Medical leave 2026: how many days, how much you get, who pays

From 1 February 2026, the first day of medical leave for ordinary illness is no longer paid, under OUG (Emergency Ordinance) 91/2025. Otherwise, the basic rules remain those of OUG 158/2005: the benefit is calculated on the average income over the last 6 months, the rate is as a rule 75% for ordinary illness and 100% for emergencies and infectious-contagious diseases, and the leave is issued by the medic de familie (family doctor) or the specialist physician. Below you will find a short summary of how many days you get, how much you receive, and who bears the cost.

What changed in 2026: the unpaid first day

The most important recent change comes from OUG (Emergency Ordinance) 91/2025, which establishes that, starting 1 February 2026, the first day of temporary work incapacity is no longer paid for medical leave granted for ordinary illness.

In practice, the benefit for ordinary illness is calculated starting from the second day of leave. The measure is part of a budget-consolidation package and is applied differentially: there is a list of exceptions for which the first day remains fully paid.

Who is an exception (the first day remains paid)

• Pregnant women and situations of maternal risk;
• Medical-surgical emergencies;
• Group A infectious-contagious diseases (diseases with mandatory reporting and treatment);
• Certain chronic conditions from the list set by regulation;
• Leave to care for a sick child.

Because this is a new regulation, which may be adjusted by implementing rules, check the full and updated list on cnas.ro before making a final calculation.

How many days of medical leave you can receive

Medical leave (officially called the medical leave certificate) is granted in calendar days, depending on who issues it:

• The medic de familie (family doctor) can grant at most 10 calendar days through a single certificate, with the possibility of extension up to a limit set by regulation for the same condition.
• The specialist physician takes over extensions beyond that interval.
• The maximum duration of a medical leave for temporary work incapacity is, as a rule, 183 days within a year, with the possibility of extension in special situations, with the approval of the social insurance expert physician.

The rules for each benefit code (maternity, child care, cardiovascular diseases, etc.) differ and are detailed in the implementing rules of OUG 158/2005.

How much you receive: the percentages for each situation

The benefit is expressed as a percentage of the calculation base. The main percentages, under OUG 158/2005, are:

• 75% — ordinary illness and accidents outside work;
• 100% — medical-surgical emergencies, tuberculosis, group A infectious-contagious diseases, neoplasms (cancer) and AIDS;
• 85% — care for a sick child (up to 7 years old, or up to 18 years old for a child with a disability);
• 85% — maternity leave (pregnancy and postpartum).

The difference between 75% and 100% is significant, which is why the benefit code entered on the certificate matters enormously. It is set by the doctor based on the diagnosis, not at the patient’s request.

How the actual amount is calculated

The calculation base of the benefit is the average of the gross monthly income over the last 6 months out of the 12 months prior to the month in which you go on medical leave, months on which the social health insurance contribution was paid.

The formula, simplified:

1. The gross income from the last 6 contributing months is added up.
2. It is divided by the number of days for which the contribution was owed → this gives the daily average.
3. The daily average is multiplied by the percentage (75%, 85% or 100%) and by the number of paid leave days.

Important: from 2026, for ordinary illness, the first day is subtracted from the calculation if you do not fall under the exceptions.

The insurance-period condition (insurance seniority)

To be entitled to the benefit, you need a minimum insurance period of 6 months achieved within the last 12 months prior to the medical leave. Exceptions are medical-surgical emergencies and group A infectious-contagious diseases, where the benefit is granted regardless of the insurance period.

Who pays: the employer or the state

The source of the money is split:

• The first 5 calendar days of temporary work incapacity are borne by the employer;
• The remaining days are paid from the National Single Health Insurance Fund (FNUASS), managed by CNAS through the county health insurance houses (CAS).

The employer usually advances the entire amount and later recovers from CAS the share borne by FNUASS. For individuals without an employer (insured through their own contract), the benefit is settled directly by CAS.

What to do in practice

• Notify the employer as soon as possible that you have gone on medical leave.
• Submit the original certificate to the employer by the set date (as a rule by the 5th of the following month).
• Check the benefit code and the number of days entered on the certificate — an error here changes your amount.
• If you need a consultation or the issuance of the certificate, you can look for a family doctor in Cluj or other medical specialties in our directory.

Sources

• OUG (Emergency Ordinance) 158/2005 on social health insurance leave and benefits — legislatie.just.ro
• OUG (Emergency Ordinance) 91/2025 (fiscal-budgetary measures; unpaid first day of medical leave from 1 February 2026) — legislatie.just.ro
• National Health Insurance House (CNAS) — information on leave and benefits — cnas.ro
• Cluj County Health Insurance House (CAS Cluj) — casjcluj.ro