Nursing Home Cost in Germany: EUR 3,364/Month Out of Pocket

Long-term care is the health cost most likely to outlive a pension. It is also the one that varies most between countries, and the one that published price comparisons cover worst.

Search for what a nursing home costs and the results are almost entirely American, listed state by state. The question a person actually has is different. Can a pension carry the bill, and does the answer change across a border? That is answered in two places. One OECD study, and a handful of national figures nobody sets beside each other.

What the OECD actually found

The OECD published Is Care Affordable for Older People? in October 2024. Its headline result is a ratio rather than a price.

Out-of-pocket long-term care costs come to about 70% of an older person's median income, averaged across the OECD.¹² Publicly funded care systems still leave almost half of older people with care needs at risk of poverty.¹ Demand for that care is projected to rise by more than a third by 2050.¹

The detailed country work sits in an earlier OECD study, published in May 2020, covering 26 countries and subnational areas.³ Its central measurement is stark. Before any public support, the total cost of long-term care runs between half and five times the median disposable income of people of retirement age.³

Even a light care package fails that test. Six and a half hours of home care a week is the OECD's definition of low needs. That alone would cost more than half the disposable income of an older person on a low income.³

Public support changes the answer, and not evenly

Public coverage is what separates one country's pensioner from another's, and the OECD found the gap is wide.

Finland, Iceland, the Netherlands, Sweden and Luxembourg meet almost the full cost of home care, and do so regardless of the recipient's income.³ At the other end, in Tallinn and in Croatia, public support for an older person with low needs and a median income covers close to nothing.³

After public support is counted, out-of-pocket costs for severe home-care needs still exceed half the median older person's income in six places. They are the Czech Republic, Korea, Lithuania, Spain, and the American states of Illinois and California.³ For residential care the list is shorter: the Czech Republic, Tallinn, Illinois and California.³

The safety nets are not reliably catching people either. Thirteen countries set an income threshold below which more public support applies, and in ten of them that threshold sits far below the national relative poverty line.³

What the national figures look like now

Two countries publish current numbers a reader can check, and they are not comparable without care.

Germany's association of substitute health insurers, the Verband der Ersatzkassen, reported figures as of 1 July 2026. A resident in their first year in a nursing home pays an average of EUR 3,364 a month from their own pocket.⁴ That is EUR 256 more than a year earlier. The range runs from EUR 2,891 in Saxony-Anhalt to EUR 3,761 in Bremen.⁴

In England, Age UK puts a care home place at around GBP 1,100 a week and a nursing home place at around GBP 1,450.⁵ Anyone with capital above GBP 23,250 pays the whole amount themselves.⁵

The German figure is a national average contribution, after statutory insurance pays its share. The English figure is a gross weekly price, before any means test. They measure different things. That is exactly why a raw price comparison misleads.

What the headline numbers leave out

Spending shares disagree between sources. The A-Mark Foundation puts Dutch long-term care spending at 4.4% of GDP in 2021 and British spending at 2.6%.⁶ KFF Health News, using OECD data for the same year, gives 4.1% and 1.8%.⁷ Countries report long-term care differently, and which services get counted moves the number.⁶

Netherlands4.4% of GDP

Norway3.5% of GDP

Sweden3.4% of GDP

Denmark3.2% of GDP

United Kingdom2.6% of GDP

France2.6% of GDP

Germany2.5% of GDP

Japan2.2% of GDP

OECD average1.8% of GDP

United States1.3% of GDP

Luxembourg1.3% of GDP

Korea1.1% of GDP

Figures as compiled by the A-Mark Foundation from OECD data for 2021. Countries report long-term care differently, and other compilations of the same OECD data give different values: KFF Health News puts the Netherlands at 4.1% and the United Kingdom at 1.8% for the same year.

Source: note 6

Show the numbers

Item	Value
Netherlands	4.4% of GDP
Norway	3.5% of GDP
Sweden	3.4% of GDP
Denmark	3.2% of GDP
United Kingdom	2.6% of GDP
France	2.6% of GDP
Germany	2.5% of GDP
Japan	2.2% of GDP
OECD average	1.8% of GDP
United States	1.3% of GDP
Luxembourg	1.3% of GDP
Korea	1.1% of GDP

The detailed country ranking is dated. The per-country findings above come from the 2020 OECD study, priced mostly in 2016.³ The 2024 report updates the headline but its country tables are behind a paywall this article could not open.

A high spender is not automatically a cheap place to grow old. The Netherlands spends the most, and charges residents about 7% of the cost of institutional care.⁷ Japan spends about 2% of GDP. It asks older adults for 10% to 30% of the cost, depending on income.⁷ Spending share and personal exposure are different measurements.

None of this is priced for a foreigner. Every figure here describes what a resident with local entitlement pays. Someone retiring abroad may have neither the insurance record nor the means-test standing that these numbers assume.

How to use this before you plan

Ask for the out-of-pocket share, not the price. The useful question is what proportion of the bill the public system pays for someone with your income and residency status. It has a different answer in every country.

Check the entitlement clock before the price list. German statutory long-term care insurance and English means-tested support both depend on records a recent arrival will not have.

And treat the OECD's 70% as the planning figure rather than any single national price.¹ It is the only number here that describes the thing that actually matters, which is how much of an ordinary older income a care bill consumes.

Footnotes

1. https://eurocarers.org/oecd-is-care-affordable-for-older-people/ — Eurocarers, "OECD - Is Care Affordable for Older People?" (published Oct 31, 2024), reporting findings from the OECD report of the same name. Accessed Sep 23, 2026. ↩ ↩² ↩³ ↩⁴ ↩⁵

2. https://www.pensionpolicyinternational.com/is-care-affordable-for-older-people/ — Pension Policy International, "Is Care Affordable for Older People?", reporting findings from the OECD report of the same name. Accessed Sep 23, 2026. ↩

3. https://www.oecd.org/content/dam/oecd/en/publications/reports/2020/04/affordability-of-long-term-care-services-among-older-people-in-the-oecd-and-the-eu_de56ba81/f066a74c-en.pdf — Organisation for Economic Co-operation and Development, "Affordability of long-term care services among older people in the OECD and the EU" (published May 2020). Accessed Sep 23, 2026. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹

4. https://www.vdek.com/presse/pressemitteilungen/2026/stationaere-pflege-eigenanteile-juli-2026.html — Verband der Ersatzkassen e.V., press release on nursing home own-contributions as of 1 July 2026 (published Jul 14, 2026). Accessed Sep 23, 2026. ↩ ↩² ↩³

5. https://www.ageuk.org.uk/information-advice/care/paying-for-care/paying-for-a-care-home/ — Age UK, "Paying for a care home" (last updated Apr 9, 2026). Accessed Sep 23, 2026. ↩ ↩² ↩³

6. https://amarkfoundation.org/reports/how-is-long-term-care-handled-by-oecd-countries/ — A-Mark Foundation, "How Is Long-Term Care Handled by OECD Countries?" (published Jun 21, 2024), citing OECD data for 2021. Accessed Sep 23, 2026. ↩ ↩²

7. https://kffhealthnews.org/news/article/dying-broke-long-term-care-other-countries/ — KFF Health News, Jordan Rau, "What Long-Term Care Looks Like Around the World" (published Nov 14, 2023), citing OECD data. Accessed Sep 23, 2026. ↩ ↩² ↩³

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