In 1995, Germany launched a compulsory long-term care insurance to pool the growing financial risk of long-term care of the ageing population. Most of the population is covered by the social long-term care insurance following the same principles as the social health insurances stemming from the Bismarck model of 1883. Both employers and employees contribute to the fund. Potential beneficiaries are grouped into care grades and receive a wide portfolio of financial compensations for their care expenditure. The amount depends on the care grade. The German social long-term care insurance system is constantly reformed to reconcile the conflict between fair coverage of the population and continuously growing expenditure. The underlying problem of an ageing population with increasing demand for care cannot be solved by an insurance but has to be addressed by prevention and health promotion.