German care grade 3: how much money and who qualifies
The most common grade with dementia or after a stroke: what Pflegegrad 3 pays in 2026 and where the line to grades 2 and 4 runs.
Checked by Radif Partners · Editorial policy · How we calculate
What this care grade brings per month in 2026
Benefits per month
€772
| paid to you | €599 |
| services | €0 |
| per year incl. annual budget | €12,803 |
Care grade 3 (Pflegegrad 3) applies when the Medical Service assessment produces between 47.5 and just under 70 points, which the law describes as severe limitations of independence (section 15(3) of Book XI of the Social Code). In 2026 the long-term care fund (Pflegekasse) pays €599 a month in care allowance if the family does the caring, or up to €1,497 of services from a registered home care provider. Mixing both reduces the allowance in proportion: a care service billing €750 uses 50.1 % of the services budget and leaves €298.90 of allowance. On top come the €131 relief amount, consumable care aids up to €42, day care up to €1,357 as a separate budget and the joint annual budget of €3,539 for respite and short-term care. With family care only, that adds up to €12,803 a year, of which €7,188 is paid out as money.
What grade 3 means in the assessment
Grade 3 sits in the middle of the scale. In daily life it usually means the person manages with help but rarely gets through a morning without someone supporting them in the shower, preparing tablets, reminding them to drink or checking on them at night. In the Medical Service (Medizinischer Dienst) report this shows up as 47.5 to just under 70 points.
How the points add up matters. Self-care (module 4) weighs 40 percent; band 3 there already gives 30 points. Modules 2 and 3 are not added together: only the higher one counts, so with dementia it is often the behaviour score in module 3, not memory in module 2, that decides. Mobility weighs only 10 percent, which is why a wheelchair on its own rarely leads beyond grade 2. You can check a case against every criterion with the care grade calculator.
| Module | Weight | Weighted points for bands 0 to 4 |
|---|---|---|
| 1 Mobility | 10 % | 0 · 2.5 · 5 · 7.5 · 10 |
| 2 or 3 Cognition or behaviour (higher value) | 15 % | 0 · 3.75 · 7.5 · 11.25 · 15 |
| 4 Self-care | 40 % | 0 · 10 · 20 · 30 · 40 |
| 5 Illness and treatment | 20 % | 0 · 5 · 10 · 15 · 20 |
| 6 Daily life and contact | 15 % | 0 · 3.75 · 7.5 · 11.25 · 15 |
A typical path to grade 3: self-care in band 2 (20 points), behaviour in band 4 (15), illness management in band 2 (10), daily life in band 3 (11.25) and mobility in band 2 (5) make 61.25. Without the restlessness in module 3 the same person drops to 57.5 and stays at grade 3; take away the help with showering as well and the total falls below 47.5.
The money each month
- Care allowance (Pflegegeld): €599 when relatives, friends or neighbours provide the care (section 37 SGB XI).
- Services in kind (Sachleistung): up to €1,497 for a registered home care service that bills the fund directly (section 36 SGB XI).
- Combined benefit: the allowance falls by the share of the services budget used (section 38 SGB XI). A €750 bill uses 50.1 % and leaves €298.90; the combined benefit calculator works it out for your bill.
Separately there are budgets paid against receipts: the relief amount of €131, care aids up to €42 and day care up to €1,357. Day care does not reduce the allowance. Two days a week at a day centre give the main carer real relief, which matters a great deal if that carer is also working or travelling between countries.
How much allowance is left next to a care service
Allowance per month
€358.92
| Services budget used | 40.1 % |
| full allowance | €599 |
| you pay | €0 |
Over a year
| Benefit at grade 3 | Month | Year |
|---|---|---|
| Care allowance (family care only) | €599 | €7,188 |
| Relief amount | €131 | €1,572 |
| Consumable care aids | €42 | €504 |
| Respite and short-term care | – | €3,539 |
| Total | €772 | €12,803 |
The joint annual budget of €3,539 is the largest item after the allowance and the one most often left unused (section 42a SGB XI). It pays for a replacement carer while the main carer is on holiday or ill, and for a temporary bed in a care facility. During that time half the allowance continues, just under €300 a month at grade 3. Plan it with the respite and short-term care calculator.
Grade 3 in a care home
In a home the allowance stops. The fund pays €1,319 to the home plus a supplement on the care co-payment. Within one home the co-payment is the same for grades 2 to 5, so a higher grade makes the home more expensive for the fund, not for the family. The national average co-payment in the first year was €3,364 a month (vdek, 1 July 2026). The care home calculator shows it for each state.
If the decision looks wrong
Families who expect grade 3 often first receive grade 2, because help that is really needed was scored as independent: reminders to drink, sorting out clothes, night-time restlessness that did not happen on the day of the visit. You have one month to object. A two-week care diary listing every intervention with the time is the strongest evidence. If the condition got worse later, file a request for a higher grade instead.
For the carer
At grade 3 the fund pays pension contributions for a relative who cares at least ten hours a week over two days; with allowance only, one year adds €16.71 of monthly pension (carer pension calculator). A relative who takes no money for caring can claim the carer’s tax lump sum of €1,100 on a German tax return.