Long-term sick leave drives up costs for German health insurers

Germany's statutory health insurance system faces rising costs due to an increase in long-term employee sick leave. The umbrella association of company health insurers (BKK) reports that while the overall sick rate and average duration of illness remained stable last year, the number of claims for sick pay has grown. This benefit, paid from the 43rd day of illness, now represents a major expenditure, totaling 21.6 billion euros and accounting for over a quarter of all sick days in 2025.

The trend is largely driven by mental health conditions and musculoskeletal disorders. Although mental illnesses constitute only 5.4% of all sick certifications, they are the longest-lasting, averaging over five weeks and showing an upward trend. "It's not the common colds that financially burden the health system," stated association board member Anne-Kathrin Klemm, urging a serious discussion on prevention strategies for mental health issues, extending beyond the workplace.

In response to the rising sick leave, the ruling coalition announced plans to tighten regulations. These include requiring a doctor's note from the first day of illness and eliminating the option for phone-based sick leave certifications. Chancellor Friedrich Merz (CDU) cited the goal of reducing the overall sick rate as the rationale for these proposed changes.

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It's not the common colds that financially burden the health system.