In short: In Germany, surgery, the hospital stay, physiotherapy and many aids (knee brace, crutches) are in principle covered by statutory health insurance (GKV); rehab sport is prescribed by a doctor and subsidised. How long you are signed off work depends on your job, ranging from around 2 weeks (office job) to several months (physical work). As of 2026 – always confirm the details directly with your own insurer.
On top of the worry about your knee, a second, quieter concern often creeps in: what is all of this actually going to cost me? Who pays for the surgery, the brace, the months of physio appointments? And what about my salary if I can't work for weeks?
I know that mental arithmetic well. I had two ACL tears, both operated on, plus a hand rehab – and every time, at some point I sat there trying to work out what was coming my way. The good news first: in Germany, statutory health insurance (GKV) covers by far the largest part. The less pleasant part: there are co-payments, a few pitfalls and a lot of "it depends". Here I'll sort it out for you so you know what to watch for – and which question to ask your insurer.
Important upfront: This article is not a substitute for legal or social-welfare advice and is not a binding cost commitment. The details of coverage, amounts and limits change and differ from one insurer to the next. What's binding is always the information from your health insurer. All figures: as of 2026, focused on statutory health insurance (GKV) in Germany – with private insurance (PKV) or abroad, different rules apply.
At a glance
- Surgery, the hospital stay and the medically necessary follow-up care are in principle GKV benefits – you don't pay the bill, only at most the statutory co-payments.
- Physiotherapy, the knee brace and crutches are prescribed by a doctor and covered by the insurer; for therapeutic aids there is usually a statutory co-payment.
- Rehab sport / functional training runs via a doctor's prescription (the nationwide standard form, Muster 56) and is subsidised.
- Sick pay (Krankengeld) protects your income once continued wage payment ends; how long you're signed off depends heavily on your job (an office job is much shorter than physical work).
- For co-payments there is an annual out-of-pocket ceiling – once you reach it, you can be exempted for the rest of the year.
- What you pay yourself is mainly: statutory co-payments, genuine out-of-pocket "wish" services (IGeL) and certain extra products (e.g. supplements, comfort extras).
What statutory health insurance covers in principle
The GKV covers services that are medically necessary, adequate and economical. For an ACL tear that means: the actual treatment pathway is covered. You won't get a bill for thousands of euros for the surgery – it's settled directly between the clinic and the insurer.
Surgery and hospital stay. The ACL reconstruction, the anaesthetic, the inpatient or outpatient stay and the immediate aftercare are covered benefits. For a hospital stay there is a statutory co-payment per day, but only for a limited number of days per year – you'll find out the exact amount from your insurer or during the admission interview.
Physiotherapy and other therapeutic services. Physio, lymphatic drainage or exercise therapy are prescribed by the doctor as therapeutic services. The insurer pays for the treatment; you usually make a statutory co-payment per prescription and appointment. Important: if your physio notices you need more, the doctor can prescribe further sessions – with an ACL in particular, longer support is normal, not an exception.
Aids (knee brace, crutches, possibly a motion splint). Aids that are listed in the so-called register of aids (Hilfsmittelverzeichnis) are covered on a doctor's prescription. This typically includes the knee brace/splint and forearm crutches. Here too there is often a small statutory co-payment. If you want a more expensive comfort or brand model at the medical supply store, the difference from the standard covered model may be left with you – ask beforehand what's available "with no top-up".
Follow-up rehabilitation (AHB) / rehab. After larger procedures, a structured rehab can make sense – outpatient or inpatient. Depending on the case, either the health insurer or the pension insurance is responsible; the clinic or the social services office helps with the application. For such a rehab there may be a statutory co-payment per day, again time-limited.
Rehab sport and functional training (prescription Muster 56)
Rehab sport is doctor-prescribed exercise in a recognised group – for example targeted knee training under supervision. In Germany the prescription runs via the nationwide standard form Muster 56. Your doctor enters the diagnosis, the goal and a number of exercise sessions there; the insurer (or the relevant rehab provider) subsidises the sessions within an approved framework.
The process is usually like this: get the prescription from your doctor, submit it to the insurer or have it approved, then start with a recognised provider (often clubs or rehab centres). For you there is usually no, or only a small, personal contribution – but that's exactly the kind of "clarify beforehand" question, because the scope and approval vary.
Rehab sport is worth its weight in gold with an ACL, because you keep training under supervision once the pure physio prescriptions run out. It keeps you moving – and staying the course is, in the end, exactly what it's all about.
Sick pay and how long you're signed off
The question that really hits your wallet: what happens to my income? In Germany, your employer normally continues to pay your salary first for a limited period (continued remuneration). If the inability to work lasts longer, the health insurer steps in with sick pay (Krankengeld) – this replaces part of your net income, not the full salary.
How long you're signed off work depends less on the knee alone than on your job – that is, on what you physically have to do at your workplace:
| Type of job | Typical time signed off | What you need to know |
|---|---|---|
| Office job / mostly seated | approx. 2 weeks, sometimes earlier (also partial / home office) | Returning is often possible once sitting, short distances and the commute are tolerable |
| Standing / walking work (e.g. retail) | several weeks | Tolerance for standing and a safe walking distance are decisive |
| Physically heavy work / trades / care | several weeks to months | Full load, lifting, ladders and kneeling need considerably more time |
| Job with a high risk of falls / accidents | individual, often the longest | Safety first – only return once you have a stable clearance |
These are guideline values, not guarantees. Your doctor decides on your sick leave based on how the surgery went, your job and your healing. A useful tool is a phased return to work (the "Hamburger Modell"): you start back with reduced hours and build up – this can make the transition much easier for body and mind.
Travel costs and home help – briefly explained
Travel costs to treatments can be covered under certain conditions (e.g. in the case of medical necessity or inpatient treatment), often with prior approval and a co-payment. Home help is an option only in narrow exceptional cases, usually if you have young children in the household and can't run the household after surgery. Both are heavily case-by-case – if your situation sounds like that, ask your insurer specifically about the conditions.
What you pay yourself
Even though the GKV covers a lot, a few items typically stay with you.
- Statutory co-payments – not uniformly regulated. For therapeutic services (physio) you typically pay a percentage of the cost plus a fixed fee per prescription; for aids (e.g. brace, crutches) it's usually ten percent, but with a fixed lower and upper limit; for clinic and rehab days it isn't a percentage at all, but a fixed amount per day with a cap on the number of days per year. I deliberately don't quote the exact amounts here as a fixed guarantee, because they change and can vary in individual cases – when in doubt, ask your own insurer directly.
- Out-of-pocket ceiling. Co-payments are capped per calendar year. Once you reach your individual out-of-pocket ceiling (a certain percentage of your annual gross income, lower if you have a chronic illness), you can be exempted for the rest of the year. So: collect the receipts. Keeping your till receipts and slips is worth it.
- IGeL and wish services. Individual health services that go beyond what is medically necessary you pay for yourself.
- Certain extra products. Supplements, "premium" braces above the covered model, fitness gadgets or additional training offers are usually paid for out of your own pocket.
Always clarify with your insurer beforehand
A warning signal for your wallet: Never sign a private top-up at the medical supply store or the practice without first asking whether there's a co-payment-free covered variant. Services that require approval (rehab, certain aids, travel costs) should be agreed with the insurer before you start – doing it retroactively is harder. And: clarify early from when and at what level sick pay kicks in, so no income gap catches you by surprise.
A short overview for orientation:
| Service | Usually covered? | What you need to know |
|---|---|---|
| ACL surgery & clinic | Yes | Settled directly with the insurer; possibly a clinic co-payment per day (limited) |
| Physiotherapy / therapeutic services | Yes | Prescribed by a doctor; usually a statutory co-payment per prescription |
| Knee brace / crutches | Yes | Via the register of aids; possible top-up for comfort models |
| Rehab sport / functional training | Yes, subsidised | Prescription Muster 56; the scope is approved |
| Follow-up rehabilitation (AHB) | Often | Clarify who's responsible (insurer / pension insurance); possible daily co-payment |
| Sick pay | Yes | After continued wage payment; replaces part of your net income |
| Travel costs / home help | Partly | Case-by-case, usually with conditions and approval |
| Supplements / IGeL / extras | No | You pay for wish / extra services yourself |
Frequently asked questions
Does health insurance cover the ACL surgery in full? Yes, the medically necessary ACL surgery including the hospital stay is in principle a benefit of statutory health insurance – it's settled directly between the clinic and the insurer. You only have to reckon with statutory co-payments, for example per clinic day within a limited framework (as of 2026, details from your own insurer). Which questions to ask about the surgery and cost coverage during the consultation you'll find as a doctor's-appointment checklist in the download area of Dranbleiben.
How long am I signed off work after ACL surgery? That depends mainly on your job: with mostly seated work it's often around two weeks, with physically heavy work several weeks to months. What's decisive is the doctor's clearance and your actual load tolerance, not a fixed date. How to plan your return realistically and not overdo it is a topic of its own in the rehab roadmap of Dranbleiben.
What is rehab sport and how do I get it paid for? Rehab sport is doctor-prescribed exercise in a recognised group; in Germany the prescription runs via the Muster 56 form and is subsidised by the insurer. You have the prescription issued by your doctor, submit it to the insurer and then start with a recognised provider. How to use these offers to stay the course once the physio prescriptions run out I show you concretely in Dranbleiben.
Do I have to bear the co-payments for physio and the knee brace entirely myself? Only up to an annual out-of-pocket ceiling: co-payments are capped per calendar year, and once you reach your individual limit, you can be exempted for the rest of the year. That's why it's worth collecting all your receipts. A simple template to help you keep track of appointments, costs and receipts is ready for you in the download area of Dranbleiben.
Read more
- The knee brace after ACL surgery: how long do you wear it? – what your insurer covers and how long the brace stays on
- When can you return to work after ACL surgery? – sick leave, returning and the Hamburger Modell
Money and bureaucracy are the last things you want to deal with after an ACL tear – and that's exactly why it's worth getting some order into this once and then having a clear head for what matters: your rehab. Dranbleiben walks you through the mental and practical side of it, and in the download area you'll find checklists for the doctor's appointment, a cost-and-appointment template, and access to the rehab community, where others share their experiences with insurers and rehab sport. You don't have to figure this out alone.