Sick Pay in Germany: Lohnfortzahlung and Krankengeld

Sick pay in Germany works in two stages. First your employer keeps paying your normal salary for up to six weeks (Lohnfortzahlung or Entgeltfortzahlung). If you are still unfit for work after that, your public health insurance fund takes over with Krankengeld, which is 70% of your gross pay, for up to 78 weeks. This guide explains each stage, the paperwork, and what changes if you are a freelancer, privately insured or a parent with a sick child.

Related benefits for families: Elterngeld and Kindergeld.

How sick pay in Germany works, step by step

Germany does not have a single sick pay system. Who pays depends on how long you have been ill, whether you are an employee or self-employed, and which kind of health insurance you hold. The table shows the standard path for an employee in public health insurance.

The six weeks of employer pay and the 78 weeks of Krankengeld are not two separate allowances. The 78-week period is counted from the first day of incapacity, and periods when the Krankengeld is suspended count as used (§48 SGB V). In practice, that leaves around 72 weeks of actual Krankengeld after the employer stage.

Weeks 1 to 6: Lohnfortzahlung from your employer

If you are an employee and cannot work because of an illness that is not your own fault, your employer must keep paying you for up to six weeks. The law (§3 EntgFG) sets out the key rules:

• Waiting period: the entitlement arises once you have been employed without interruption for four weeks. In your first four weeks, you are not covered by Lohnfortzahlung.
• Six weeks per illness: the clock runs per illness, not per year. A new, unrelated illness starts a new six-week period.
• Same illness again: if the same illness returns, you get a fresh six weeks only if you were not unfit for work because of it for at least six months, or if twelve months have passed since the first incapacity from that illness began.
• No fault: the law protects you where the illness is not caused by your own fault. Ordinary illnesses and accidents normally qualify.

Lohnfortzahlung applies to all employees regardless of nationality or visa category, including those on a Blue Card or a work visa. If you are still looking for work or deciding between contracts, our guide to finding a job in Germany and the salary in Germany overview explain what to check in an employment contract. Fixed-term and part-time employees are covered in the same way once the waiting period has passed.

Calling in sick and the eAU sick note

The paperwork is where many newcomers go wrong. Under §5 EntgFG, you must tell your employer without delay that you are unable to work and how long it is likely to last. If the incapacity lasts longer than three calendar days, you must present a medical certificate (Arbeitsunfähigkeitsbescheinigung) on the next working day. Your employer is allowed to ask for it earlier, so check your contract and company policy. If you fall ill abroad, you must report your incapacity and your address abroad by the fastest route, and your employer bears the cost of that communication.

The electronic sick note (eAU)

For publicly insured employees, the paper certificate has largely been replaced by the eAU. Since 1 October 2021 the doctor's practice sends the certificate electronically to your health fund, and since 1 January 2023 your employer retrieves it from your fund once you have reported sick. You still have to report your illness to your employer yourself. Where an employer does not yet support retrieval, you may still need a printout, and you may always ask your practice for a copy for your own records. If the electronic transmission fails, the practice hands you a paper certificate.

Publicly insured employees do not have to hand the certificate to the employer themselves in the standard procedure (§5 Abs. 1a EntgFG), but they must make sure the doctor issues it. If you are privately insured, the eAU procedure is run through public health insurers, so ask your doctor what certificate you need and check what your own insurer requires before you claim Krankentagegeld.

Krankengeld from week 7: how much, how long

Krankengeld is a benefit of public health insurance. When your employer stops paying, your fund steps in and pays Krankengeld directly to your account. You do not apply for it in the usual sense: the fund sends you a questionnaire and the doctor's certificates drive the process.

The amount

Under §47 SGB V, Krankengeld is 70% of your regular gross pay, but it must not exceed 90% of your net pay. Which of the two limits applies depends on your tax class and deductions, and the lower result is what you get. The base is your regular pay from the last settled pay period, at least the last four weeks, excluding one-off payments.

There is also a ceiling. Gross pay is counted only up to the daily contribution assessment ceiling. For 2026, the annual ceiling for health and long-term care insurance is €69,750, or €5,812.50 per month. On that basis the maximum Krankengeld works out at roughly €135.63 per calendar day (70% of €193.75, our own calculation from the official ceiling). Krankengeld is paid per calendar day, and a full month counts as 30 days, so the ceiling equals about €4,069 per month before deductions.

Because Krankengeld is calculated on income up to the ceiling, higher earners lose more relative to their salary. If you earn well above €69,750 per year, the gap between your normal pay and Krankengeld is large, which is one reason high earners often add a private daily sickness allowance. Our taxes in Germany guide explains how gross and net pay differ.

The duration: 78 weeks in 3 years

You can receive Krankengeld for the same illness for a maximum of 78 weeks within a period of three years, counted from the first day of incapacity. If another illness appears while you are already ill, the 78 weeks are not extended. After the three-year period, you can only start a new Krankengeld period for the same illness if you were not unfit for work because of it for at least six months in the meantime and you were working or available for the labour market (§48 SGB V).

How not to lose your Krankengeld

The most common mistake is a gap between two medical certificates. Under §46 SGB V, your entitlement continues without a break only if the doctor confirms that the incapacity continues no later than the next working day after the last certified end date. Saturdays do not count as working days. A certificate that ends on a Friday needs a follow-up on Monday at the latest.

• Book your follow-up appointment before the current certificate ends, not after.
• Do not leave it to the last day: surgeries close, queues form and a missed day can be costly.
• Keep your fund informed, reply to its questionnaires on time and tell it about any stay abroad before you travel.
• Check your fund's letter on the 78-week deadline well in advance.

Sick pay for self-employed people and freelancers

As a freelancer you have no employer, so no Lohnfortzahlung. Your income stops from day one unless you have insured it. In public health insurance, the law treats the main-profession self-employed as excluded from Krankengeld unless they make a declaration to their fund (Wahlerklärung, §44 Abs. 2 SGB V).

Public insurance: the Wahlerklärung and the Wahltarif

• Reduced rate, no Krankengeld: the reduced contribution rate of 14.0% applies to members without a Krankengeld entitlement (§243 SGB V). Many freelancers pick it because it is cheaper.
• General rate with Krankengeld: the general rate is 14.6% (§241 SGB V). If you declare that you want Krankengeld, your entitlement starts only from the seventh week of illness (§46 SGB V). Both rates are then topped up by your fund's own Zusatzbeitrag.
• Earlier start with a Wahltarif: funds must offer a Krankengeld tariff for the self-employed under §53 Abs. 6 SGB V. Entitlement can then begin earlier, according to your fund's rules, but no later than the third week. The premium may not depend on your age, sex or health risk. These tariffs bind you for at least three years (§53 Abs. 8 SGB V).
• How much you get: for people who are not employees, the Krankengeld is based on the income last used to assess your contributions (§47 Abs. 4 SGB V). Declare your real income, because it drives both your contributions and your payout.

Artists and writers insured through the Künstlersozialkasse are handled separately: the law lets them take a Krankengeld tariff that starts no later than the third week (§§46, 53 SGB V). Check your status with the KSK and your fund before choosing.

Sick pay with private health insurance: Krankentagegeld

Private health insurance does not include Krankengeld. If you are an employee, your employer still pays the first six weeks. After that, there is no legal claim against the insurer unless you have taken out a Krankentagegeld (daily sickness allowance) policy. The same applies to freelancers from the first day.

Under §192 Abs. 5 VVG, the insurer replaces the loss of earnings through the agreed daily amount. In other words, your cover is whatever you agreed in the contract, not a legal percentage of your pay. That puts three decisions in your hands:

• The daily amount: aim near your average daily net income, because an overly high amount can be refused or can cost more than it is worth.
• The waiting period: the start of benefits is chosen in the tariff. A longer wait lowers the premium, but you need savings to cover it.
• The conditions: check how the insurer treats self-employed income, how it proves loss of earnings and what happens if your income changes.

If you are employed with an income above the €84,150 threshold from 2027 (€77,400 in 2026) and are considering the private system, make sure Krankentagegeld is part of the offer you compare. Our private health insurance in Germany guide and the private vs public comparison show where income protection fits into the decision.

Who pays what: comparison by situation

If you are unsure which row describes you, an independent consultant can run the numbers for you. MyHealthcareBroker's independent consultants compare Krankentagegeld and public options without being tied to one insurer, and the first call is free. See the consultation box at the end of this guide.

Child sick days: Kinderkrankengeld in 2026

If your child is ill and needs you at home, publicly insured parents can claim Kinderkrankengeld from their fund (§45 SGB V). It applies when the child is under 12, or has a disability and depends on help, and when no one else in the household can look after the child. Employers must give you the time off, unpaid, for the days in question, and the fund pays the benefit instead.

• Amount: 90% of your lost net pay, or 100% if you received one-off payments such as a bonus in the previous twelve months. It is capped at 70% of the contribution ceiling, which is the same daily maximum as for Krankengeld.
• Standard rule: the permanent figures in the law are 10 days per child (20 for single parents) and 25 days per parent (50 for single parents). The higher 2026 numbers are a temporary rule written into §45 SGB V for 2026, so check the figures again for 2027.
• Privately insured parents: Kinderkrankengeld is a public insurance benefit. If you or your child are privately insured, ask your employer and insurer what applies. Some employment contracts and the general rule on short absences in §616 BGB can provide short paid leave, unless excluded by contract.
• How to claim: get a medical certificate for the child's care, send it to your fund and submit the fund's form. Your fund and employer handle the rest.

What to do when you fall ill: a checklist

Employees

• Tell your employer immediately, with the expected duration.
• See a doctor early. For anything longer than three calendar days, the certificate is due on the next working day.
• Make sure the certificate is sent electronically if you are publicly insured.
• From week 6, watch for your fund's Krankengeld letter and answer the questionnaire quickly.
• Book each follow-up appointment before the previous certificate ends.

Freelancers and privately insured people

• Check today whether your contract contains Krankengeld or Krankentagegeld and when it starts.
• Keep proof of income (tax assessments, invoices), because insurers use it to assess your daily amount.
• Build a savings buffer at least as long as your waiting period.
• Report your illness to your insurer on time and keep every medical certificate.

If you also need broader insurance advice, read our liability insurance guide and the health insurance in Germany overview. For a licensed adviser on contracts and tax questions, see professional help for expats.

FAQ

Sources

• Six weeks of continued pay, waiting period, repeat illness: §3 EntgFG
• Reporting duty and sick note deadline: §5 EntgFG
• Who is excluded from Krankengeld, Wahlerklärung: §44 SGB V
• Child sick days and Kinderkrankengeld: §45 SGB V
• Start of the Krankengeld entitlement and follow-up certificates: §46 SGB V
• Amount of Krankengeld (70% / 90%, ceiling): §47 SGB V
• Duration (78 weeks in three years): §48 SGB V
• Krankengeld Wahltarif and three-year binding period: §53 SGB V
• General contribution rate 14.6%: §241 SGB V; reduced rate 14.0%: §243 SGB V
• Krankentagegeld in private health insurance: §192 VVG
• Short absences with continued pay: §616 BGB
• 2026 contribution ceiling (€69,750) and income threshold (€77,400 in 2026): Deutsche Rentenversicherung, Rechengrößen 2026
• How the eAU works: Bundesärztekammer, eAU