What Other Countries Pay For, and Whether a Newcomer Could Use It
Pat has read that Spain has a law for people who need daily help, and she asked Clarence to find out what it pays.
Picture a couple named Clarence, 67, and Pat, 65. They are planning to retire in Spain. Pat has read that Spain has a law for people who need daily help, and she asked Clarence to find out what it pays.
Clarence read the law. He stopped at the fifth article.
"Five years," he said. "Two of them right before you apply."
"We would be here two," Pat said.
"Then we would look at it again in three."
| Country | What the public system pays for | Could a newcomer use it? |
|---|---|---|
| Spain (Ley 39/2006) | Services, such as home help or a care home place, or a cash payment that supports a family member giving care. The person pays a share based on their means | The law asks for 5 years of residence in Spain, 2 of them right before applying. Foreigners are also governed by the immigration law. A recent arrival would not meet the 5-year test |
| Germany (care insurance) | A monthly payment by care grade. In 2026 the home cash benefit runs from 347 euros a month at grade 2 to 990 euros at grade 5. Higher limits apply when professional services provide the care at home | It is paid through German care insurance. For a newcomer, ask the office, or a paid professional |
| Japan (long-term care insurance) | Care services. The user pays 10%, 20% or 30% by income. About half the cost comes from premiums and half from taxes | Covers people 65 and older, and people 40 to 64 for age-related illness. The rules for foreign residents are a question for the office |
| United States (Medicare) | Short-term skilled nursing or rehabilitation, up to 100 days, after a hospital stay | See below |
Spain's system is large. In the summer of 2025, 1,575,682 people were receiving a benefit. There were 2,272,565 applications, and 174,406 people (7.67%) were waiting. Regions set many of the rules, so a person in Andalusia and a person in Catalonia could meet different offices.
Germany sorts people into five care grades, by points from an assessment. Japan certified 6.91 million people in April 2022.
Medicare, the United States program for people 65 and older, says it does not cover custodial care if that is the only care a person needs. Custodial care means help with bathing, dressing, eating and moving about. The cost falls to the family or to the person's savings, or to Medicaid, the state-run program, for people who qualify.
A residence rule is one way a system decides who it is for. A newcomer could still hire help privately, and other pieces on this site look at what that costs.
You could…
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Read the first pages of the Spanish law, Ley 39/2006, in translation, and note the residence rule.
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Ask your target region's social services office what a foreign resident can apply for and when.
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Price private help for the first years, so the plan does not depend on a public benefit.
What did you learn about care rules when you read them for the country you chose? Share it here. Someone reading may be about to start.
Figures are estimates for planning, based on public data. Sources: Ley 39/2006 (Boletín Oficial del Estado); Spain's Ministry of Social Rights, benefit panel for July to September 2025; German Federal Ministry of Health, 2026 benefit table; Japan Ministry of Health, Labour and Welfare, long-term care insurance outline; Medicare.gov.
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