Private substitute caregiver: Your comprehensive guide to eligibility, costs, and application
3 Apr 2025
4
Minutes
Katrin Straub
CEO at nextsure
Family caregivers provide indispensable support every day, but what happens if they are unable to continue? A private substitute caregiver steps in to ensure continued care. This article explains everything you need to know about what is known as respite care.
The topic in brief and concise terms
Replacement care (preventive care) ensures continued care when the main caregiver is unavailable for up to six weeks annually, with up to €1,612 (plus €806 from short-term care).
Requirements are care level two and six months of preliminary care time (the latter will be waived from July 2025).
From July 2025, there will be a combined relief budget for respite and short-term care, estimated at €3,539.
Understanding the basics of substitute care and categorizing it correctly
The substitute care, officially known as respite care, is a benefit of the care insurance. It steps in when the primary private caregiver is temporarily unavailable. Reasons can include a six-week holiday or an acute illness. In such cases, the care fund covers the costs for a replacement. This service ensures continuous care at home. It is an important pillar of the care insurance.
Substitute care can be arranged on an hourly, daily, or weekly basis. It is intended for those in need of care from care level two onwards. The care fund reimburses up to €1,612 annually for substitute care. This amount can be topped up with unused funds from short-term care. Many are unaware that this can make up to €2,418 available. The regulations are found in § 39 SGB XI.
Check and meet eligibility requirements for substitute care
A claim for replacement care is available from care level two. The person in need of care must have been cared for at home for at least six months beforehand. This so-called pre-care period is a central requirement. From the first of July 2025, this six-month period will be abolished. Then the entitlement will apply directly from the determination of care level two. This is an important change in the care system.
The main caregiver must be registered with the care fund. A change of caregiver within the six-month pre-care period is possible. Replacement care can be provided by professional services or private individuals. Close relatives can also take over the representation. Please note the different reimbursement rates for relatives. A supplementary care insurance can fill gaps here.
There are already some relaxations for young people in need of care. Persons under 25 years of age with care level four or five have special regulations. They can use replacement care for up to eight weeks. The six-month pre-care period is already waived for this group. The care allowance is continued at half the rate during the replacement care for up to eight weeks.
Making the most of financial benefits for substitute care
The care fund regularly provides up to €1,612 per calendar year for replacement care. This amount applies to those in care levels two to five. This amount can be significantly increased through clever combinations. Up to €806 from unused funds for short-term care can also be used. Thus, up to €2,418 is available to you for replacement care. Find out more about short-term care services.
If replacement care is provided by close relatives (up to the second degree by blood or marriage) or persons in the same household, different rates apply. Here, the fund reimburses a maximum of 1.5 times the monthly care allowance for up to six weeks. From 1 July 2025, this rate will increase to twice the amount of the care allowance. Verified additional expenses such as travel costs (often €0.20 per kilometre) or loss of earnings can increase the amount to €1,612.
During replacement care, half of the care allowance continues to be paid for up to six weeks. Under the special regulation for young people under 25 with care level four or five, it is up to eight weeks. Applications can be made retroactively for up to four years. A government-subsidised care insurance can provide additional security.
Select and commission an appropriate private substitute caregiver
Choosing a substitute caregiver is an important decision. You can hire professional nursing services. These often settle directly with the care fund. Alternatively, private individuals can take over the care. These can be neighbours, friends or distant relatives. The hourly wage for private carers can range between five and 25 euros.
The following individuals can act as substitute caregivers:
Outpatient nursing services with qualified personnel.
Individual caregivers providing hourly support.
Voluntary carers from neighbourhood help.
Friends or acquaintances of the family.
Relatives who are not related up to the second degree receive the full rate.
Close relatives (parents, children, siblings, grandchildren, grandparents) with adjusted rates.
Clarify the extent of the required services in advance. This includes basic care, domestic help and supervision. Medical treatment care is not part of the substitute care. This must be prescribed by a doctor and carried out by professionals. Consider a private health insurance for comprehensive protection.
Expert knowledge: Leveraging legal nuances and design tips
Section 39 of the SGB XI forms the legal basis for respite care. It details claims, duration, and the amount of benefits. The care fund covers proven costs for up to a maximum of six weeks per calendar year. For those under 25 years old with care level four or five, it extends to up to eight weeks. The prior care period of six months is not required in this case.
Our expert tip: Respite care for less than eight hours per day does not count towards the 42 days. You can take regular short breaks without affecting the daily allowance. The budget of €1,612 (or €1,685 according to some funds) is also available for this purpose. You should carefully collect evidence for expenses. Consultation with your care fund or a care centre can clear up uncertainties. For self-employed individuals, the topic of sickness benefits is also relevant.
Consider the tax aspects. Income from respite care is generally considered income. For close relatives or if fulfilling a moral duty, it can be tax-free. This applies as long as the income does not exceed the care allowance of the person in need of care. A precise assessment with a tax advisor is advisable here.
Future-proof planning: The joint relief budget from 2025
A significant change will come into effect on the first of July 2025. The benefit amounts for respite care and short-term care will be combined. This will create a joint annual amount, the so-called relief budget. This budget is expected to be 3,539 euros. Care recipients from care level two can use this amount flexibly.
The advantages of the new relief budget are:
More flexibility: Freedom to choose between respite care and short-term care.
Less bureaucracy: Only one overall budget to manage.
Elimination of previous care period: Entitlement to respite care directly from care level two.
Simplified use for all care recipients from care level two.
This new regulation significantly simplifies the utilisation process. It offers more scope for individual care situations. For care recipients under 25 years with care level four or five, this regulation has partially applied since the first of January 2024. They can already use 100 percent of short-term care funds for respite care. Make sure you inform yourself early about the details to be optimally prepared. A good additional care insurance remains an important complement nevertheless.
Let us review your individual situation free of charge. We at nextsure can help you find the right insurance solutions. Request your individual risk analysis now and receive concrete optimisation suggestions.
More useful links
The Bundesgesundheitsministerium offers detailed information on respite care.
gesund.bund.de provides comprehensive information on respite care.
Wikipedia offers a comprehensive article on nursing insurance in Germany.
The Statistische Bundesamt (Destatis) provides up-to-date statistics on nursing in Germany.
The Pflegenetzwerk Deutschland provides information on respite care and holiday cover.
Further information on home care can be found at the Bundesgesundheitsministerium.
FAQ
Who is entitled to a private replacement carer?
People in need of care are entitled from care level two onwards, if their main private caregiver (e.g. due to vacation or illness) is temporarily unavailable and they have been cared for at home for at least six months beforehand (the prior care period is eliminated from 01.07.2025).
What are the benefits for a private substitute caregiver?
The care fund covers up to €1,612 per calendar year. This amount can be increased by up to €806 from unused short-term care funds, making a total of up to €2,418.
How long can I use a private replacement caregiver?
The benefit is granted for a maximum of six weeks (42 days) per calendar year. For individuals under 25 years of age with care level four or five, it can be up to eight weeks.
What happens to the care allowance during substitute care?
During the period of substitute care, half of the previously received care allowance will continue to be paid for up to six weeks (or eight weeks for the specific group of young adults).
Can relatives also take over the respite care?
Yes, close relatives (up to the second degree) or people living in the household can also take over the substitute care. The benefit is then limited to 1.5 times the care allowance (double the amount from 01.07.2025), but it can be increased to up to 1,612 euros by proving additional expenses (e.g., travel costs, loss of earnings).
What is the new relief budget from 2025?
From 01/07/2025, the funds for respite care and short-term care will be combined into a joint annual amount (relief budget) of approximately €3,539. This can be flexibly used for both types of services, and the initial care period requirement for respite care will be eliminated.
