Barmer Health Insurance: Optimise your financial safeguard during extended illness
31 Mar 2025
3
Minutes
Katrin Straub
CEO at nextsure
An accident or a serious illness can quickly lead to weeks of inability to work. For many self-employed individuals and certain groups of employees, this means a direct loss of income. Discover how the Barmer sickness benefit can secure your financial livelihood.
The topic in brief and concise terms
The Barmer daily sickness benefit offers self-employed individuals and certain employees flexible tariff options (e.g., KGS 22 from the 22nd day, KGS 92 from the 92nd day) to safeguard against income loss due to illness, complementing statutory sick pay.
Statutory sick pay is approximately 70% of the gross income, a maximum of 90% of the net income, and is usually paid from the 7th week for a maximum of 78 weeks, which often leaves a 20% gap to the net income.
Choosing the right daily sickness allowance tariff requires a careful analysis of your financial situation and the point in time when coverage is needed; premiums vary (e.g., KGS 22: 1.0% of income).
Financial Stability During Illness: Understanding the Need for Sickness Benefits
An unexpected illness often hits hard. Employees typically receive six weeks of continued pay. After that, statutory sick pay takes over. This amounts to about seventy percent of the gross salary, but no more than ninety percent of the net salary. For high earners, the gap to the previous net income can quickly be more than a thousand euros. Self-employed and freelancers are often hit harder; they often have no income replacement from day one. The Barmer daily sickness allowance offers an important safeguard in this regard. This financial provision is crucial to continue covering ongoing costs. Without such protection, prolonged illness can quickly lead to existential problems. Proper planning ensures your standard of living even when sick. Therefore, a sensible daily sickness allowance insurance is indispensable for many.
Statutory Sick Pay vs. Private Daily Sickness Allowance: Knowing the Differences
Statutory sick pay is a benefit from the statutory health insurance (GKV). It is paid after the salary continuation, usually from the seventh week, for a maximum of 78 weeks within three years for the same illness. Private daily sickness allowance, on the other hand, is a voluntary supplementary insurance. It fills the gap left by statutory sick pay. For privately insured individuals, it is often the only form of income protection during illness. The main difference lies in the level of benefits and flexibility. You can better adjust the daily sickness allowance to match your net income. Barmer offers various daily sickness allowance tariff options. These allow for coverage before the 43rd day. A clear difference between statutory sick pay and daily sickness allowance is the contract basis.
Barmer Daily Sickness Allowance Options: Choices for Personal Protection
Barmer offers various optional tariffs for sick pay to cater to different needs. These are mainly aimed at the self-employed and employees without at least six weeks of continued salary payment. A crucial requirement is often the choice of statutory sick pay as a basis. The premiums for these optional tariffs are due in addition to the standard health insurance contribution. Here is an overview of the main options:
Sick Pay Tariff KGS 22: Benefits start from the 22nd to the 42nd day of incapacity for work. The premium amounts to one percent of the contributable income.
Sick Pay Tariff KGS 92: Benefits start from the 92nd day of incapacity for work. The premium here is zero point four percent of income.
Sick Pay Tariff KGK 15: Specifically for artists and publicists, benefits start from the 15th to the 42nd day. A flat premium of eight euros per month is payable for this.
All these tariffs have a binding period of three years to the tariff and Barmer. Our expert tip: Carefully check when you need coverage in the event of illness to choose the right tariff. The question of how long sick pay is paid is central to this.
Contributions and Benefits of Barmer Sickness Benefit in Detail
The amount of sick pay from the Barmer optional tariffs is usually seventy percent of your income. There is a legal cap, which in the year 2025 is 128.63 euros per day. The premiums for the optional tariffs are percentage surcharges on your income subject to contributions or flat rates. For example, the KGS 22 tariff costs an additional one point zero percent. The KGS 92 tariff costs zero point four percent. These contributions are calculated up to the contribution assessment ceiling. While you receive sick pay, you do not need to pay premiums for the optional tariff. An adjustment of the sickness daily allowance due to changes in income is often possible. Important is the three-month waiting period when concluding a new optional tariff if you are already self-employed; this does not apply in the event of accidents.
Who is the Barmer sickness allowance particularly important for?
The Barmer sickness daily allowance is particularly relevant for groups who receive no or only short-term continued pay. This mainly includes the self-employed and freelancers. For them, being unfit for work often means an immediate 100% loss of income. Employees in short-term or irregular employment also benefit. Statutory insured individuals with high incomes can use an additional sickness daily allowance to bridge the gap to statutory sickness benefits, which often only cover about eighty percent of net income. Privately insured employees also require a private sickness daily allowance as they are not entitled to statutory sickness benefits. A sickness daily allowance for the self-employed is often essential. The Barmer tariffs offer flexible solutions here.
Calculating Individual Needs: How to Determine the Right Amount
To determine the appropriate amount of your daily sickness benefit, you should be fully aware of your monthly fixed costs. List all unavoidable expenses, such as rent, loans, insurance, and living costs. Compare these costs with your income in the event of illness (e.g., statutory sick pay). The difference divided by thirty gives you the required daily rate. For example, with fixed costs of 2,500 euros and sick pay of 1,700 euros, the gap is eight hundred euros. Therefore, the daily rate should be at least 26.67 euros (800 / 30). Note the enrichment prohibition: The daily sickness benefit, combined with other wage replacement benefits, must not exceed your net income. For self-employed individuals, calculating the average profit over the last twelve months provides a good foundation. There are also options without a waiting period, although these are usually more expensive.
Expert Tips: What to consider when concluding and in case of a claim
Before concluding a Barmer daily sickness allowance tariff, you should carefully review the insurance conditions. Pay attention to the definition of incapacity for work and any exclusions. The waiting or elimination periods are also important; at Barmer, the elimination period for those already self-employed is three months when a new optional tariff is taken out. Always promptly report incapacity for work to your health insurance company and the insurer. Adhere to all deadlines for submitting evidence. Our expert tip: Keep a complete record of your medical history and doctor visits. This can be crucial in the event of problems if the private health insurance does not pay the daily sickness allowance. Combining it with an occupational disability insurance can be sensible, as daily sickness allowance ends upon the occurrence of occupational disability.
The following points are important when selecting and claiming benefits:
Check the exact conditions for eligibility, especially the definition of incapacity for work.
Pay attention to the amount of the agreed benefit and whether this meets your needs (at least eighty percent of net income).
Find out about applicable waiting and elimination periods (often three months).
Determine what evidence is required in the event of a claim and observe the deadlines.
Note the maximum benefit duration (legally usually 78 weeks).
Consider options for adjusting premiums in case of income changes.
Compare the costs of different tariffs (e.g. KGS 22 with a one point zero percent premium).
Inquire about the cancellation conditions of the optional tariff (often a three-year commitment).
A careful selection and knowledge of the contract details ensure you have the necessary financial support in an emergency.
Legal foundations: SGB V and its relevance for sick pay
Your next step towards financial security in case of illness
More useful links
Statistisches Bundesamt (Destatis) provides information on sickness statistics in Germany.
GKV-Spitzenverband offers a report on patient advisory services in Germany.
Bundesgesundheitsministerium provides information on health reporting and monitoring.
Deutsche Rentenversicherung publishes a rehabilitation report.
WIdO (Wissenschaftliches Institut der AOK) offers the 2024 absence report on employee retention and sickness-related absences.
Gesetze im Internet provides Paragraph 48 of the Social Code Book V (SGB V) on sick pay.
Bundesanstalt für Arbeitsschutz und Arbeitsmedizin (BAuA) provides information on the costs of incapacity for work.
BARMER offers their health report.
Statistisches Bundesamt (Destatis) provides information on disease costs.
FAQ
When does the Barmer sickness benefit start to pay out?
That depends on the chosen tariff plan. The KGS 22 tariff starts payment from the 22nd day, KGS 92 from the 92nd day, and KGK 15 (for artists/publicists) from the 15th day of inability to work. Statutory sick pay regularly begins from the 43rd day.
How long does Barmer pay sickness benefits?
Sickness benefits (including those from optional tariffs) are paid for the same illness for a maximum of 78 weeks within three years. The specific optional tariffs may provide for shorter benefit durations for certain periods (e.g., KGS 22 until the 42nd day).
Is there a waiting period for Barmer sick pay?
Yes, if you are already self-employed and choose a new optional tariff, there is a three-month waiting period. This does not apply if the incapacity to work is caused by an accident.
Is the Barmer sickness benefit taxable?
Private sickness benefits are generally tax-free and not subject to the progression clause, whereas statutory sickness benefits are.
Can self-employed individuals insure sickness benefit with Barmer?
Yes, Barmer offers special optional tariffs for sickness benefits that are aimed at full-time self-employed individuals, such as the KGS 22 and KGS 92 tariffs, as well as KGK 15 for artists and publicists.
What happens if my income changes?
The premiums for the Barmer daily sickness allowance options KGS 22 and KGS 92 are based on your income subject to contributions. In case of changes in income, you should inform Barmer to ensure the correct contribution amount and any benefit entitlement. An adjustment of the insurance coverage is often possible.
