When you get sick, you first receive your salary from the employer for up to 6 weeks (Entgeltfortzahlung)- and then sickness benefits (Krankengeld) from your statutory health insurer (gesetzliche Krankenkasse). What sounds simple, might become complicated quickly, especially after a dismissal and payment of unemployment benefits: Who pays the sickness benefits after dismissal? Which deadlines apply? How long do you get these benefits? This article explains your entitlement to sickness benefits after a dismissal in Germany in more detail.
Key points at a glance:
- Employees who are unable to work due to illness are entitled to their salary from their employer for up to six weeks (Entgeltfortzahlung). After that, employees insured under the statutory health insurance receive sickness benefits (Krankengeld) for as long as they remain unable to work.
- Unemployed people receiving unemployment benefit are entitled to payment of their benefits for up to six weeks (Leistungsfortzahlung) by the Employment Agency (Agentur für Arbeit). After that, the statutory health insurer takes over and pays sickness benefit.
- Duration: The right to sickness benefits lasts for a maximum of 78 weeks (1.5 years) within a three-year period. The six weeks paid by the employer/Employment Agency count towards this total.
- Calculation: (1) An employee’s sickness benefit is 70% of the gross daily pay (up to a maximum of currently around €183 gross/day). The benefit must not exceed 90% of the lost net pay. (2) For recipients of unemployment benefits, sickness benefits are paid in the same amount as the unemployment benefit.
Contents
Sickness benefit during an ongoing employment relationship
Employees generally have to pay contributions to the statutory health insurance. In this case they have the right to sickness benefits (Krankengeld), if they are unable to work due to illness during an ongoing employment relationship. The same applies to trainees (Auszubildende).1
The entitlement to sickness benefits arises on the first day of incapacity to work. But as the employer has to pay the salary for up to 6 weeks (Entgeltfortzahlung)2, the statutory health insurer only takes over with sickness benefits after these 6 weeks.
The employee must confirm the incapacity to work due to sickness by a medical certificate (Arbeitsunfähigkeitsbescheinigung, AU-Bescheinigung). The employee has to send this to the employer. In case of a longer illness, the employee should send it to the health insurer as well.
Sickness benefits in a new job
If an employee has started a new job and becomes unable to work within the first four weeks, the statutory health insurer pays sickness benefit until the end of the fourth week.
From the fifth week onwards, the employer has to pay the salary for the full six weeks. During this time there is no payment of sickness benefits. If the incapacity to work continues beyond that, the statutory health insurer takes over again.
If the new employment ends before the four-weeks waiting period, there is no entitlement either to a continued salary by the employer or sickness benefits by the health insurance.
Sickness benefits when caring for a sick child
Employees are also entitled to sickness benefits if
- a medical certificate confirms that they are unable to work because they need to look after an ill, insured child,
- no other person living in the household can take care of the child, and
- the child has not yet turned twelve.
Since 2025 the entitlement is 15 working days per child, or 30 working days for single parents. The overall cap (across several children) is 35 working days, or 70 working days for single parents.
Sickness benefit during the ordinary notice period
If incapacity to work occurs during the ordinary notice period, the entitlement to sickness benefit (Krankengeld) also arises from the first day of the incapacity. But first the employer has to pay the salary for up to 6 weeks during the ordinary notice period as well. As long as the employer pays, the health insurer does not have to pay the sickness benefits.
The following rules apply to continued salary pay during the notice period:
- If incapacity to work occurs after the dismissal, the employee receives the usual salary pay from the employer for up to 6 weeks. With longer notice periods, sickness benefits follow. With shorter notice periods, the continued pay stops with the end of the notice period. More on this in our article: Sick leave after dismissal.
- If the employee is already unable to work before the dismissal, the continued pay of the salary continues even after the employment relationship has ended, if the employer has dismissed “because of the incapacity to work”. The reason: the employer should not be able to dismiss the employee just to avoid the continued-payment.3
Sickness benefits during unemployment
If an unemployed person receiving unemployment benefits is getting sick, they receive continued benefits (Leistungsfortzahlung) from the Employment Agency (Agentur für Arbeit) for up to 6 weeks. The payment equals the unemployment benefits. The following conditions must apply:
- Incapacity to work: The unemployed person is unable to work.
- Inpatient treatment: The unemployed person is in hospital.
- Caring for a sick child: The unemployed person cares for a sick child under the age of twelve. The benefit lasts for up to ten days. Single parents are entitled to up to 20 days per child and calendar year.4
The unemployed person does not receive the continued benefit:
- if the unemployed person was already unable to work before the start of unemployment. In that case they receive sickness benefit directly.
- if the Employment Agency suspended the unemployment benefits (Sperrzeit).
After the end of 6 weeks, the statutory health insurer pays sickness benefit for up to 72 weeks (78 weeks minus the six weeks of continued benefit) within a three-year period.
In the case of unemployment the incapacity to work exists where the unemployed person, due to the same illness, cannot perform the work for which the person has made itself available to the Employment Agency. A medical certificate is necessary.
The unemployed person must report the incapacity to work to the Employment Agency without delay. By the end of the third calendar day after the incapacity to work has started, the employee must submit a medical certificate to the Employment Agency. Since 2024, the Employment Agency gets the medical certificate electronically from the statutory health insurer, but the unemployed person must still report the incapacity separately.
Duration of benefits
Sickness benefits are paid for the same illness for a maximum of 78 weeks (1.5 years) within a three-year period. The six weeks of continued pay count towards that total.
The three-year period starts when the incapacity to work has started.
if the insured person has exhausted the 78 weeks (including the six weeks of continued salary pay), the person can only apply again for sickness benefit after the first three-year period has expired if:
- the person was not unable to work due to this illness for at least 6 months during that time and
- the person was either employed, or
- available for job placement by the Employment Agency.
Example: On 31 August 2025, an employee receives a doctor’s sick note for a back condition:
- For the first six weeks, the employer continues the salary payment.
- After that, the statutory health insurer pays sickness benefit. The entitlement to sickness benefit covers up to 72 weeks within three years (78 weeks total minus the six weeks of continued pay). The three-year period starts on the first day of incapacity to work, i.e. 31 August 2025.
- Once the 78 weeks have expired, a new three-year period can begin at the earliest on 1 September 2028. The person can only receive sickness benefits again if, the person has not been unable to work due to the same illness for at least six months. The person must either be in employment or available for a job placement by the Employment Agency.
Calculation of benefits
For an employee in an ongoing employment relationship, sickness benefit are 70% of the regular gross pay. It is calculated per calendar day and is only taken into account up to the maximum daily amount. In 2026 the maximum daily amount is €135,63 or €4.069 gross per month.
- The benefit must not exceed 90% of the net pay before.
- For unemployed person the amount of sickness benefits is the same as unemployment benefit.5
For a precise calculation, we recommend to directly contact your statutory health insurer. Every insurer offers a sickness benefit calculator.
Below is an example based on a monthly gross salary of €4,000 (with tax bracket 3 and two children, that’s roughly €2,900 net). The employee becomes unable to work in October. The last relevant pay period is therefore the pay slip for September:
| Gross pay (September) | €4,000 |
| Net pay (September) | €2,900 |
| Daily regular pay (€4,000 ÷ 30 calendar days) | €133.33 |
| 70% of daily regular pay | €93.33 |
| Daily net pay (€2,900 ÷ 30) | €96.66 |
| 90% of daily net pay | €86.99 |
| Less social security contributions (around €10.57) | €76.42 |
How to apply for sickness benefits
For employees with statutory health insurance, the doctor sends the medical certificate electronically to the health insurer. The insurer then requests any further information either from the employer or directly from the employee (for example, the duration of the incapacity and the last gross and net pay).
Note: We recommend to contact the insurer directly as soon as possible to ask which documents and information they still need. Despite the electronic transmission, some insurers (such as AOK) still offer application forms.
If an unemployed person is receiving continued benefit and remains unable to work afterwards, they need to (1) inform the Employment Agency (there is a form for this) and (2) inform the statutory health insurer.
Payout of sickness benefits
Sickness benefits are paid retrospectively for the past period of incapacity. In other words: once the employer’s payment of the 6 weeks salary has expired, the doctor issues a follow-up medical certificate for a further two weeks, e.g. up to the 31 October. The employee only receives the sickness benefits for those extra 2 weeks after the extra two weeks have lapsed, i.e. after the 31 October.
Because sickness benefits are calculated per calendar day, there is also no fixed payout date. Unlike a salary, it is not paid at the end of every month.
Frequently asked questions
- Section 44 SGB V ↩︎
- Section 3 EFZG (Entgeltfortzahlungsgesetz) ↩︎
- Section 8 subsection 1 EFZG ↩︎
- Section 146 SGB III ↩︎
- Section 47b SGB V ↩︎
