What is a Krankengeld-Bescheid?
A Krankengeld-Bescheid is your statutory health insurer's (Krankenkasse) official decision on Krankengeld — sickness benefit under Book V of the Social Code (SGB V). It replaces part of your wages when you are unable to work due to illness and employer sick pay has ended or does not apply.
This is different from a Krankenkasse Beitragsanpassung (contribution notice) or from Arbeitslosengeld (unemployment benefit). Krankengeld requires ongoing medical incapacity for work.
When Krankengeld starts — after Lohnfortzahlung
Employers must continue paying salary for up to six weeks for the same illness (Entgeltfortzahlung im Krankheitsfall). After that, if you are still unfit for work, the Krankenkasse pays Krankengeld — usually from week seven, provided you submitted Arbeitsunfähigkeitsbescheinigungen (AU certificates) from your doctor on time.
The Bescheid should show the start date of Krankengeld and the daily amount from that point.
Types of decision
- Bewilligungsbescheid — Krankengeld approved for a stated period
- Teilkrankengeld-Bescheid — partial benefit during phased return to work
- Änderungsbescheid — amount or period changed (e.g. new wage data)
- Ablehnungsbescheid — no entitlement (missing AU, not incapacitated, max duration reached)
- Aufhebungsbescheid — payments end (fit for work, failed to cooperate)
How to read your Krankengeld Bescheid
- Krankengeld täglich — daily sickness benefit (monthly ≈ daily × 30)
- Bemessungsentgelt / Regelentgelt — average pay used for calculation (typically ~70% of gross, capped by statutory maximum)
- Bewilligungszeitraum — approved payment period
- Restleistungsanspruch — remaining weeks of Krankengeld entitlement for this condition
- Höchstleistungsdauer — legal maximum (generally up to 78 weeks within three years for the same illness)
- Teilkrankengeld — reduced rate if you work part-time while still partially unfit
Annex pages show how the Krankenkasse calculated your Entgelt. Compare with payslips if the daily rate seems wrong.
AU certificates — what you must send
From day one of illness you need an Arbeitsunfähigkeitsbescheinigung (AU) from a doctor, sent to employer and Krankenkasse (often electronically eAU). Late or missing certificates are a common reason for denied or stopped Krankengeld.
- Initial AU from first day of incapacity
- Follow-up AU before the previous certificate expires
- Notify employer and insurer immediately if fit for work returns or hours change
Medical review (MDK / Gutachten)
If you are sick for a long time, the Krankenkasse may request a review by the Medizinischen Dienst (MDK) or similar. The result can affect whether Krankengeld continues. You must cooperate with examination appointments; refusal can stop payment. The same MDK also assesses care needs for a Pflegegrad — a different letter; see our Pflegegrad-Bescheid guide.
If a Gutachten finds you able to work, the Bescheid will cite the end date. You can challenge this with a Widerspruch and your own medical opinions.
Teilkrankengeld — returning gradually
When you return to work step by step (e.g. part-time while still recovering), you may receive Teilkrankengeld alongside partial wages. The Bescheid should state reduced hours, employer pay, and insurer top-up. Report any schedule change immediately — overpayment leads to Erstattung (repayment).
If payment stops early
- Maximum duration (78 weeks / 3 years) reached for the same underlying condition
- MDK finds you fit for work
- Missing or expired AU certificates
- You started employment without notifying the insurer
- Failure to attend a medical examination
Always request the decision in writing with the legal reason. If you still cannot work, discuss rehabilitation (Reha), reduced earning capacity pension (Erwerbsminderungsrente), or Bürgergeld with the relevant offices.
Filing a Widerspruch
You generally have one month from receipt to file a Widerspruch against the Krankenkasse (§ 70 SGB X). State your insurance number, Bescheid date, and why the amount or termination is wrong. Attach medical reports and AU history if relevant.
Continue sending AU certificates while unfit for work, even during an appeal.
What to do — step by step
Step 1: Note delivery date and whether this is approval, change, or termination.
Step 2: Check daily Krankengeld and Bewilligungszeitraum.
Step 3: Verify Restleistungsanspruch / Höchstleistungsdauer if long-term sick.
Step 4: Ensure all AU certificates were submitted on time.
Step 5: Calendar one-month Widerspruch deadline if you disagree.
Step 6: If benefits end — ask about Reha, Erwerbsminderungsrente, or Bürgergeld pathways.
When to get help
- Daily amount much lower than ~70% of your usual net pay (within caps).
- Payment stopped after MDK without you understanding the report.
- Teilkrankengeld calculation does not match your part-time schedule.
- Krankenkasse denies Krankengeld despite continuous AU certificates.
- You approach the 78-week limit and need planning for income after Krankengeld ends.
Key terms glossary
| Krankengeld | Sickness benefit from health insurance |
| Krankenkasse | Your statutory health insurer |
| Lohnfortzahlung | Employer continues salary (up to 6 weeks) |
| AU-Bescheinigung | Doctor's certificate of incapacity for work |
| Bemessungsentgelt | Wage base for Krankengeld calculation |
| Teilkrankengeld | Partial sick pay during gradual return |
| MDK | Medical review service for insurers |
| Höchstleistungsdauer | Maximum payment period (often 78 weeks) |
| Restleistungsanspruch | Remaining entitlement weeks |
| Widerspruch | Formal objection (one month) |
| Erstattung | Repayment of overpaid Krankengeld |
Still not sure what your letter wants?
- ✓ Plain English summary of daily Krankengeld and period
- ✓ Teilkrankengeld or termination reason highlighted
- ✓ Widerspruch deadline check
- ✓ Draft Widerspruch or Krankenkasse reply in German
Last updated: June 2026