Financing Long-Term Care in Germany

In 1995, after many years of public discussion dating back to the 1970s, mandatory social long-term care insurance (SLTCI) was implemented in Germany as the fifth pillar of the social security system. Prior to the introduction of mandatory SLTCI, acute care was covered by the mandatory health insurance programme while expenditures for long-term care (LTC) coverage were covered by the private income or private savings of the LTC-dependent individual or the individual’s family. If these were exhausted, individuals in need of care could then apply for public welfare. These payments, however, were provided only for those identified as ‘needy’ by a community-based means-tested programme (Hilfe zur Pflege) under the aegis of Germany’s social assistance programmes.