Sickness benefit (Krankengeld) is for many employees and self-employed people the main income protection during longer illness. The benefit has a limit, though, and that is where the income gap appears for many people. This guide explains how long sickness benefit is paid for the same illness, how the amount is calculated and what can happen once the entitlement ends.
Short answer: Sickness benefit is paid for the same illness for at most 78 weeks within each period of three years (§ 48 SGB V). It amounts to 70 percent of the regular earnings and may not exceed 90 percent of net earnings (§ 47 SGB V). The gap appears when the entitlement runs out and no other income covers the shortfall. Last updated: November 2026.
Key points
- The maximum period is 78 weeks for the same illness, counted within a three-year window.
- A further illness during the period of incapacity does not extend this period.
- Sickness benefit is 70 percent of the regular earnings, capped at 90 percent of net earnings.
- The gap appears in two stages: first through the reduction, later through the end of the entitlement.
- Occupational disability insurance (Berufsunfähigkeitsversicherung, BU) asks a different question from sickness benefit and does not pay automatically when sickness benefit ends.
How long does the health insurer pay sickness benefit?
Under § 48 subsection 1 SGB V, sickness benefit is granted for at most 78 weeks within each period of three years. The period starts on the first day of incapacity for the same illness. Seventy-eight weeks correspond to 546 calendar days, because sickness benefit is calculated per calendar day. The benefit is therefore not unlimited once the same illness has used up that period.
| Feature | Rule | Basis |
|---|---|---|
| Maximum duration | 78 weeks for the same illness | § 48 subsection 1 SGB V |
| Period of entitlement | Within each three-year window, counted from the start of incapacity | § 48 subsection 1 SGB V |
| Further illness | Does not extend the period of payment | § 48 subsection 1 sentence 2 SGB V |
| New entitlement for the same illness | Possible after a new three-year window, if at least six months without incapacity for that illness have passed and you were employed or available for placement | § 48 subsection 2 SGB V |
How is the amount of sickness benefit calculated?
The amount follows from the regular earnings, meaning the contribution-liable earnings from employment or self-employment. Under § 47 subsection 1 SGB V, sickness benefit is 70 percent of that amount. The benefit calculated in this way may, however, not exceed 90 percent of net earnings. The cap is an upper limit, and the calculation in an individual case shows whether it applies.
- Determine the regular earnings from the contribution-liable income before incapacity began.
- Calculate 70 percent of those regular earnings as the provisional sickness benefit.
- Establish the net earnings and check whether 90 percent of them is lower.
- Use the lower of the two values as the actual daily sickness benefit.
When does the income gap arise?
The gap does not begin only when the entitlement ends. Even during sickness benefit part of the previous income is missing, because the benefit does not replace the full wage. Only after the 78 weeks does the benefit stop completely, unless another protection applies. This second stage is for many the real challenge, because it can arrive without warning.
What happens after sickness benefit ends?
If you still cannot work once the maximum period has passed, the next step depends on your situation. The German pension insurance (Deutsche Rentenversicherung) may examine whether a pension for reduced earning capacity is possible. Depending on the circumstances, other benefits can also play a role. The competent body decides this case by case, so the question is worth raising early.
Occupational disability insurance does not follow the sickness benefit rules. Under § 172 subsection 2 VVG, what matters is whether you are expected to be permanently unable to practise your last occupation because of an illness. A temporary incapacity that ends after 78 weeks is not automatically enough for that. How to prepare an application is explained in BU-Leistungsantrag stellen: Unterlagen, Fristen und Gutachten (in German).
How does your insurance status affect the benefit?
Whether and to what extent you receive sickness benefit depends on your insurance status. Employees, self-employed people and students are not automatically protected in the same way. The special features during studies are explained in Krankengeld für Studierende: Gibt es das? (in German). If you work self-employed, keep daily sickness allowance cover (Krankentagegeld) in view as well, whose waiting period is described in Krankentagegeld Wartezeit: Was Freelancer wissen müssen (in German).
Which documents help with the calculation?
For the amount of sickness benefit, the contribution-liable earnings from the months before incapacity count. Pay slips and an employer confirmation help you reconstruct the regular earnings. The health insurer decides on the basis of the data reported, so it is worth checking discrepancies early.
What does this mean for your planning?
If you know the gap arises in two stages, you can react earlier. A reserve that bridges the reduction to 70 percent is a different buffer from cover for the case in which the entitlement ends completely. The two cannot be equated, and planning should take both stages into account.
For self-employed people, career starters and students the question often weighs even more, because entitlements differ depending on insurance status. An honest review of your own cover is therefore the first step before deciding on supplements.
Frequently asked questions
Do breaks between two periods of illness count?
That depends on whether you were employed or available for placement in between. Under § 48 subsection 2 SGB V, a new entitlement for the same illness can arise if at least six months have passed without incapacity for that illness. Periods without entitlement to sickness benefit are not counted towards the period of payment. Periods in which the entitlement is suspended or the benefit is refused do count.
Does a second illness extend the entitlement?
No. If a further illness occurs during incapacity, the period of payment is not extended under § 48 subsection 1 sentence 2 SGB V. A condition that follows an ongoing one can therefore use up the maximum period faster, without the deadline moving.
Does the maximum period also apply after a short return to work?
A short return to work does not automatically end the maximum period. What matters is whether the time without incapacity for that illness covers at least six months. For shorter gaps the previous period of payment remains decisive.
Is sickness benefit always time-limited?
Not in every case. Under § 48 subsection 1 sentence 1 SGB V, sickness benefit is initially granted without time limit. The maximum period applies to incapacity for the same illness. If you want to know how long the benefit runs in your specific case, ask your health insurer for information.
How to proceed now
- Record the start of each period of incapacity with its date, so that the three-year window stays traceable.
- Ask your health insurer for the regular earnings and the net earnings used in your calculation.
- When the end of sickness benefit approaches, check early which benefits and protections apply.
- If you may want to file a disability claim, document the disability in writing with medical records first.
Related guides
- How do I protect my working capacity? The overview for career starters (in German)
- Daily sickness allowance waiting period: what freelancers need to know (in German)
- Filing a disability claim: documents, deadlines and assessments (in German)
- Disability insurance or care top-up: which cover comes first (in German)
- Sickness benefit for students: does it exist? (in German)
Sources: § 48 SGB V, Duration of sickness benefit, last updated November 2026; § 47 SGB V, Amount and calculation of sickness benefit, last updated November 2026; § 172 VVG, Benefits of the insurer (occupational disability), last updated November 2026.
Last updated: November 2026. This guide is general information, not individual advice.
