percent** of cases (Medizinischer Dienst Bund). No promise for an individual case can be derived from that.

Which content belongs on a care service's guide page?

A short section of independent pages works better than a catch-all page: filing the claim, deadlines and procedure, preparing for the assessment, the decision and the appeal, benefits by care level. Each page carries a question in the title, a date of last review, the statutory reference for every deadline and a short route to a conversation. The need for it is documented: **44 percent** of the carers surveyed feel only partly well informed about the benefit entitlements they have as a caring relative (ZQP Foundation 2018), and **59 percent** of respondents use the internet for questions around health and care (ZQP Foundation 2015). The boundary matters: the page explains the procedure and replaces neither legal nor medical advice.

Applying for a Care Level: The Guide Page That Works

Q: How long does it take until the decision arrives?

The care fund has to notify its decision in writing no later than **25 working days** after the claim arrives (**Section 18c SGB XI**). If it misses that deadline and is responsible for the delay, **70 euros** are payable to the claimant for every week begun (**Section 18c SGB XI**). Shorter deadlines apply in particular situations, for instance during a stay in hospital or in an inpatient rehabilitation facility under the further conditions named there (**Section 18a SGB XI**). How long the procedure actually takes depends on the individual case, which is why a guide page should name the deadline and at the same time leave open when the decision will arrive in a specific case.

In short and in plain language

When care is new, relatives first look for the claim. Only later do they look for a care service.

A guide page explains such a topic calmly. It can show the way from the claim to the decision.

The article shows what belongs on such a page. The page does not replace advice. It says clearly where your help ends.

Offer a short call back. That turns reading into a talk. Add the date when the page was last checked.

We build a page like this for you.

When care becomes a topic in a family for the first time, the first question is rarely which care service to hire. The first thing is a claim. Someone has to call the long-term care fund, someone has to prepare an assessment appointment with the Medizinischer Dienst, and someone has to understand why the process ends with a number between 1 and 5. This is exactly the phase in which relatives search online. On the websites of many home care services they find three passing remarks, because the claim is treated as the fund's business and the site would rather describe its own services. That leaves the earliest source of enquiries unoccupied. This article shows how those three remarks become a guide section that holds: which questions it has to answer, which deadlines and assessment modules the law prescribes, where the line to legal and medical advice runs, and how a piece of writing that gets read turns into a conversation.

Key takeaways

The claim comes before the service in the search: in 2025 the fifteen regional Medizinische Dienste carried out around 3.1 million assessments, and in home care 47.3 percent of them were initial claims (Medizinischer Dienst Bund).
Deadlines belong on the page: the care fund has to notify its decision in writing no later than 25 working days after the claim arrives (Section 18c SGB XI); if that is missed, 70 euros are due for every week begun, provided the fund is responsible.
The assessment follows six modules with fixed weightings, and self-care carries the most weight at 40 percent (Section 15 SGB XI). Describing that plainly removes part of the uncertainty around the appointment without promising an outcome.
The need is documented: 44 percent of the carers surveyed feel only partly well informed about the benefit entitlements they have as a caring relative under long-term care insurance (ZQP Foundation 2018).
A guide page does not replace advice, it leads to it: a date of last review, the statutory reference, a clear boundary and a short call-back offer turn the explanation that was read into an enquiry.

The claim is the first search

The route into care usually begins with a claim to the long-term care fund, and that route is well travelled. In December 2023 close to 5.7 million people in Germany were in need of long-term care within the meaning of the long-term care insurance act, 86 percent of them were cared for at home, and 1.1 million lived in private households and were cared for together with or entirely by home care and support services (Federal Statistical Office). In 2025 the fifteen regional Medizinische Dienste carried out around 3.1 million assessments, the highest figure so far (Medizinischer Dienst Bund). In home care, 47.3 percent of those assessments were initial claims and 40.0 percent were claims for a higher care level (Medizinischer Dienst Bund). Behind every one of those assessments stands a family that searched beforehand: for the form, for the deadline, for the question of what the assessor actually wants to know.

That search happens online, and it happens early. Even a decade ago 59 percent of respondents used the internet very often or occasionally to inform themselves about health and care questions; among people with their own care experience it was 66 percent (ZQP Foundation 2015). At the same time the level of knowledge is thin: 44 percent of the carers surveyed feel only partly well informed about the benefit entitlements they have as a caring relative, and 33 percent are only partly informed about the entitlements of the person in need of care (ZQP Foundation 2018). For a home care service that is an unoccupied position in the market. Whoever explains the claim phase is already in the conversation before the question of which service to choose is even asked. Which content relatives expect on a care website beyond that is covered in the article on website content for relatives.

The figures at a glance

5.7 million people in need of long-term care in Germany in December 2023, 86 percent of them cared for at home (Federal Statistical Office); around 3.1 million care assessments in 2025 (Medizinischer Dienst Bund); 25 working days for the fund's written decision and 70 euros for every week begun beyond that deadline where the fund is responsible for the delay (Section 18c SGB XI); 40 percent weighting for the self-care module in the arithmetical determination of the care level (Section 15 SGB XI); 59 percent of respondents use the internet for health and care questions (ZQP Foundation 2015).

What belongs on a guide page about care levels

A guide page about care levels is not a statute rewritten in your own words. It answers the questions relatives are actually asking this week, and it answers them in the order in which those questions arise. The most common structural mistake is the catch-all page: one long text under the heading care level that covers the claim, the assessment, the appeal and the benefits in a single run. Pages like that get skimmed and left again, because nobody works through forty paragraphs to find one deadline. A short section of independent pages holds far better: a question in the title, a date of last review under the heading, one section per sub-question and a route to a conversation at the end. The same structure is used in the article on guide pages for the relief budget, there for benefits rather than for the claim. What matters is that every page works on its own, because relatives arrive from search in the middle of the section and not via the home page.

Who files the claim and how: informally by phone or in writing to the long-term care fund attached to the health insurer of the person in need of care, and by an authorised representative if preferred
From when benefits run: benefits are granted from the point of claim, and where the claim is filed later, from the beginning of the month in which it is filed (Section 33 SGB XI)
Which prior insurance period applies: at least two years of insurance within the ten years before the claim (Section 33 SGB XI)
Which deadlines the care fund has to observe and what happens if they are exceeded (Section 18c SGB XI)
How the assessment works: the insured person is to be examined in their own living environment, and independence is rated across six modules (Section 18a SGB XI, Section 15 SGB XI)
What belongs in a care diary, over what period it is kept and why the night counts just as much as the morning
What the decision letter contains, when the assessment report comes with it and which routes remain open afterwards
Where the care fund's advice ends and where your service takes over the actual care

The deadlines: what the law prescribes for the care fund

Deadlines are the part of the claim procedure that is easiest to document, which is precisely why they belong on the page. Under Section 18 SGB XI the care fund forwards the assessment order within three working days of the claim arriving, in secured electronic form. It has to notify the claimant of its decision in writing no later than 25 working days after the claim arrives (Section 18c SGB XI). If the fund misses that deadline and is responsible for the delay, 70 euros are payable to the claimant for every week begun (Section 18c SGB XI). Shorter deadlines apply in particular situations, for instance during a stay in hospital or in an inpatient rehabilitation facility where one of the further conditions named there also applies (Section 18a SGB XI). Whether such a situation applies is decided case by case; your page describes the rule, not the outcome.

Step in the procedure	What the law prescribes	What your page says about it
Order to the Medizinischer Dienst	within three working days of the claim arriving, in secured electronic form (Section 18 SGB XI)	Why the assessment appointment is not fixed on the day of the claim
Decision by the care fund	no later than 25 working days after the claim arrives, in writing (Section 18c SGB XI)	From when it makes sense to follow up, and with whom
Shortened assessment	by the fifth working day during a stay in hospital or in an inpatient rehabilitation facility where one of the further conditions named there also applies (Section 18a SGB XI)	Which details the care fund needs for that
Announced care leave	assessment within ten working days of the claim arriving (Section 18a SGB XI)	How working relatives make this clear to the fund
Choice among assessors	a list of at least three independent assessors if no assessment has taken place after 20 working days (Section 18 SGB XI)	That this choice exists and how it is exercised
Payment for a missed deadline	70 euros for every week begun where the care fund is responsible for the delay (Section 18c SGB XI)	That this rule exists, without promising anything for the individual case

The value of this overview is not that relatives start demanding deadlines. It is that the waiting time becomes explainable. Someone who knows that several weeks can pass between claim and decision does not call the fund on the fifth day, and does not blame the delay on the care service, which has nothing to do with it anyway. So put a sentence next to every deadline about what is worth doing in the meantime: start the care diary, collect medical reports and medication plans in one place, look through the flat for trip hazards, sort out the funding question. For the last point there is a route of its own, described in the article on the care cost calculator on the website.

Explaining the assessment without judging it

For many families the assessment appointment is the most uncomfortable part of the procedure, because nobody knows in advance what counts. Yet the framework is set out in law. The insured person is to be examined in their own living environment (Section 18a SGB XI). Independence is rated across six modules that enter the total score with fixed shares (Section 15 SGB XI). Of modules two and three only the higher weighted value counts, so the points are not added together. Activities outside the home and household management are recorded, but are not separately taken into account in the arithmetical determination of the care level (Section 18a SGB XI). Setting this out plainly on a page removes part of the uncertainty around the appointment. Make sure the format also works with screen readers and at high magnification; the requirements are set out on our page about the accessible design of care websites.

Mobility, 10 percent

Changing position in bed, holding a stable sitting position, transferring, moving within the living area and climbing stairs. At 10 percent this module carries the least weight, yet relatives often overestimate it because restricted movement is visible (Section 15 SGB XI).

Cognition and communication, 15 percent

Recognising people from the immediate circle, orientation in place and time, understanding facts, communicating needs. This module shares a 15 percent weighting with the behaviour module, and only the higher weighted value counts (Section 15 SGB XI).

Behaviour, 15 percent

Restlessness at night, resistance to care measures, anxiety, lack of drive or aggressive behaviour. A care diary pays off here, because these events rarely happen in the morning and otherwise go unmentioned during the appointment (Section 15 SGB XI).

Self-care, 40 percent

Washing, dressing, nutrition, dealing with excretion. At 40 percent this is the heaviest module and therefore the part a care diary should record most precisely, with times and durations rather than weekly estimates (Section 15 SGB XI).

Illness-related demands, 20 percent

Administering medication, changing dressings, injections, medical appointments, keeping to diets and therapy plans. The share is 20 percent, and trips to specialists in particular are often forgotten when writing things down (Section 15 SGB XI).

Everyday life and social contacts, 15 percent

Structuring the day, keeping occupied, planning ahead, maintaining contacts. The share is 15 percent and describes the part of independence that lies outside personal hygiene (Section 15 SGB XI).

The decision and what remains open afterwards

The assessment report is usually sent together with the decision letter, unless the claimant has objected to that (Section 18c SGB XI). What the results look like is shown by the initial assessments: 34.5 percent ended with a recommendation for care level 2, 29.0 percent with care level 1 and 21.3 percent with the finding of no need for long-term care (Medizinischer Dienst Bund). For claims seeking a higher care level, an upgrade was recommended in 69 percent of cases (Medizinischer Dienst Bund). These figures do not belong on the page in order to raise expectations, but to show that a low or negative decision is neither an isolated case nor an end point. Which wording is permissible and which mandatory details a care website needs in any case is covered in the article on the legally compliant care website.

Read the assessment report: which point values were awarded per module and which everyday details are missing from it
Observe the deadline in the decision letter: the legal remedies notice names it, and it starts when the decision is served
Keep the appeal short at first and submit the reasoning once the assessment report is available
Use the statutory care counselling: the entitlement also exists where a claim has been filed and there is a recognisable need for help and advice (Section 7a SGB XI)
Consider a higher care level if the situation changes: for claims seeking an upgrade, one was recommended in 69 percent of cases (Medizinischer Dienst Bund)
Keep assistive devices in view: in more than 40 percent of initial assessments the assessors recommended assistive and care aids (Medizinischer Dienst Bund)
Sort out the care arrangement in parallel so that no gap opens between the decision and the first visit

The line to legal and medical advice

A guide page describes the procedure, it does not judge an individual case. Name deadlines and amounts only with the statutory reference and the source, and put beside them the note that the care fund decides on approval, level and duration of benefits on the basis of the assessment report. Avoid wording that holds out an outcome, avoid estimates of the likely care level, and avoid statements about the prospects of success of an appeal. Assessing a decision letter in legal terms is the job of lawyers and of the recognised advice centres, and the medical assessment is the job of the treating doctors. Your page points to them and does not put itself in their place. That restraint costs nothing and protects both sides: the family from false expectations, and your service from a statement it may not be able to keep.

Turning an explanation into an enquiry

A guide page without a route to a conversation stays a brochure. The transition works when it fits the moment: someone reading the page about the assessment is looking for preparation, not an offer about basic care. So offer what helps this week, and keep the route to it short. A second pointer comes from the claim data: in 2025 59.6 percent of claimants applied for the care allowance, 19.3 percent for combined benefits and 11.2 percent for home care benefits in kind (Medizinischer Dienst Bund). The majority therefore think of care by the family first. For a home care service that means the guide should explain that care allowance and benefits in kind can be combined, rather than offering a full package straight away. In practice a form with three fields carries much further than one with ten; the arguments are set out in the article on more enquiries via the care website.

A call-back offer instead of a long contact form: a name, a phone number and a time window are enough for the first step
A care diary as a printable template, downloadable without registration and without transmitting personal data
An appointment booking for the advisory meeting, as described in the article on online booking for care consultations
A pointer to the statutory care counselling under Section 7a SGB XI, so that it stays clear which route is free of charge via the care fund
A phone number in the visible area, because some relatives would rather talk than write at this stage
A link to your own service pages, so that the explanation turns into a concrete offer in your catchment area

Visibility: what relatives actually search for

At this stage relatives are not searching for the name of a service but for their problem: applying for a care level, points for care level 2, how the assessment works, appealing against the decision. Those searches are not tied to a place, but the decision that follows them is. A guide section therefore carries the most when it is professionally sound and at the same time recognisably rooted in your catchment area: place names in the running text rather than in a footer list, a sentence about which municipalities you serve, and a connection to the local signals described in the article on local SEO for care services. That way the same page answers two questions one after the other: the professional one and the one about the right service nearby.

The second lever is the format. Questions as subheadings, short paragraphs, a table instead of a paragraph with five figures, and a table of contents at the top of the page: that helps people reading on a phone in a hospital corridor, and it helps the systems that assemble answers out of pages. The article on visibility in AI-driven search describes why a cleanly structured guide page is cited as a source more often than a long unstructured text. Make sure as well that the page stays readable on small screens without zooming and that tables do not run off the side there; the details are in the article on mobile optimisation for relatives.

Keeping the section current: review date and routine

A guide section ages quietly. Amounts change at the turn of the year, sections of the law get moved, forms are given new names, and nobody reports that to the website. A date of last review on every page is therefore not decoration but a promise that somebody is watching. How well the information around the procedure lands today can be measured: 85.8 percent of the people assessed during a home visit were satisfied with the information provided about the assessment procedure (Medizinischer Dienst Bund), while 78.3 percent were satisfied with how easy the Medizinischer Dienst was to reach for follow-up questions (Medizinischer Dienst Bund). The gap between the two figures describes exactly the point at which a well-kept page and a phone that gets answered make the difference. If you would rather not handle that upkeep on the side, our website maintenance for care services provides the framework.

Check all amounts and deadlines against the statute once a year in January and then set a new date of last review
When the law changes, touch the affected guide page first and only then the home page and the menu
Leave the statutory reference in the text so that the next check takes minutes rather than hours
Evaluate the search queries that bring people to the section and add the missing questions as new sections
Note the questions that come in by phone: whatever gets asked three times there belongs on the page as its own section
Compare printable templates and form notes with the care funds' own templates once a year
Check the links to your own service pages so that the guide does not lead into a dead end

The claim section is the beginning of a longer chain of explanations. Someone who has understood the care level asks next about the care arrangement that fits it, and that is where the actual conversation about your service begins. Two frequent follow-up questions have articles of their own: explaining dementia care clearly on your website and presenting round-the-clock care without legal risk. Together that makes a section which accompanies relatives from the first question to the first meeting, without anyone having to search from the home page. The technical framework for it is described under our care website service; if you would like to discuss the structure, the short route is via the contact form for care services.

Sources and Studies

This article is based on data from Medizinischer Dienst Bund, the Federal Statistical Office, the ZQP Foundation for quality in long-term care and on the wording of Book Eleven of the German Social Code. The figures quoted refer to the state of the respective publication.

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