If you are employed, apprentice, doing a voluntary year (FSJ), self-employed, or even receiving unemployment benefits from the state at the moment, you might be wondering what happens if you are unable to work, or cannot search for work for a certain period of time due to sickness. Lets go through all the details:
Most important points:
Sickness benefit is provided by statutory/public health insurance. The amount depends on your regular income. Generally, it amounts to 70% of your gross salary (average monthly income for self-employed). However, sickness benefit is limited to a statutory maximum amount of €120.75 per day (2024).
Employees, trainees, Voluntary workers (FSJ), self-employed, and recipients of unemployment benefit 1 (ALG1) are entitled to sickness benefit.
Health insurance fund starts paying sickness benefit from the 7th week (42 days) after the first "sick note" from a doctor.
Insured persons receive sickness benefit for the same illness for a maximum of 78 weeks in any 3-year period. This is calculated from the first "sick note" from a doctor.
Contributions to pension, unemployment and long-term care insurance are deducted from the sickness benefit. You do not normally have to pay health insurance contributions if you receive sickness benefit.
Employed, Apprentices and Voluntary workers (FSJ)
If you are employed, apprentice or doing a year of voluntary work (FSJ), your employer will pay you a full salary for the first 6 weeks.
From the 7th week onwards, your public provider takes over, and will start paying you the sickness benefit for max of 78 weeks within the 3 year period, for the same illness. The first 6 weeks are also taken into the the calculation.
You will only receive continuous sickness benefit if your doctor writes you off work without interruption. Retroactive sick leave is not possible, so make sure you request an additional "sick note" from your doctor on time, before your current one expires.
Before, you were responsible for manually sending the "sick note" to your employer and your health insurance provider. However, since January 1st 2023, the electronic certificate of incapacity for work (eAU) has been mandatory, therefore, providing proof to your employer and your health insurance company is much easier:
Your doctor will send the certificate to the health insurance fund electronically.
You must notify your employer of your incapacity to work yourself. However, they will then receive the detailed information about your incapacity to work directly from your health insurance fund. You do not need to provide proof.
The follow-up certificate is also sent electronically to the health insurance fund each time your incapacity for work is extended.
Self-employed
As mentioned above, self-employed members of the public health fund also have the possibility to receive sickness benefit, but you will need to specifically request it from your insurance provider. There are two scenarios:
You agree to pay a higher contribution to the statutory health insurance (14.6% instead of 14%) (2024). For this 0.6% additional monthly payment, you will be eligible to receive the sickness benefit starting from the 43rd day of your sickness.
You are also entitled to maternity benefit before and after the birth.
You are bound to this decision for 3 years - even if you change health insurance providers in the meantime. You cannot switch to private health insurance during this time.
You can also take the additional supplementary benefit plan, or so called Wahltarif. This tariff will bridge the gap and cover you up to that 43rd day of your sickness (this period is covered by the employer in the case of employees). You generally start receiving sickness payment from the 14th day of your sickness, but since these tariffs are really flexible, you can arrange various scenarios with your public provider, and pay more or less accordingly.Alternatively, some health insurance funds also offer optional tariffs that completely replace the classic sickness benefit. In such tariffs, you can agree on an earlier or later start of sickness benefit payments. In return, you pay the reduced contribution rate of currently 14% (2024), and the extra contribution for the optional tariff. How expensive the optional tariffs are varies between the health insurance funds.
Same as for employees: since 2021, your doctor should send the certificate of incapacity for work digitally to your statutory health insurance fund so that you no longer have to send the certificate to the health insurance fund yourself.
If you did not choose one of the Wahltarif(s), and are therefore only covered by the sickness benefit from 43rd day of your initial sickness onwards, you can still receive the sickness benefit before the 43rd day in case you already suffered from the same illness prior and was unable to work.
So let's say you were unable to work for 40 days due to illness. You did not reach the 43rd day, and were therefore not eligible for sickness benefit. However, if you were to be unable to work again soon due to the same illness, the previous time counts. So in this case, you would be eligible for a sickness benefit from the 3rd day onwards already (find more info in the Bundessozialgericht paragraph).
Receiving unemployment benefits (ALG 1)
If you are receiving ALG 1 from the unemployment agency, you are required to apply for various jobs that the unemployment agency sends you. Meaning, you need to be actively trying to find new work. That is basically your job at the moment, and for that you receive about 60-67% of your last year average salary.
However, if you are unable to "work" due to sickness, sickness benefit will kick in after 6 weeks of your sickness, same as with employees and self-employed. Therefore, from the 43rd day of your sickness, you will not be eligible for the unemployment benefit anymore, and sickness benefit will replace it. Your public insurance provider will automatically pass the "sick note" to the unemployment agency after 6 weeks of your sickness. However, you still have to inform the unemployment agency yourself.
Can I travel while receiving sick benefit?
Travel within Germany does not require the consent of the health insurance fund. You also do not have to inform the health insurance fund about such a trip. You only have to take part in medical treatment and examinations. If no treatment is planned during your trip, you can travel within Germany without any problems. You can even travel abroad, with the pre-approval from your health insurance provider (EU wide travels generally have to be allowed).
Students are not eligible for sickness benefit, even if they are working along their studies. Working student contracts are free of social contribution, meaning students do not pay into the full insurance, therefore are not eligible for all the benefits).