Monthly out-of-pocket costs for nursing homes in Germany have risen further at the start of 2026. According to AOK and vdek data, the national average in the first year is around 3200 to 3245 euros. Insurers' associations are calling for reform to limit the burden.
The costs for a place in a nursing home are increasingly burdening those in need of care and their families. Between June and December 2025, the average out-of-pocket contribution in the first year of stay rose by 112 euros to 3204 euros monthly, according to AOK-Bundesverband figures. Including long-term care insurance payments, the total monthly cost exceeds 5000 euros for the first time, specifically 5033 euros – up from 4715 euros at the end of 2024.
The Association of Substitute Health Funds (vdek) reports a national average of 3245 euros for January 2026 in the first year, 137 euros more than in July 2025 and 261 euros higher than in January 2025. Regional differences are significant: Highest out-of-pocket costs in North Rhine-Westphalia at 3528 euros (AOK) or Bremen at 3637 euros (vdek), lowest in Saxony-Anhalt at 2661 or 2720 euros. In Saxony, costs are 2986 euros (up 266 euros from the previous year), in Hamburg 3284 euros (up 105 euros since July 2025), in Bavaria 3196 euros, and in Lower Saxony 2903 euros.
Out-of-pocket contributions cover accommodation costs, investments, and parts of care. They decrease with longer stays due to insurance subsidies: In the second year to 2914 euros (AOK), third year to 2528 euros, and from the fourth year to 2044 euros. AOK chief Carola Reimann urges Federal Health Minister Nina Warken (CDU) to use the planned care reform: "In the context of the upcoming care reform, various levers must be adjusted to effectively limit the co-payments of those in need of care in full inpatient facilities." She criticizes that residents compensate for states' failures in investments and demands excluding training costs – a relief of one billion euros.
Similarly, vdek board chair Ulrike Elsner appeals: "We call on the federal states to finally take over these costs." In Lower Saxony, association head Hanno Kummer suggests that the state cover building and training costs to save more than 600 euros per month. The black-red coalition plans a fundamental reform of care financing this year.
