Sickness benefit under statutory health insurance; application for self-employed persons

Even if you are self-employed, you can insure yourself at the general contribution rate with statutory sickness benefit entitlement from the 7th week, just like employees subject to compulsory insurance. To do this, you must submit a declaration of choice to your health insurance fund.

Zum Antrag einer Wahlerklärung über den Kassen-Navigator des GKV-Spitzenverbands

This form can be submitted electronically (e.g. via a secure contact form using your user account with login via the electronic ID function or the ELSTER certificate) or handwritten and signed in paper form to the responsible authority.

For contact details of the responsible authoritiy and local valid information select under "Select location" a location.

If you are self-employed and insured with a statutory health insurance fund, you are not entitled to sickness benefit. This means that if you are unable to work for a longer period of time for health reasons, you will not receive any money from your health insurance fund.

If you would like to have such additional cover and be entitled to sickness benefit, you must inform your health insurance fund of this in writing. This written notification is also called a "declaration of choice".

If you submit a declaration of choice to your health insurance fund, you will pay a slightly higher contribution to the statutory health insurance scheme, which also includes the entitlement to sickness benefit. You are entitled to statutory sickness benefit from the 43rd day of incapacity for work.

The amount of sickness benefit is generally 70 percent of your income from work over the past 12 months. This refers to the income on which your health insurance fund has based the assessment of your insurance contribution.

If you have opted for an optional declaration and wish to receive sickness benefit from your health insurance fund in a specific case, you must note the following:

Entitlement to sickness benefit only arises from the 7th week of incapacity for work in each case.
If you are ill, you must submit a sick note to your health insurance fund within 1 week in order to receive sickness benefit.

During the period in which you receive sickness benefit, you may still have to pay contributions to your long-term care insurance, health insurance and social insurance:

If you receive sickness benefit, you do not have to pay health insurance contributions for the earnings replacement benefit. However, if you are compulsorily insured for pension, unemployment or long-term care insurance, you must continue to pay these contributions during your sick leave.

The declaration of election only applies to a future case of illness.
If you are unable to work at the time of submitting the application or if you become unable to work between the day you submit the application and the day it takes effect, the application will take effect from the day you are able to work again.

Required Documents
- Einkommenssteuerbescheid
- In Spezialfällen können weitere Unterlagen erforderlich sein. Bitte informieren Sie sich dazu bei Ihrer Krankenkasse.

You can submit the application for statutory sickness benefit (declaration of choice) in writing or - in the case of many statutory health insurance funds - in person at the office or online.

Submit the application informally. This means that you must inform your health insurance fund in your own words that you want to increase your contribution rate in order to receive sickness or maternity benefit.
Some statutory health insurance funds offer you forms for declaring your choice.
Your health insurance fund will confirm receipt of your letter or form and your future entitlement to sickness or maternity benefit.

You do not have to pay anything for the processing of your election declaration.

The declaration of choice can be submitted to your health insurance fund at any time. Entitlement to sickness benefit begins at the start of membership of your health insurance fund when you submit the declaration of election with your membership application.
The declaration of choice is valid for 3 years.
If you do not cancel the relevant tariff before the 3 years have expired, it will be extended by 12 months.
You cannot cancel your declaration of choice even if you change health insurer.
It is not possible to switch to private health insurance during the 3-year period.

Processing normally takes 3 to 7 working days.

Your health insurance fund must have all the necessary information and any required documents in a complete and meaningful form in order to process and decide quickly.
The health insurance fund decides on applications promptly, whereby the statutory processing period is observed in order to protect patients' rights.
Please note that the processing time stated is an average value for all health insurance funds. It may vary in individual cases.
The exact processing time also depends on the complexity of the individual case and may be extended accordingly. The same applies if documents or records are sent to you or your health insurance fund by post.

If you have health insurance through the Künstlersozialkasse (KSK), you are automatically entitled to sickness benefit.
The various health insurance funds offer different optional tariffs that allow you to receive sickness benefit before the 43rd week. For more information, please contact your statutory health insurance fund.