Private replacement carer: Your comprehensive guide to entitlement, costs, and application
3 Apr 2025
Katrin Straub
Managing Director at nextsure
Family carers provide invaluable service every day, but what happens if they are unable to perform their duties? 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 care in the absence of the primary caregiver for up to six weeks annually, with up to €1,612 (plus €806 from short-term care).
Requirements include care level two and six months of preliminary care (the latter will be omitted from July 2025).
From July 2025, there will be a joint relief budget for respite and short-term care, estimated at €3,539.
Understanding the basics of substitute care and categorising them correctly
Substitute care, officially known as respite care, is a benefit provided by the nursing care insurance. It steps in when the main private caregiver is temporarily unavailable. The reasons could be a six-week holiday or an acute illness. The care insurance fund then covers the cost of a replacement. This service ensures continuous home care. It is an important pillar of the nursing care insurance.
Substitute care can be provided on an hourly, daily, or weekly basis. It is intended for those in need of care from care level two. The care insurance fund reimburses up to €1,612 annually for substitute care. This amount can be increased with unused short-term care funds. Many are unaware that up to €2,418 can be available. The regulations are found in § 39 SGB XI.
Check and meet the prerequisites for substitute care
An entitlement to substitute 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 in advance. This so-called preliminary care period is a key condition. From the first of July 2025, this six-month period will no longer apply. Then, the entitlement will be directly granted from the determination of care level two. This is an important change in the care system.
The primary carer must be registered with the care insurance fund. A change of carer within the six-month preliminary care period is possible. Substitute care can be provided by professional services or private individuals. Close relatives can also take over the representation. Note the different reimbursement rates for relatives. A supplementary care insurance can fill gaps here.
For young people in need of care, there are already facilitations. Persons under 25 years of age with care level four or five have special regulations. They can use substitute care for up to eight weeks. The six-month preliminary care period does not apply to this group already. The care allowance continues to be paid at half during substitute care for up to eight weeks.
Make the most of financial benefits from substitute care
The care insurance fund regularly provides up to 1,612 euros per calendar year for respite care. This amount applies to those in care levels two to five. This amount can be significantly increased through clever combinations. Up to 806 euros from unused short-term care funds can also be utilised. This gives you up to 2,418 euros available for respite care. Find out more about short-term care benefits.
If respite care is provided by close relatives (up to second-degree kinship) or individuals 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 the first of July 2025, this rate will increase to twice the care allowance amount. Verified additional expenditures such as travel costs (often 0.20 euros per kilometre) or loss of earnings can raise the amount up to 1,612 euros.
During the respite care period, half of the care allowance continues to be paid for up to six weeks. Under special arrangements for young people under 25 with care grades four or five, this extends to up to eight weeks. Applications can be submitted retroactively for up to four years. A state-supported care insurance can offer additional security.
Select and commission a suitable private replacement caregiver
Choosing a replacement caregiver is an important decision. You can hire professional nursing services, which often settle directly with the care insurance fund. Alternatively, private individuals can take on the care, which could be neighbors, friends, or distant relatives. The hourly wage for private caregivers can range between five and 25 euros.
The following individuals can act as replacement caregivers:
Outpatient care services with qualified staff.
Individual caregivers providing support on an hourly basis.
Volunteers from neighborhood assistance programs.
Family friends or acquaintances.
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 scope of required services in advance. This includes basic care, household help, and supervision. Medical treatment care is not part of replacement care. It must be prescribed by a doctor and carried out by professionals. Consider a private health insurance for comprehensive protection.
Future-proof planning: The joint relief budget from 2025
A significant change will take effect on 1st July 2025. The benefit amounts for respite care and short-term care will be combined. A joint annual amount, the so-called relief budget, will be created. This budget is expected to be 3,539 euros. Care recipients from care level two will be able to use this amount flexibly.
The benefits of the new relief budget include:
More flexibility: Free choice between respite care and short-term care.
Less bureaucracy: Only one total budget to manage.
Elimination of the pre-care period: Entitlement to respite care starts directly from care level two.
Simplified use for all care recipients from care level two onwards.
This new regulation significantly simplifies access. It offers more flexibility for individual care situations. For caregivers under 25 years old with care level four or five, this regulation has been partially in place since 1st January 2024. They can already use 100% of the short-term care funds for respite care. Make sure to get informed early about the details to be optimally prepared. A good supplementary care insurance remains an important addition nonetheless.
Let us review your individual situation free of charge. We at nextsure will help you find the right insurance solutions. Request your individual risk analysis now and receive concrete optimization suggestions.
More useful links
The Bundesgesundheitsministerium provides detailed information on respite care.
gesund.bund.de offers comprehensive information on respite care.
Wikipedia provides a comprehensive article on long-term care insurance in Germany.
The Statistical Office (Destatis) delivers up-to-date statistics on care in Germany.
The Pflegenetzwerk Deutschland provides information on respite care and holiday cover.
You can find more information on home care at the Bundesgesundheitsministerium.
FAQ
Wer hat Anspruch auf eine private Ersatzpflegekraft?
Anspruch haben Pflegebedürftige ab Pflegegrad zwei, deren private Hauptpflegeperson (z.B. wegen Urlaub oder Krankheit) vorübergehend ausfällt und die zuvor mindestens sechs Monate zu Hause gepflegt wurden (Vorpflegezeit entfällt ab 01.07.2025).
Wie hoch sind die Leistungen für eine private Ersatzpflegekraft?
Die Pflegekasse übernimmt bis zu 1.612 Euro pro Kalenderjahr. Dieser Betrag kann um bis zu 806 Euro aus nicht genutzten Mitteln der Kurzzeitpflege aufgestockt werden, also insgesamt bis zu 2.418 Euro.
Wie lange kann ich eine private Ersatzpflegekraft in Anspruch nehmen?
Die Leistung wird für längstens sechs Wochen (42 Tage) pro Kalenderjahr gewährt. Für Pflegebedürftige unter 25 Jahren mit Pflegegrad vier oder fünf sind es bis zu acht Wochen.
Was passiert mit dem Pflegegeld während der Ersatzpflege?
Während der Inanspruchnahme der Ersatzpflege wird die Hälfte des bisher bezogenen Pflegegeldes für bis zu sechs Wochen (bzw. acht Wochen für die spezielle Gruppe junger Erwachsener) weitergezahlt.
Können auch Verwandte die Ersatzpflege übernehmen?
Ja, auch nahe Verwandte (bis zum zweiten Grad) oder im Haushalt lebende Personen können die Ersatzpflege übernehmen. Die Leistung ist dann auf den 1,5-fachen Betrag des Pflegegeldes begrenzt (ab 01.07.2025 zweifacher Betrag), kann aber durch Nachweis von Mehraufwendungen (z.B. Fahrkosten, Verdienstausfall) bis auf 1.612 Euro aufgestockt werden.
Was ist das neue Entlastungsbudget ab 2025?
Ab dem 01.07.2025 werden die Mittel für Verhinderungspflege und Kurzzeitpflege zu einem gemeinsamen Jahresbetrag (Entlastungsbudget) von voraussichtlich 3.539 Euro zusammengelegt. Dieses kann flexibel für beide Leistungsarten genutzt werden, und die Vorpflegezeit für die Verhinderungspflege entfällt.
