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PNOG: what could change for the relief amount and household help from 2027

A draft law is intended to reorganise long-term care insurance. We summarise what it provides for the relief amount and for help in the household – and what is still open.

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This article describes German law; the German version is authoritative.

Legislative procedure ongoing – not yet passed

Status:

The Long-Term Care Reorganisation Act (Pflegeneuordnungsgesetz, PNOG) is a draft law. Changes in the parliamentary procedure are still possible.

Published · Updated · Category: Legislation · Pflege Patienten editorial team

Summary

On 30 Sep 2026 the Federal Cabinet adopted the draft of a Long-Term Care Reorganisation Act (PNOG). According to the Cabinet draft, today’s relief amount (Entlastungsbetrag) for care levels 2 to 5 is to become a social space budget (Sozialraumbudget): higher, but more narrowly earmarked – only for recognised everyday support services. For care level 1 the relief amount is to be dropped; instead, the draft provides for care accompaniment. Help in the household from home care services remains possible under the draft – financed from the benefits-in-kind budget.

Current status of the procedure

This is the schedule as planned so far. Dates in the legislative procedure may shift.

1. Cabinet decision

The Federal Cabinet adopted the draft law on 30 Sep 2026.

2. Bundesrat

The draft has been forwarded to the Bundesrat (printed paper 587/26(neu), 9 Oct 2026).

3. Bundestag

The first reading in the Bundestag is planned for 5 Nov 2026.

4. Entry into force

According to the draft, in principle on 1 Jan 2027, with some provisions later. Changes in the parliamentary procedure are still possible.

The law today: the relief amount

People in need of care who are cared for at home are currently entitled to a relief amount of up to €131 per month (Section 45b SGB XI). It is earmarked. Among other things, it can be used for:

  • day or night care,
  • short-term care,
  • services of home care services – for care levels 2 to 5 not for services in the area of self-care, but for care-related supervision and help with running the household,
  • everyday support services recognised under state law.

This list is simplified. The wording of the law is authoritative: Section 45b SGB XI – relief amount (German).

What the draft law provides

Care levels 2 to 5: According to the Cabinet draft, a social space budget is to replace the relief amount. It provides for up to €175 per month from the age of 25 and up to €300 per month for people under 25.

Earmarking: The social space budget is only to be usable for services of everyday support offers within the meaning of Section 45a SGB XI that are recognised under state law or by the long-term care insurance funds. Recognition by the insurance funds concerns neighbourhood help. The draft no longer provides for saving up unused amounts.

Reasoning of the draft: The increase from €131 to €175 is intended to be cost-neutral because the possible uses become narrower. Today the amount can be used more flexibly, for example also for home care services or day and night care.

Care level 1: The relief amount is to be dropped for care level 1; instead, care accompaniment under Section 7c SGB XI as amended by the draft is planned. As a transition, the draft refers to counselling under Section 37(3) SGB XI. Care level 1 itself remains.

Home care services and household help: financing is what matters

The draft does not prohibit home care services from providing help with running the household. Under Section 36 SGB XI as amended by the draft, people with care levels 2 to 5 who are cared for at home are entitled to physical care measures, care-related supervision and help with running the household as a benefit in kind – up to the amount of a benefits-in-kind budget.

What matters is the budget from which a service is paid. According to the reasoning of the draft, professional providers draw on the benefits-in-kind budget; the social space budget is meant for low-threshold services. Household help from a home care service would therefore be paid from the benefits-in-kind budget, not from the social space budget.

Who can provide services from the social space budget?

The draft distinguishes two routes for everyday support services (Section 45a SGB XI as amended by the draft):

A – Recognised low-threshold services: services recognised under state law or, as neighbourhood help, by the long-term care insurance funds. Only these are to be eligible for the social space budget.

B – Licensed care services: alternatively, services can be licensed as an outpatient care service within the meaning of Section 71(1a) SGB XI under Section 72 SGB XI. They then bill via the benefits-in-kind budget, not via the social space budget.

Both at the same time is not possible under the draft: a licence under Section 72 SGB XI rules out recognition under state law or by the long-term care insurance funds.

Under the draft, the state regulations are to receive more uniform criteria nationwide, for example on requirements, procedure, proof of suitability, prices and quality assurance. For neighbourhood help, the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) is to adopt guidelines by 1 Jan 2028; until then, recognition under state law in the version applicable until 31 Dec 2026 is to continue to apply.

What is the current situation in North Rhine-Westphalia?

In North Rhine-Westphalia, the state ordinance AnFöVO currently governs everyday support services. Services that can currently be recognised there include in particular individual supervision, relief for family carers, household support and individual help in everyday life.

Among others, commercial providers without a care contract under Section 72 SGB XI can also be recognised if they meet the requirements.

This describes current state law. It does not follow that all of these providers will be able to bill via the social space budget in future – the PNOG is a draft. Which recognition requirements will apply from 2027 also depends on further implementation at federal and state level.

Recognised services in North Rhine-Westphalia are listed in the official service finder of the state of NRW (German).

What could this mean for home care services?

An example: a home care service looks after a client with care level 3. It provides basic care and medical treatment care prescribed by a doctor and also helps in the household. Today the client pays for this household help partly from the relief amount.

Under the draft, the client could continue to receive the household help from the home care service – paid from the benefits-in-kind budget. For this help she could, however, also use a recognised everyday support service and use the social space budget for it. What suits the individual case depends, among other things, on the scope of services, the remaining benefits-in-kind budget and the services available locally.

The example is for orientation only and is not advice on an individual case. People in need of care and relatives should contact their long-term care insurance fund or care counselling; home care services should contact their association or their legal advisers.

Reorganising care

If a new provider is needed for part of the existing care, the entire care does not have to be reorganised. On Pflege Patienten you can also search for individual service areas separately. Posting a care need is free of charge.

Post a care need
Register as a provider

For home care services: refer household help onwards

More on this topic

Our guide Social space budget from 2027 explains how the social space budget is intended to work under the draft.

Read more: All guides · All articles · For private individuals: find care

Sources

Editorial status:

The Long-Term Care Reorganisation Act is going through the legislative procedure. The changes described reflect the current draft law and may still change.