[Germany] Long-term sick leave: navigating the complexities

Germany’s health and social insurance system offers financial security during long absences from work due to sickness but navigating the system’s complexities can be challenging, GVS reports.

GVS’s breakdown explores key aspects of German health and social insurance, offering a comprehensive understanding of how it works and how it can offer protection during periods of illness.

The Foundation of German Health Insurance:

Germany’s statutory health insurance system is known as Krankenversicherung. This system ensures that all residents have access to affordable healthcare. It is mandatory for employees with an income below a certain threshold. Others may reportedly choose between statutory or private health insurance.

Sick Pay Benefits:

One of the most significant advantages German health insurance brings is the provision of sick pay benefits. When an employee falls ill and cannot work, they are entitled to receive sick pay, known as Krankengeld. This benefit provides financial support during sickness-related absences, safeguarding individuals from financial difficulties.

Eligibility for Sick Pay:

To be eligible for Krankengeld, individuals must reportedly be insured under statutory health insurance for at least six months. Employees receive full salary continuation from their employer for up to six weeks during this period. After this initial period, statutory health insurance takes over and provides sick pay benefits.

Duration and Amount of Sick Pay:

The duration and amount of Krankengeld depend on various factors. Initially, sick pay covers 70 per cent of an employee’s gross salary, capped at a maximum daily rate. After six weeks, the amount reduces to 50 per cent of the gross salary. However, some collective bargaining agreements may offer higher percentages or longer durations of sick pay.

Notification and Documentation:

To claim Krankengeld, employees must promptly notify their employer of their illness and submit a medical certificate from a licensed physician. This documentation serves as proof of the illness and ensures a smooth transition to receiving sick pay benefits.

Integration of Health and Social Insurance:

In Germany, health insurance and social insurance are closely connected. Social insurance, known as Sozialversicherung, reportedly encompasses various benefits, including pension, unemployment, accident and long-term care insurance. These insurances work together to provide comprehensive coverage for individuals during different life circumstances.

Co-Payments and Additional Insurance:

German health insurance covers the majority of medical expenses but GVS says it is important to note that co-payments, known as Zuzahlungen, might apply for certain treatments, medications or hospital stays. In addition,  individuals may opt for supplementary private health insurance to cover any gaps in the statutory system or to access additional services.

Rehabilitation Measures:

German health insurance puts the emphasis on rehabilitation measures to support individuals in returning to work after a prolonged illness. These measures include physical therapy, occupational therapy, and vocational training programmes. The goal is reportedly to provide comprehensive support and enable individuals to reintegrate into the workforce successfully.

Support for Long-Term Illnesses:

In cases where an illness extends beyond the duration of Krankengeld, individuals may be eligible for long-term benefits such as disability pension or long-term care insurance. These benefits ensure continued financial stability and access to necessary care for those facing chronic or severe health conditions.

Source: GVS

Germany’s health and social insurance system offers financial security during long absences from work due to sickness but navigating the system’s complexities can be challenging, GVS reports.

GVS’s breakdown explores key aspects of German health and social insurance, offering a comprehensive understanding of how it works and how it can offer protection during periods of illness.

The Foundation of German Health Insurance:

Germany’s statutory health insurance system is known as Krankenversicherung. This system ensures that all residents have access to affordable healthcare. It is mandatory for employees with an income below a certain threshold. Others may reportedly choose between statutory or private health insurance.

Sick Pay Benefits:

One of the most significant advantages German health insurance brings is the provision of sick pay benefits. When an employee falls ill and cannot work, they are entitled to receive sick pay, known as Krankengeld. This benefit provides financial support during sickness-related absences, safeguarding individuals from financial difficulties.

Eligibility for Sick Pay:

To be eligible for Krankengeld, individuals must reportedly be insured under statutory health insurance for at least six months. Employees receive full salary continuation from their employer for up to six weeks during this period. After this initial period, statutory health insurance takes over and provides sick pay benefits.

Duration and Amount of Sick Pay:

The duration and amount of Krankengeld depend on various factors. Initially, sick pay covers 70 per cent of an employee’s gross salary, capped at a maximum daily rate. After six weeks, the amount reduces to 50 per cent of the gross salary. However, some collective bargaining agreements may offer higher percentages or longer durations of sick pay.

Notification and Documentation:

To claim Krankengeld, employees must promptly notify their employer of their illness and submit a medical certificate from a licensed physician. This documentation serves as proof of the illness and ensures a smooth transition to receiving sick pay benefits.

Integration of Health and Social Insurance:

In Germany, health insurance and social insurance are closely connected. Social insurance, known as Sozialversicherung, reportedly encompasses various benefits, including pension, unemployment, accident and long-term care insurance. These insurances work together to provide comprehensive coverage for individuals during different life circumstances.

Co-Payments and Additional Insurance:

German health insurance covers the majority of medical expenses but GVS says it is important to note that co-payments, known as Zuzahlungen, might apply for certain treatments, medications or hospital stays. In addition,  individuals may opt for supplementary private health insurance to cover any gaps in the statutory system or to access additional services.

Rehabilitation Measures:

German health insurance puts the emphasis on rehabilitation measures to support individuals in returning to work after a prolonged illness. These measures include physical therapy, occupational therapy, and vocational training programmes. The goal is reportedly to provide comprehensive support and enable individuals to reintegrate into the workforce successfully.

Support for Long-Term Illnesses:

In cases where an illness extends beyond the duration of Krankengeld, individuals may be eligible for long-term benefits such as disability pension or long-term care insurance. These benefits ensure continued financial stability and access to necessary care for those facing chronic or severe health conditions.

Source: GVS