Pflegeheim-Eigenanteil steigt bundesweit um 256 Euro: Bremen am teuersten, Sachsen-Anhalt am günstigsten

A nationwide evaluation by the Association of Replacement Health Funds (vdek) shows that the personal share of nursing home costs in Germany rose sharply as of 1 July 2026. The average monthly co-payment in the first year of residence reached 3,364 euros, an increase of 256 euros compared to the same period a year earlier.

Drivers of the cost surge

Rising personnel expenses are the primary factor behind the increase. Vdek chairwoman Ulrike Elsner stated that nursing staff wages have risen significantly and now exceed the sector average. The co-payment covers purely care and support costs, accommodation and meals, facility investment, and training levies. The long-term care insurance only covers a portion of the expenses, unlike the statutory health insurance system.

The salaries of nursing staff have risen sharply in recent years and are now above the sector average.

Wide regional disparities

Costs differ substantially between federal states, driven by varying wage levels and state investment policies. Bremen recorded the highest average monthly co-payment at 3,761 euros, followed by Saarland at 3,695 euros and Baden-Württemberg at 3,657 euros. Hamburg residents paid 3,481 euros, an over-average increase of 302 euros year-on-year. Hesse reached 3,431 euros, while Rhineland-Palatinate came in slightly below the national average at 3,289 euros. At the lower end, Schleswig-Holstein residents paid 3,148 euros and Mecklenburg-Western Pomerania recorded 3,032 euros, although its 280-euro rise exceeded the national average. Saxony-Anhalt had the lowest burden at 2,891 euros per month.

How duration reduces the burden

The total co-payment decreases with length of stay due to relief supplements from the care insurance funds. The personal share for pure nursing care is reduced by 15 percent in the first year, 30 percent in the second, 50 percent in the third, and 75 percent from the fourth year onward. Even with the maximum supplement from year four, residents in Baden-Württemberg still pay an average of 2,216 euros, those in Saarland pay 2,389 euros, and those in Hesse pay 2,091 euros per month.

Calls for reform and state responsibility

The vdek is urging federal states to fully cover investment and training costs, arguing that this would relieve residents by around 650 euros per month. Current rules also require adult children earning more than 100,000 euros gross annually to contribute to financing, a regulation under active discussion within the coalition government. Should residents be unable to pay, they may be eligible for state assistance under specific conditions.

Investment costs are a matter for the states and must finally be borne by them in full.