An elderly mother with her daughter
Age & care
09.11.2026 Gabriele Strasser 20720

How Do I Apply for a Care Level? A Step-by-Step Guide

People in need of long-term care may be eligible for benefits under the long-term care insurance program. 
In this article, we’ll walk you through all the necessary steps for applying for a long-term care level—from making initial contact to the visit by the medical service, and including how to file an appeal if your application is denied or your long-term care level is lower than expected.

Read more in this article:


What is a care level?

A care level is the official classification used to assess the extent to which a person in need of care is limited in their ability to perform daily activities and to determine whether this qualifies them for a care level and, consequently, entitlement to benefits. There are five care levels in total, and different benefits may be available depending on the care level. 

Applying for a Care Level – The Steps

  1. Contact your long-term care insurance provider
  2. Fill out the application
  3. The Medical Service schedules an evaluation appointment
  4. Preparing for the Medical Service's Evaluation
  5. Schedule an appointment with the Medical Service
  6. Review the decision and file an appeal if necessary 

Who can apply for a care level—and what are the requirements?

The following individuals may apply to the long-term care insurance program for a long-term care level: 

  • The person in need of care
  • A family member or a trusted individual (with written power of attorney or a durable power of attorney if the family member is unable to sign the application personally)
  • Legal Guardians

The requirement is that the individual must have been covered by social long-term care insurance for at least 2 years during the 10 years prior to filing the application—family coverage may also count toward this period.

In addition, the impairments are expected to last for at least 6 months. 

The diagnosis is rarely the deciding factor in determining a care level. What matters to the long-term care insurance provider is how the limitations affect the person in need of care in their daily life.

Where and how do I apply for a long-term care level?

Individuals with statutory health insurance must submit an application for a long-term care level to the long-term care insurance fund associated with their health insurance provider or that of their family member. They can submit the application by phone, in writing, or using a form provided by the long-term care insurance fund.

It is recommended that you submit the request in writing, as this will allow you to prove when it was submitted.

Important Information:

  • Name and date of birth of the individual concerned
  • Insurance Number
  •  Explicit request to receive nursing care services
  • Signature (of the person requiring care or the authorized representative)

Make a note of the date you submitted the application and, if necessary, keep a copy of the letter.
After you contact them, you will receive the application form from the long-term care insurance fund. On this form, you should describe your need for assistance in daily life as specifically as possible. If you are acting on behalf of another person, clarify whether a power of attorney or other proof of authorization is required.
Privately insured individuals should submit the application to their private insurance company. 

"Since eligibility for benefits is determined by the date the application is submitted, it makes sense to submit the application immediately."
Jürgen Griesbeck, Product Manager for Homecare and Eldercare

As a general rule, a decision on an application for a long-term care level must be made within 25 business days, although exceptions provided for by law are possible.

How do I prepare for the medical examination by the Medical Service?

Next, the long-term care insurance fund sends a confirmation of receipt and schedules an assessment appointment with the Medical Service. 

During this appointment, which usually takes the form of a home visit, an assessment is made of how independently a person can manage their daily life and in what areas they need assistance.
The typical procedure: 

  • Interview: The evaluator asks questions about the individual areas of evaluation
  • Home tour to assess existing barriers or the use of assistive devices
  • Consultation: Initial recommendations, e.g., regarding assistive devices or rehabilitation measures

The Medical Service’s assessment serves as the basis for the long-term care insurance provider’s decision regarding whether the person in need of care will receive benefits and, if so, which ones. Family members and the person in need of care should prepare thoroughly for this appointment (which must be scheduled well in advance): 

  • Before your visit, keep a care log for several days: Where and how often is help needed, and what can the person do on their own? 
  • Talk to your family member about his or her need for assistance in daily life. 
  • Please have documents such as reports from your primary care physician or specialists,
    discharge summaries from hospitals, and medication schedules ready.

To ensure that the Medical Service gains as complete a picture as possible of the person’s daily life during the visit, it is essential that the person have a trusted individual present. This person can serve as a reminder and provide specific examples of the support the person has already received in daily life prior to submitting the application.  


 

"A lot depends on the visit from the Medical Service. It’s important to realistically demonstrate the need for assistance in everyday life and neither downplay nor exaggerate the situation."
Jürgen Griesbeck, Product Manager for Home Care and Elder Care

What does the Medical Service evaluate during the care level assessment?
 

The Medical Service assesses how independently the person in need of care can manage daily life and where they regularly require assistance. In other words, the decisive factor is always how independently the person in question can handle specific everyday situations.
The assessment focuses primarily on six areas where assistance is deemed necessary:

  • Mobility 
  • Cognitive and communicative skills
  • Behavior and Psychological Stress
  • Self-sufficiency
  • Dealing with Requirements Related to Illness and Treatment
  • Daily Life and Social Interactions

The areas are evaluated according to established criteria and then combined on a weighted basis. 

Was your care level denied or deemed too low? Here's how to file an appeal

Please read the decision and the information on legal remedies carefully. If you agree with the decision, the next step is to select and arrange the appropriate services.  

If the application is denied or if the care level is lower than expected, individuals in need of care and their family members may file an appeal against the decision within one month. 

  • Ask for a reason for the rejection and use this to formulate your objection.
  • The long-term care insurance fund reviews the appeal and sends an assessor again.
  • If the new assessment is positive, you will receive benefits from long-term care insurance retroactively from the date of the first application.
  • If you still haven't been granted a care level, you can submit a new application after a certain amount of time.
  • If your application is rejected again, you may also file a lawsuit with the Social Security Court.
  •  You can file a so-called "deterioration request" if your health status changes significantly and the assigned care level is no longer accurate.

Care Levels for Children and Adolescents: What Are the Specific Considerations?

A care level for children is granted not only for physical and mental disabilities, but also for chronic conditions such as diabetes, as well as rare or life-limiting illnesses. Developmental or behavioral disorders such as autism or ADHD can also be grounds for a care level.

For more information, read our article Children and Adolescents in Need of Care: What to Keep in Mind

Get Good Advice from Homecare-Eldercare

Our expert advisors provide information on legal regulations, offer personalized and tailored advice, assist with decision-making, and connect you with suitable service providers to ensure that you can balance caregiving and work as effectively as possible.

Our team at pme Homecare-Eldercare (Link) is here to assist you online, by phone, and in person. This offer is available to employees of our contract partners.

FAQ: Frequently Asked Questions About Applying for a Long-Term Care Level

Can I submit the application on behalf of a family member?

Yes, family members and trusted individuals may also submit the application; a power of attorney may be required in some cases.

Where do I apply for a long-term care level?

Contact the affected person's long-term care insurance fund. Those with private insurance should contact their insurance company.

Do I have to submit all the documents when I file the application?

No. To submit the application, you only need to provide the most important personal information and indicate your need for long-term care services. You can submit the documents required for the assessment later.

How long will it take to reach a decision?

As a general rule, the long-term care insurance fund must make a decision within 25 business days. Exceptions are possible.

What does the Medical Service examine during the assessment?

The Medical Service assesses how independently the person functions in daily life and where they need assistance.

How do I prepare for the medical examination by the Medical Service?

Record the care needs in a care journal and describe the daily situation realistically.

What can I do if my application is denied or if my care level is too low?

You have one month to file an appeal. Please observe the deadline and follow the instructions in the notice.

What should I do if my health gets worse?

If your need for care has increased significantly, you can file a claim for a reassessment with the long-term care insurance fund.

This YouTube content can only be loaded if you accept the privacy policy of Google LLC.

To the data protection settings "

zero "Mental Health First Aid" Best Practice at the Hesse Ministry of Justice

Marc-Eric Peter, Ministry of Justice of Hesse
01.06.2026 Christin Müller 4794

Best Practices in the Hesse Judicial System

As a support person for people with severe disabilities at the Hesse State Justice Department, one thing is particularly important to Marc-Eric Peter: he wants to be able to support his colleagues in difficult situations as an equal—especially when emotional distress is involved. That is why he completed the “Mental Health First Aid” training program to become a mental health first responder.

Mental health has been a focus of his for many years, both professionally and personally. When Marc-Eric Peter read about the “Mental Health First Aid” training in the pme newsletter, he knew right away that it was the right fit. He signed up immediately. 


 

In a 12-hour live online training session plus four hours of e-learning, participants work in small groups to learn how to recognize mental health issues early on, better understand the development of mental health conditions such as depression and anxiety disorders, and provide empathetic and appropriate support to affected colleagues.

Support from colleagues plays a particularly important role here—because not everyone feels comfortable bringing their concerns directly to their manager. This makes it all the more valuable when colleagues are approachable on an equal footing.

The “Mental Health First Aid” training program for community leaders was developed specifically for people like him. Through this program, the pme Familienservice trains working professionals to become first responders for mental health emergencies.

The participants will be guided by the two pme seminar leaders, Petra Dinkelacker and Cara Isabella Limburger. 

Health scientist Petra Dinkelacker explains the training program's approach as follows:

"Our goal is for participants to gain confidence in supporting colleagues who are struggling. They need to know: How do I listen, and how can I provide concrete help? Just as with first aid after an accident, the aim is to provide initial support in mental health emergencies—without taking on the role of a psychologist. What’s important is making a sound initial assessment and then referring the person to appropriate support services."

There is a special focus on the participants’ self-care.Life coach Cara Isabella Limburger adds:

"Those who help others must also be able to take care of themselves. That is why the training covers not only communication techniques but also strategies for maintaining one's own mental health."

"Mental Health First Aid" Training: Upcoming Dates​​​​​​​


Cara Isabella Limburger (left) and Petra Dinkelacker (right) lead the "Mental Health First Aid" training course

A plus for the role of confidant

For Marc-Eric Peter, the combination of theoretical expertise, practical examples, and a focus on self-care is a perfect fit for his role as the first point of contact for employees experiencing mental health challenges or health limitations: “This training is a major asset to my work.”

He was impressed not only by the content but also by the way it was presented—the combination of live instruction, group discussion, and supplementary e-learning elements. “I would definitely recommend the training course, if only because of the two excellent instructors and the breadth of the material covered.”

From the workshop to everyday life: Three colleagues supported

The value of the training became particularly clear to Marc-Eric Peter in situations where he was able to immediately apply what he had learned and gain new confidence: “So far, I’ve been able to help three colleagues—one of whom had a situation similar to a case we’d worked on in the seminar.”

What was practiced in the safe environment of the training—listening, sorting, and working together to identify next steps—has directly translated into concrete support for colleagues.

Marc-Eric Peter thus exemplifies the goal of “Mental Health First Aid”: to empower employees so that they can support one another as colleagues in their day-to-day work—in an accessible way and on an equal footing.