The German Bundestag passed a major healthcare reform on 10 July 2026 that will fundamentally change how long-term illness is handled in the workplace. From 2027, doctors will be able to certify an employee as partially incapacitated — at 25, 50, or 75 percent — rather than forcing a binary fit-or-unfit judgment. The change is part of the GKV-Beitragssatzstabilisierungsgesetz (Statutory Health Insurance Contribution Rate Stabilisation Act), a package designed to save roughly €19 billion in 2027.
The new partial sick note (Teil-AU) applies only when an illness has lasted longer than four weeks, for example in cases of cancer or mental health disorders. Employers gain a seven-day right to object to the partial certification. During the first six weeks of incapacity, full wage continuation remains; after that, proportional sickness benefits kick in. Privately insured individuals and mini-job holders are excluded from the scheme — a point that has already drawn criticism from business associations and medical professional bodies.
No Backdoor Into Public Insurance Via Staged Return to Work
Separately, Germany’s Federal Social Court (Bundessozialgericht) issued a landmark ruling on 18 May 2026 (case number B 12 KR 6/24 R) that closes a potential loophole. The court clarified that a phased return to work after a long illness — known as stufenweise Wiedereingliederung — does not create a new employment relationship, even if the employee’s income temporarily falls below the compulsory insurance threshold. Therefore it cannot serve as a lever to switch from private health insurance (PKV) into the statutory system (GKV).
The judges in Karlsruhe stressed that for a change of insurance regime, a new or amended employment contract with a permanently lower salary is required. In the case before them, the annual income limit for compulsory insurance stood at €77,300. A temporary dip during the reintegration phase, they ruled, is legally irrelevant. Additionally, switching insurers is generally only possible before the age of 55. The court emphasised that staged reintegration serves medical rehabilitation, not a contractual redesign of the employment relationship.
Extra Costs and Fewer Notifications for Insured Members
Alongside the structural change to sick notes, the reform package introduces heavier financial burdens. From 2027, the contribution assessment ceiling will rise to €5,812.50 per month. Co-payments for medicines and therapeutic treatments will increase by 50 percent — meaning between €7.50 and €15 per service. Statutory health insurance will stop covering homeopathy, cannabis therapies, and skin cancer screening for those aged 35 and over. Subsidies for dental prostheses will also be cut.
A further change arrives in 2028: spouses currently covered free of charge under family insurance (Familienversicherung) will attract a 2.5 percent surcharge, with some exceptions.
Communication rules are also being relaxed. Health insurers will no longer be required to inform individual members by letter about increases in supplementary contributions. Instead, a notice on the insurer’s website or in its member magazine will suffice. While the special right to terminate membership remains, consumer advocates warn that the change erodes policyholder rights. The GKV-Spitzenverband (the umbrella organisation of statutory insurers) plans to maintain a central overview.
Separately, the coalition committee decided in early July to abolish telephone sick notes entirely. A requirement to prove incapacity from the first day of illness is to be introduced, with legislation expected to be complete by the end of 2026.
