Resource article
Krankengeld Germany 2026 — Lohnfortzahlung 6 weeks + 78-week Krankenkasse rule
Germany's sick-pay system has two phases: employer pays 100% gross for 6 weeks (Lohnfortzahlung), then your Krankenkasse pays 70% gross / 90% net cap for up to 78 weeks per illness in 3 years. We explain the calculation, the 'Aussteuerung' transition to disability assessment, and how to handle recurring sick episodes.
What you will learn
- The two-phase German sick-pay system
- How the Krankengeld amount is calculated
- The 78-week rule and Aussteuerung
- Tarifvertrag top-up: when employers pay more
The two-phase German sick-pay system
Phase 1 — Lohnfortzahlung (Entgeltfortzahlung im Krankheitsfall, EFZG): for the first 6 calendar weeks (42 days) of illness, your employer pays 100% of your normal gross salary. This is mandatory under §3 EFZG and applies from day 1 — no carenza in Germany.
Phase 2 — Krankengeld: from day 43, your statutory health insurance (gesetzliche Krankenkasse — AOK, TK, Barmer, etc.) takes over and pays 70% of your gross income, capped at 90% of net (whichever is lower). Maximum 78 weeks per illness within a 3-year reference window.
If you change jobs and fall ill in the new role, the 6-week clock RESTARTS — but only if the new role is materially different (different employer / different illness). If the same illness recurs within 6 months of returning to work, the 78-week clock CONTINUES from where it left off.
How the Krankengeld amount is calculated
Your Krankenkasse takes the gross income from the last completed billing period before the illness (typically the last full month before phase 2 begins) and applies: Krankengeld = MIN(0.70 × gross, 0.90 × net).
The 90%-of-net cap rarely binds for low-to-mid earners — for most workers, 70% × gross is below 90% × net. The cap matters most for high earners with high tax burden, where 70% gross might exceed 90% of their actual take-home.
Krankengeld is INCOME-TAX-FREE during the year you receive it BUT subject to Progressionsvorbehalt — meaning it raises the rate that applies to your other income that year. Plan for a small tax adjustment when filing.
Krankengeld is also FREE from social-security contributions (no pension, no health insurance, no unemployment insurance taken from it). This means your effective net income from Krankengeld is closer to 75-85% of your normal net than the headline 70% would suggest.
The 78-week rule and Aussteuerung
You can receive Krankengeld for a maximum of 78 weeks (546 days) per illness within a rolling 3-year window. This is called the Bemessungsrahmen.
If your illness persists past 78 weeks, the Krankenkasse 'aussteuert' (releases) you — Krankengeld stops. At this point, your Krankenkasse / Bundesagentur typically prompts you to apply for either: (a) Erwerbsminderungsrente (reduced-earnings pension via Deutsche Rentenversicherung), or (b) Arbeitslosengeld (unemployment benefit if you've been continuously employed during the 3-year window).
Erwerbsminderungsrente has two tiers: full (under 3 hours work capacity) and partial (3-6 hours). The amount is calculated similarly to a regular age pension based on accumulated entgeltpunkte, but with a deduction for early commencement.
Strategy: if you anticipate exceeding 78 weeks, start the Erwerbsminderungs-application at week 70 — the process takes 4-6 months and you don't want a gap between Krankengeld ending and the pension starting.
Tarifvertrag top-up: when employers pay more
Many German Tarifverträge top up the Krankengeld during phase 2 to maintain 100% of net salary. Common examples for 2026:
Banking sector (TVöD-Banken): 100% net for weeks 7-26 (so 32 weeks total at full pay).
Public sector (TVöD): 100% net for weeks 7-13 if tenure ≥1 year, weeks 7-26 if tenure ≥3 years.
Metalworkers (IG Metall): 100% net for weeks 7-13 typically, sometimes 7-26 in regional variants.
Retail (Tarifvertrag Einzelhandel): 100% net for weeks 7-9 (just 3 extra weeks above legal floor).
Always check your specific Tarifvertrag (employee's intranet, works council, IG Metall office). The top-up clause is called 'Krankengeldzuschuss' or 'Aufstockungsleistung'.
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