Choosing a home care service in Germany: a 20-question checklist for the first meeting

To find the right home care service (ambulanter Pflegedienst) in Germany, contact two or three approved services near you and compare them against fixed criteria: approval with a care contract with the funds, service area and free capacity, visit times, cost estimate and care contract. Only an approved service can bill benefits in kind (Pflegesachleistung) directly to care insurance; from care grade 2 these are €796, €1,497, €1,859 or €2,299 a month. The 20 questions below will help you in the first meeting. You can find services in your city in our home care directory.

Step 1: find approved services nearby

Home care services need a care contract with the care insurance funds (Versorgungsvertrag) to bill benefits in kind. For medical treatment care (Behandlungspflege), such as giving medication or changing dressings on a doctor’s prescription, a contract with the health insurance funds is also needed. Your care insurance fund can give you a list of approved services.

Check the service area early. Many services only cover certain districts or towns because travel times would otherwise be too long. Ask directly whether they have capacity at the moment, as home care services are very busy in many regions. Allow some time and contact several services in parallel.

Step 2: first meeting and care needs

In the first meeting, often at your home, the service assesses what help is needed: personal care, help with dressing, mobility, nutrition, housework or supervision. Have these ready:

• the care grade decision, if available
• the assessment report from the Medical Service (Medizinischer Dienst)
• doctor’s prescriptions for treatment care
• the medication plan
• preferred times and frequency of visits

If there is no care grade yet, apply as soon as possible, because benefits are paid from the month of application. See applying for a care grade.

Step 3: check the cost estimate

Before you sign the contract and with every significant change, the service generally has to inform you in writing about the expected costs (§ 120(3) SGB XI). Ask for each service to be listed with its price and compare how much care insurance will cover.

Care grade	Benefits in kind per month	Note
1	none	Relief amount of €131 a month can be used
2	up to €796	Rest paid privately
3	up to €1,497	Rest paid privately
4	up to €1,859	Rest paid privately
5	up to €2,299	Rest paid privately

If you do not use the full benefits-in-kind amount, you receive a proportional care allowance; see benefits in kind and the combination benefit. For prices and personal contributions, read how much a home care service costs.

Step 4: sign the care contract

The service must conclude a written care contract (Pflegevertrag) with you no later than the start of the first visit (§ 120 SGB XI). It sets out the type, content and scope of services and the agreed fees, each listed separately. Important for you:

• As the person receiving care, you can terminate the contract at any time without notice.
• If your condition changes significantly, the service must notify the care insurance fund without delay.
• Keep a copy of the contract and the records of services provided.

The rule is set out in the legal text of § 120 SGB XI (in German).

Quality: what to look for

Approved home care services are inspected regularly by the Medical Service, or for privately insured people by the private care insurance’s inspection service. Ask the service for its latest inspection report. Often, though, your personal impression tells you more than any rating: how easy is the service to reach, how clearly does it explain things and how does it handle your questions?

Checklist: 20 questions for the home care service

Approval and organisation

1. Do you have a care contract with the care insurance funds?
2. Do you also have a contract with the health insurance funds for treatment care?
3. Is our address within your service area?
4. Do you have capacity now, and when could you start?
5. How can we reach you, including at night, at weekends and on public holidays?
6. Will we have a fixed contact person or care manager?

Visits and staff

7. At what times will visits take place, and how reliable are they?
8. How large is the team that will visit us, and how often does it change?
9. What qualifications do staff have for the planned services?
10. How will we be told if a visit is moved or cancelled?
11. Can you add visits at short notice if needed?
12. Are there staff who speak English or another language, if that matters to us?

Costs and contract

13. Will we receive a written cost estimate with individual prices?
14. What share will care insurance probably cover, and what will we pay?
15. Are there other costs, for example travel or investment costs?
16. Can you bill via the relief amount (Entlastungsbetrag)?
17. What are the rules on termination and price changes?

Care and cooperation

18. How is care documented, and can we see the records?
19. How do you work with the GP, pharmacy and relatives?
20. Do you also offer advisory visits for people receiving the care allowance?

Write down the answers for each service on a separate sheet so you can see the differences quickly.

Common mistakes

• Asking only one service: when capacity is tight, you lose time if you only keep searching after a refusal.
• Signing without a cost estimate: unclear personal contributions cause surprises later.
• Not applying for a care grade: without one, you pay for care services in full yourself.
• Not using advice: you are entitled to free care advice, which can help with the search.

More articles are in our care at home section. This guide does not replace legal advice.