German Sick Pay Calculator 2026

Understanding German Sick Pay (Krankengeld) in 2026

If you work in Germany and fall ill for an extended period, the German social insurance system provides a structured safety net. As an expat, understanding how Krankengeld (sick pay) works is essential because the rules differ significantly from most other countries. Germany distinguishes between two phases of income protection during illness: the employer-paid phase and the health insurance-paid phase. Knowing how each phase works, what you are entitled to, and what steps you must take can save you from financial hardship and bureaucratic pitfalls.

The legal framework for sick pay is found in the German Social Code, Book V (SGB V), sections 44 through 51. Approximately 1.8 million people in Germany receive Krankengeld each year, and the number has been steadily rising.

Phase 1: Continued Pay by Your Employer (Entgeltfortzahlung)

Before your health insurer pays anything, your employer must continue your full salary for the first 6 weeks (42 calendar days) of your illness. This obligation is governed by the Continued Remuneration Act (Entgeltfortzahlungsgesetz, or EntgFG). During this period, you receive your regular gross salary, and all normal deductions (taxes, social insurance) apply as usual.

Key rules for the employer-paid phase:

• Your employment relationship must have existed for at least 4 weeks before the illness begins.
• Continued pay starts from the first day of illness, provided you submit a doctor's certificate (Arbeitsunfaehigkeitsbescheinigung, or AU) within 3 days (or as required by your employment contract).
• Since January 2023, the electronic sick note (eAU) is transmitted directly from your doctor to your health insurer and employer, so you typically no longer need to submit a paper copy.
• If you become ill again with the same condition within 12 months, you only get another 6 weeks of employer-paid leave if at least 6 months have passed since the last bout, or 12 months since the first onset.

For expats, a common concern is what happens if you fall ill during your probation period (Probezeit). The good news: the 6-week continued pay obligation applies even during probation, as long as you have been employed for at least 4 weeks.

Phase 2: Sick Pay from Your Health Insurer (Krankengeld)

Starting from the 43rd day of your illness, your statutory health insurance fund (gesetzliche Krankenkasse) takes over and pays Krankengeld. The calculation follows a two-tier system defined in section 47 SGB V:

1. Sick pay equals 70% of your gross salary (called the Regelentgelt), based on your last fully completed pay period before the illness began.
2. However, it must not exceed 90% of your net salary.
3. Additionally, it is capped by the health insurance contribution assessment ceiling (Beitragsbemessungsgrenze): EUR 5,512.50 per month in 2026.

From this gross Krankengeld, your share of social insurance contributions is deducted: pension insurance, unemployment insurance, and care insurance (approximately 12.4% in total). You do not pay health insurance contributions on your Krankengeld. The result is your net sick pay, which is what actually arrives in your bank account.

Worked Example: Sick Pay on EUR 3,500 Gross

Suppose you earned EUR 3,500 gross per month before your illness, with a net salary of EUR 2,350.

• 70% of EUR 3,500 gross = EUR 2,450
• 90% of EUR 2,350 net = EUR 2,115
• The lower value applies: EUR 2,115 gross Krankengeld
• After social insurance deductions (~12.4%): EUR 2,115 - EUR 262 = approximately EUR 1,853 net Krankengeld

Compared to your previous net income of EUR 2,350, this represents a monthly income loss of approximately EUR 497. For expats sending remittances or paying rent in expensive cities like Munich or Frankfurt, this gap can be significant, which is why many consider supplementary daily sickness benefit insurance (Krankentagegeldversicherung).

Maximum Sick Pay in 2026

The daily Krankengeld cannot exceed 70% of the daily contribution assessment ceiling. For 2026:

• Health insurance assessment ceiling: EUR 5,512.50/month = EUR 183.75/day
• 70% of that: EUR 128.63/day (gross)
• Monthly (x 30): EUR 3,858.75 gross
• After social insurance deductions: approximately EUR 3,380 net

Even high earners with salaries well above the ceiling will receive no more than this maximum. If you earn significantly more, the income gap during Krankengeld can be substantial, which is another reason to consider supplementary insurance.

Duration: The 78-Week Rule

Under section 48 SGB V, sick pay for the same illness is limited to 78 weeks (546 calendar days) within a 3-year period (called the Blockfrist). Since your employer covers the first 6 weeks, the actual Krankengeld period is 72 weeks (504 days).

Important details for expats:

• The 3-year period starts on the first day you were unable to work due to that specific illness.
• All periods of incapacity for the same illness are added together, even if you worked in between.
• If you develop a different, unrelated illness, a new 78-week entitlement begins for that condition.
• Follow-up conditions (e.g., depression resulting from chronic pain) may be classified as the "same illness" if there is a causal connection. Discuss diagnosis coding with your doctor.

Social Insurance Coverage During Sick Pay

While receiving Krankengeld, you remain fully covered under all branches of the German social insurance system:

• Health insurance: Contribution-free. Your membership continues without interruption.
• Care insurance (Pflegeversicherung): You pay the full contribution rate (3.4% or 4.0% for childless individuals over 23) on your sick pay.
• Pension insurance (Rentenversicherung): Your health insurer pays contributions based on 80% of your Regelentgelt, so you continue to accumulate pension entitlements, though at a reduced level.
• Unemployment insurance (Arbeitslosenversicherung): Your health insurer pays contributions, preserving your ALG I entitlement.

This is particularly reassuring for expats who may worry about gaps in their pension record or losing eligibility for unemployment benefits.

Gradual Reintegration (Hamburger Modell)

The gradual reintegration program (stufenweise Wiedereingliederung), commonly known as the "Hamburg Model" (Hamburger Modell), is defined in section 74 SGB V. It allows employees recovering from long-term illness to return to work step by step. Your doctor creates a reintegration plan, for example: 2 hours per day in the first week, 4 hours in the second, 6 hours in the third, building up to full working hours over several weeks.

During the Hamburg Model:

• You are still considered unable to work (arbeitsunfaehig).
• You continue to receive Krankengeld (not wages from your employer).
• You enjoy full employment protection rights.
• You can stop the reintegration at any time if your health deteriorates.

For expats, this is an excellent mechanism to ease back into work without risking your health or losing your sick pay entitlement. Research shows that gradual reintegration significantly increases long-term return-to-work rates compared to abrupt comebacks.

What Happens After 78 Weeks (Aussteuerung)?

When your sick pay entitlement expires after 78 weeks, this is called Aussteuerung. Your health insurer will automatically notify the Federal Employment Agency (Agentur fuer Arbeit). You have several options:

1. Unemployment benefits (ALG I): If you are still able to work at least 15 hours per week, you can register as unemployed and apply for ALG I.
2. Disability pension (Erwerbsminderungsrente): If your ability to work is permanently reduced (less than 6 or less than 3 hours per day), you can apply for a partial or full disability pension under section 43 SGB VI.
3. Citizen's benefit (Buergergeld): As a basic safety net if neither ALG I nor a disability pension is available.

Sick Pay and Termination of Employment

A common worry for expats: can your employer fire you while you are on sick leave? While German law does not absolutely prohibit dismissal during illness, strict requirements apply. More importantly for your finances: even if you are terminated, your Krankengeld continues as long as you remain unable to work and have not exhausted the 78-week limit. Under section 19(2) SGB V, you retain a post-employment entitlement to health insurance benefits for at least one month.

If your employer attempts to dismiss you because of your illness, the dismissal must meet stringent legal criteria: a negative health prognosis, significant operational disruption, and an adverse balance-of-interests assessment. Seek legal advice immediately in such cases.

Sick Pay for Self-Employed Expats

Self-employed individuals who are voluntarily insured in the statutory health system can receive Krankengeld, but only if they pay the general contribution rate (14.6% plus the supplementary contribution). Those paying the reduced rate (14.0% plus supplementary contribution) are not entitled to sick pay.

Many health insurers offer elective tariffs (Wahltarife) under section 53 SGB V that provide sick pay starting from day 15, 22, or 43, after a waiting period. Since self-employed individuals do not receive continued pay from an employer, this coverage gap is critical. Private supplementary daily sickness benefit insurance (Krankentagegeld) is strongly recommended for all self-employed expats.

Child Sick Pay (Kinderkrankengeld)

Parents insured through the statutory health system are entitled to Kinderkrankengeld under section 45 SGB V when they need to stay home to care for a sick child under 12 (or a disabled child of any age). The allowance per year is:

• Per parent: 10 working days per child per year (maximum 25 days for multiple children)
• Single parents: 20 working days per child per year (maximum 50 days)

Child sick pay is typically 90% of net salary and is paid by your health insurer. Your employer does not have to pay wages for these days. For a seriously ill child with a limited life expectancy, the entitlement is unlimited in duration.

Practical Tips for Expats on Sick Leave

1. Never leave gaps in your sick notes: Ensure that your Arbeitsunfaehigkeitsbescheinigungen (AU certificates) follow each other without any gap, not even a single day. A gap can jeopardize your entire Krankengeld entitlement.
2. Appeal rejections: If your health insurer denies your sick pay (e.g., after an MDK review), you have 4 weeks to file an objection (Widerspruch). Over 40% of objections are successful.
3. Consider supplementary insurance: A Krankentagegeld policy can close the gap between your net salary and Krankengeld, which can be EUR 500 or more per month.
4. Use workplace reintegration support: After more than 6 weeks of illness in a year, your employer must offer a workplace reintegration management process (BEM) under section 167(2) SGB IX. Accept this offer.
5. Keep your employer informed: While you do not have to disclose your diagnosis, keep your employer updated on your expected return date. Good communication protects the employment relationship.

How Sick Pay Is Taxed

Krankengeld is tax-free, but it is subject to the progression proviso (Progressionsvorbehalt) under section 32b of the Income Tax Act (EStG). This means that while Krankengeld itself is not taxed, it is factored into the calculation of your marginal tax rate on other income. As a result, you may face a higher tax rate on any remaining taxable income, which can lead to a tax bill (Steuernachzahlung) when you file your annual tax return.

Expats should plan for this by setting aside reserves or adjusting their quarterly advance tax payments (Vorauszahlungen). If you received Krankengeld exceeding EUR 410 during the year, you are required to file an income tax return.