Krankengeld für Krankenversicherte Gewährung für den Versicherungsnehmer Unfortunately this specification of service has not yet been completely translated.

Sickness benefit is intended to compensate the insured person * the loss of earnings. The duration and amount of sick pay are prescribed by law. In the event of illness, you as an employee will continue to be paid your salary in accordance with the provisions of labour law (continued payment of remuneration in the event of illness, generally for six weeks). After this period, legally insured persons may be entitled to sickness benefit if they are unable to work for a longer period of time or if they are treated as an inpatient in a hospital or in a preventive care or rehabilitation facility. Sickness benefit amounts to 70 percent of gross pay (insofar as it is subject to the calculation of contributions) up to a maximum of 90 percent of net pay. The entitlement to sickness benefit exists for a maximum of 78 weeks within each 3-year period of incapacity for work due to the same illness. If another illness occurs during the incapacity for work, the benefit period will not be extended. After the three years, you can only receive sickness benefit again for the same illness if, in the meantime, you have been fit for work and gainfully employed for at least six months or have been available to the employment service. Caution. The insurance relationship existing when the entitlement to sickness benefit arises determines who is entitled to sickness benefit and to what extent. To make up the difference between sickness benefit and net pay, private health insurance companies offer daily allowance insurance. As soon as you receive a pension due to full reduction in earning capacity or disability, a full pension due to old age, a pension or an early retirement pension or comparable benefits, the entitlement to sickness benefit ends from the start of these benefits. *) In order to remain comprehensible, we have restricted ourselves to the generalised designations of persons; they always refer to each sex - editor's note. Contact Statutory health insurance (Krankenkasse) > List of health insurance companies Database of the GKV-Spitzenverband

Check with your health insurance company to find out what documents you need to submit.


Preconditions
There must be health insurance with entitlement to sick pay. The deadline for continued payment of wages in the event of illness has expired. You must report the inability to work to the health insurance fund without delay. Also recipients of unemployment benefit, transitional allowance or short-time allowance are entitled to sick pay. This is granted from the first day of incapacity for work. Since sickness benefit has the function of replacing remuneration, it can be claimed by voluntarily insured persons in principle as a replacement for those earnings which the insured person received as remuneration or income from work before the onset of the incapacity for work and which cease to apply due to the illness. Mainly self-employed persons who are voluntarily insured in the statutory health insurance scheme can cover loss of income due to illness (from the seventh week of incapacity for work) by taking out insurance with a claim to sickness benefit in accordance with § 44 SGB V or - if the health insurance scheme provides for a sickness benefit optional tariff in its statutes - by taking out this optional tariff. By taking out this optional tariff, the insured person is bound to his health insurance fund for three years. Insured persons who are insured under the family insurance scheme or recipients of unemployment benefit II or compulsorily insured students or trainees, for example, are not entitled to sickness benefit.
While you are still ill and the employer continues to pay your wages, you must send a copy of the certificate of incapacity for work to your health insurance fund. If you are still unable to work, apply to your sickness insurance fund for sickness benefit and submit the current certificate of incapacity for work. Payment of sickness benefit Sickness benefit is calculated per calendar day. If you are entitled to sickness benefit for a whole calendar month, this is calculated as 30 days. If you are only partially entitled to sickness benefit in a month, payment will be made for the days actually accrued. The sick pay is reduced by the contributions for the insured person's share of pension, unemployment, and nursing insurance, if insurance is compulsory in these areas. The contribution supplement for childless persons in the nursing care insurance is borne by the sickness benefit recipient alone.

Responsible for the content
The Senator for Health, Women and Consumer Protection

Last update or date of publication
01.07.2021