A Comprehensive Guide to Sickness Benefit (Krankengeld) in Germany: Conditions, Procedures and Duration

Sickness benefit (in German: Krankengeld) is one of the most important forms of social protection in the German health system. It ensures that employees receive financial compensation when they suffer from an illness that keeps them away from work for a relatively long period of time. In this comprehensive guide, we explain all the essential information about Krankengeld – including eligibility criteria, application procedures, maximum duration and how the payment is calculated.

What is Sickness Benefit (Krankengeld) in Germany?

Krankengeld is a financial benefit paid to people who are covered by statutory health insurance (gesetzliche Krankenversicherung – GKV) when their illness lasts longer than the period for which they receive continued wage payment (Entgeltfortzahlung) from their employer.
Normally, an employee who is unable to work due to illness continues to receive full pay from the employer for up to six weeks. If the incapacity for work continues beyond this period, responsibility for payment shifts from the employer to the statutory health insurance provider in the form of Krankengeld.

The Difference Between Continued Wage Payment (Entgeltfortzahlung) and Sickness Benefit (Krankengeld)

Continued wage payment (Entgeltfortzahlung)

• The employer is obliged to continue paying the full salary if an employee is unable to work due to illness for a period of up to six weeks.

• A valid employment contract must exist, and the employee must submit a medical certificate (Krankmeldung / certificate of incapacity for work) confirming the inability to work.

Sickness benefit (Krankengeld)

• Payment of Krankengeld begins on the day after the six-week period of continued wage payment ends, provided the incapacity for work is still ongoing.

• It is paid by the statutory health insurance fund.

• The amount is lower than the regular full salary, as it is calculated as a percentage of the previous income.

Who is Entitled to Sickness Benefit?

In general, the following groups of people covered by statutory health insurance (GKV) may be entitled to Krankengeld:

• Employees in jobs subject to compulsory social insurance.

• Trainees (Azubis) and some students with statutory health insurance.

• Employees in a mini-job, if they have taken out an additional option within the statutory health insurance that entitles them to Krankengeld and are not exclusively privately insured.

• Certain self-employed persons who are voluntarily insured with a statutory health fund and pay an additional premium to be covered for sickness benefit.

Note:
If you have private health insurance (private Krankenversicherung – PKV), different rules apply. In that case, you generally need to include a separate clause for daily sickness allowance in your insurance contract if you want to be financially protected during longer periods of illness.

How is Sickness Benefit Calculated?

Percentage rate

• As a rule, Krankengeld amounts to 70% of the gross salary (Bruttolohn), but it must not exceed 90% of the net salary (Nettolohn).

• Social security contributions (for pension insurance, unemployment insurance and long-term care insurance) are deducted from this amount.

• No additional contribution for health insurance is deducted, because the health insurance fund itself is the paying body.

Daily maximum amount

• The law sets a maximum daily amount for Krankengeld.

• Employees with high incomes might therefore receive less than 70% of their actual gross salary if their income exceeds certain contribution ceilings.

Assessment period

• To determine the amount of Krankengeld, the health insurer usually looks at the average monthly earnings during the months prior to the illness.

• This is intended to ensure that the calculated benefit reflects the actual previous income as fairly as possible.

Maximum Duration of Sickness Benefit

• For the same illness, Krankengeld can be paid for a maximum of 78 weeks within a 3-year period.

• This period starts on the first day on which the incapacity for work is certified by a doctor, not on the day the sickness benefit payments begin.

• If the insured person recovers, returns to work and later becomes unable to work again due to a different illness, a new entitlement period may begin for this new condition.

Important:
The 78-week limit includes both the initial six weeks of continued wage payment by the employer and the subsequent period during which the health insurance fund pays Krankengeld. However, the first six weeks are fully financed by the employer; Krankengeld is paid only for the period after these six weeks.

Procedures for Receiving Sickness Benefit

1. Notify your employer immediately

• As soon as an illness prevents you from working, you must inform your employer without delay.

• The employer continues to pay the full salary for up to six weeks, provided this entitlement has not already been exhausted due to previous illnesses in the last 12 months.

2. Certificate of incapacity for work (Arbeitsunfähigkeitsbescheinigung)

• Your treating doctor issues a certificate of incapacity for work (AU-Bescheinigung).

• In most cases, this certificate is transmitted electronically to the health insurance fund.

• You may receive a copy for your employer and one for your own records.

3. Contact your health insurance fund

• As the end of the six-week continued wage payment approaches, you should contact your health insurance fund in good time to apply for Krankengeld.

• You will be asked to complete certain forms and provide your bank account details.

• The health insurer may also request additional documents, such as payslips or more detailed medical certificates.

4. Ongoing medical assessment

• The health insurance fund may arrange medical examinations or assessments to check whether you are still unable to work.

• In some cases, the insurer may suggest or require participation in rehabilitation programmes (Rehabilitation / Reha), with the aim of restoring your ability to work.

When Does Sickness Benefit End or Get Interrupted?

Recovery and return to work

• If you recover before the maximum entitlement period is reached and resume work, payment of Krankengeld stops immediately once you return to work.

Reaching the maximum period (78 weeks)

• Once the limit of 78 weeks has been reached, the Krankengeld payments end.

• If you are still unable to work, you may need to consider other benefits, such as:

  • an invalidity or reduced earning capacity pension (Erwerbsminderungsrente),

  • or unemployment benefit (Arbeitslosengeld) if the statutory requirements are met.

Transition to rehabilitation benefits (Reha and Übergangsgeld)

• The health insurance fund or the pension insurance provider may propose a medical or vocational rehabilitation programme.

• During such a programme, the Krankengeld can be replaced by transition benefit (Übergangsgeld), which covers living costs during rehabilitation.

Practical Tips

Keep thorough records

• It is advisable to keep copies of:

  • all certificates of incapacity for work,

  • previous payslips,

  • and all correspondence with your health insurer.

Communicate proactively with your health insurer

• If there are important changes in your health condition, delays in payment or any uncertainties, you should contact your health insurer directly.

• Clear communication can help prevent misunderstandings and delays.

Seek legal advice if necessary

• If disputes arise regarding your entitlement to Krankengeld or the amount paid, you may wish to consult a lawyer specialised in social law (Sozialrecht).

• Social associations and counselling centres can sometimes also provide support.

Apply for alternative benefits in good time

• If you expect that you will not be able to return to work once your Krankengeld entitlement ends, you should seek advice at an early stage about:

  • a possible reduced earning capacity pension (Erwerbsminderungsrente),

  • or unemployment benefit, if you meet the relevant conditions.

• Early planning can help you avoid financial gaps.

Conclusion

Sickness benefit (Krankengeld) is an important instrument for securing income in Germany when illness prevents employees from working for longer periods. It enables those affected to concentrate on recovery without immediately facing severe financial hardship.
However, the details – such as the maximum duration of benefits, the calculation method, coordination with employer-provided continued pay and the communication with the health insurer – can seem complex.

Therefore, it is crucial to keep careful documentation, observe deadlines and maintain close contact with the relevant institutions. By understanding your rights and obligations and seeking advice when needed, you can significantly improve your chances of receiving the sickness benefit to which you are entitled without unnecessary obstacles or delays.

The editorial team of this website strives to provide accurate information based on thorough research and consultation of multiple sources. However, errors or incomplete information cannot be entirely ruled out. Please regard the contents of this article as an initial reference only and always contact the competent authorities or qualified professionals for binding and up-to-date information.