Sickness benefit for insured persons Granted to the policyholder Unfortunately this specification of service has not yet been completely translated.
The sickness benefit is intended to replace the insured * with the loss of earnings. The duration and amount of sickness benefit are required by law. In the event of illness, you, as an employee, will continue to be paid the remuneration in accordance with labour law regulations (continued payment in the event of illness is usually paid for six weeks). After the expiry of this period, persons insured by law in the event of permanent incapacity for work or if you are being treated in a hospital or in a preventive or rehabilitation facility may be entitled to sickness benefit. Sickness benefit amounts to 70 percent of gross earnings (as far as it is subject to the calculation of contributions) up to a maximum of 90 percent of the net wage. The right to sickness benefit is for a maximum of 78 weeks within 3 years in case of incapacity for work due to the same illness. If another illness occurs during incapacity for work, the duration of benefits is not extended. At the end of the three-year period, you can only receive sick pay for the same illness if you have been able to work and work for at least six months in the meantime or have been available to the employment service. Attention! The insurance relationship in place at the time of the entitlement to sickness benefit determines who is entitled to sickness benefit to what extent. To make up for the difference between sickness benefit and net pay, private health insurance companies offer daily benefit insurance. As soon as you receive a pension for full disability or disability, a full pension on grounds of age, a pension or an early retirement benefit or similar benefits, the entitlement to sickness benefit ends from the beginning of these benefits. *) In order to remain comprehensible, we limit ourselves to the generalising personal names, they always refer to each gender _ i.e. red. Contact point Statutory health insurance (health insurance) -> Health insurance list Database of the GKV-Spitzenverband
Check with your health insurance company what documents you need to provide.
There must be health insurance with entitlement to sickness benefit. The deadline for continued payment of wages in the event of illness has expired. You must report the incapacity to work to the health insurance company without delay. Recipients of unemployment benefit, transitional allowance or short-time working allowance are also entitled to sickness benefit. This is granted from the first day of incapacity for work. Since the sickness benefit has a compensation function, it can in principle be claimed by voluntarily insured persons as a substitute for those income which the insured person has received before the incapacity for work as remuneration or income and which are no longer paid due to the illness. Employees who are voluntarily insured under the statutory health insurance can cover loss of income (from the seventh week of incapacity for work) by insuring themselves with a claim to sickness benefit in accordance with Section 44 sGB V or - if the health insurance fund provides for a sickness benefit option rate in its statutes - by taking out this choice rate. By concluding this electoral tariff, the insured person is bound to his health insurance fund for three years. For example, insured persons who are insured under family insurance or those receiving unemployment benefit II or duly insured students or trainees are not entitled to sickness benefit.
While you are sick and the employer continues to pay your salary, you must send a copy of the incapacity certificate to your health insurance company. If you are still incapacitated, you apply to your health insurance company for sickness benefit by presenting the current certificate of incapacity for work. Payment of sickness benefit The sickness benefit is calculated per calendar day. If you are entitled to sickness benefit for a whole calendar month, it is set at 30 days. If you are only partially entitled to sickness benefit in one month, payment will be made for the days actually incurred. Sickness benefit is reduced by contributions for the insured's share of pension, unemployment and long-term care insurance if there is an obligation to provide insurance. The sickness benefit recipient alone bears the contribution supplement for childless people in long-term care insurance.