Recognised Incoming products (Care Expatriate, Care Economy) cover acute medical only under § 5 AufenthG — they do NOT pay German Pflegegrad 1–5 benefits. Pflegeversicherung is a separate German social insurance (SGB XI) tied to GKV/SPV or substitutive PKV+PPV.

Care need: health insurance vs long-term care insurance — short differences for retirees in Germany

Entry age 41–60: from €68/monthEntry age 61–74: from €246/month

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Sources: § 27 SGB V (medical benefits) · § 5 SGB V (KVdR 9/10 rule) · §§ 14, 15, 18 SGB XI (Pflegegrad / NBA) · § 20 SGB XI (Soziale Pflegeversicherung) · § 23 SGB XI (private Pflegepflichtversicherung) · § 5 AufenthG · EU Reg. 883/2004 (Form S1) · BMG-Leistungsübersicht Pflegeversicherung 2026 · HanseMerkur Care Expatriate AVB · HanseMerkur Care Economy AVB

The 10 differences between Krankenversicherung and Pflegeversicherung retirees confuse most

Quick answer: "What is the difference between Krankenversicherung and Pflegeversicherung in Germany?" — Krankenversicherung (SGB V) covers acute medical care: doctors, hospital, medication, rehab. Pflegeversicherung (SGB XI) covers Pflegegrad 1–5 cash and care-in-kind benefits when daily activities can no longer be done independently. The two are legally separate; only Krankenversicherung is required for the residence permit. Recognised Incoming products (Care Expatriate from €68/mo · €246/mo) cover acute medical only — never Pflegegrad benefits.

• 1. Krankenversicherung (KV) — § 27 SGB V
  Pays for doctors, hospital stays, medication, rehab, surgery and most acute medical care. Mandatory under § 5 AufenthG for any residence permit. Recognised Incoming lane: Care Expatriate from €68/month (41–60) · €246/month (61–74).
• 2. Pflegeversicherung (PV) — SGB XI
  Pays Pflegegrad 1–5 cash benefits + care-in-kind when daily activities can no longer be done independently (§ 14 SGB XI). Legally separate from KV; cannot be replaced by an Incoming product.
• 3. Soziale Pflegeversicherung (SPV) — § 20 SGB XI
  Statutory pillar: every GKV member pays into SPV automatically. Contribution rate is set by the BMG and includes a surcharge for childless members from age 23 (current rate via BMG). Pflegegrad benefits paid in full from the SPV pool.
• 4. Private Pflegepflichtversicherung (PPV) — § 23 SGB XI
  Mandatory private parallel for substitutive PKV holders. Premiums age-based; benefits at least equal to SPV. Required to hold the German residence permit alongside substitutive PKV.
• 5. Pflegegrad 1–5 — § 14 SGB XI (NBA assessment)
  Determined by the MDK (GKV) or Medicproof (PKV) using the Neues Begutachtungsassessment (NBA). Grade 1 (mild) → Grade 5 (most severe). Cash (Pflegegeld) and care-in-kind (Pflegesachleistungen) amounts are set by the BMG and updated each year — see the official Leistungsübersicht. Only paid by SPV/PPV — never by Care Expatriate.
• 6. Care Expatriate — what it covers
  Acute medical care up to 5 years per contract: outpatient, inpatient, medication, surgery, repatriation. Recognised under § 5 AufenthG. From €68/month (entry age 41–60) · €246/month (entry age 61–74). Does NOT pay Pflegegrad benefits.
• 7. Care Economy — what it covers
  Acute medical care up to 2 years (with deductible). Per-day pricing from €1.00/day (0–64) · €2.95/day (65–74), minimum €10. Recognised under § 5 AufenthG as a bridge product. Does NOT pay Pflegegrad benefits.
• 8. GKV + SPV (combined) — typical retiree route
  If KVdR is open under the 9/10 rule (§ 5 Abs. 1 Nr. 11 SGB V), GKV pays acute medical and SPV pays Pflegegrad benefits together. The route most German pensioners use; for non-EU retirees the 9/10 rule is rarely met.
• 9. EU Form S1 — EU Reg. 883/2004
  EU/EEA/Swiss pensioners with a pension from the home country may register Form S1 with a German GKV and be treated like a German resident — including SPV access. Non-EU retirees cannot use this route.
• 10. Long-term care risk while on an Incoming contract
  Pflegegrad benefits are NOT covered. The risk is carried personally: home care via family or a private Pflegedienst is paid out-of-pocket; nursing home costs in Germany typically run €3,000–€5,000+ per month. Plan with savings, family support, or aim for GKV/SPV admission.

Three lanes that combine health and long-term care insurance — GKV+SPV, PKV+PPV, Care Expatriate (acute only)

One wrong insurance choice can cost you money, time and your application deadline

A medical incident can become expensive fast — but the wrong certificate can also delay your visa, enrollment, residence permit or work start.

• Wrong or incomplete proof can delay your visa, enrollment or authority process.
• Cheap home-country policies may miss the exact coverage, dates or repatriation wording required.
• The cheapest policy can become expensive if it is the wrong proof for your situation.

Before you apply, check: coverage amount, validity dates, destination area and repatriation cover.

Why act before family visit or residence paperwork

Older visitors often face age-based pricing and eligibility limits. Waiting too long can make the right option harder to choose.

Recommended tariffs for foreign retirees — Care Expatriate (long-term acute medical), Care Economy (short bridge). Pflegegrad benefits remain outside both — plan SPV/PPV separately if accessible.

Wondering when GKV (with SPV) is open instead? Retirees in Germany — when statutory vs private. Want to avoid the typical retiree mistakes around proofs and deadlines? Common mistakes — retirees in Germany. For the full overview see the foreign-retirees hub.

Frequently Asked Questions