Investment & Wealth
Health insurance for daily sickness allowances
Barmer daily sickness allowance
Barmer Sick Pay: Optimise your financial safety net for prolonged illness
An accident or a serious illness can quickly lead to weeks of inability to work. For many self-employed individuals and certain employee groups, this means a direct loss of income. Discover how the Barmer daily sickness allowance can secure your financial livelihood.
The topic in brief and concise terms
The Barmer 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 protect against income loss due to illness, in addition to statutory sick pay.
Statutory sick pay is approximately 70% of the gross income, a maximum of 90% of the net income, and is generally paid from the 7th week for a maximum of 78 weeks, often leaving a gap of 20% compared to the net income.
The choice of the appropriate daily sickness benefit tariff requires a careful analysis of one's financial situation and the timing from which coverage is needed; premiums vary (e.g. KGS 22: 1.0% of income).
Financial Stability During Illness: Understanding the Necessity of Sickness Benefit Payments
An incapacity to work often hits many unexpectedly and hard. Employees typically receive six weeks of continued salary payments. After that, statutory sick pay steps in. This amounts to roughly 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 amount to over one thousand euros. Self-employed and freelancers are often hit harder; they frequently have no income replacement from day one. Barmer's sickness benefit provides an important safety net here. This financial provision is crucial for continuing to cover ongoing expenses. Without such protection, extended illness can quickly lead to existential problems. Proper planning secures your standard of living, even in the case of illness. Therefore, a sensible sickness benefit insurance is essential for many.
Statutory sick pay vs. private daily sickness allowance: Knowing the differences
The statutory sick pay is a benefit provided by the statutory health insurance (GKV). It is paid after sick pay, 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 amount and flexibility of the benefit. You can better adjust the daily sickness allowance to match your net income. Barmer offers various daily sickness allowance elective tariffs. These allow for coverage even before the 43rd day. A clear difference between sick pay and daily sickness allowance is the contractual basis.
Barmer Sick Pay Optional Tariffs: Options for Individual Protection
Barmer offers various elective tariffs for sickness benefit to meet different needs. These are primarily aimed at self-employed individuals and employees without a minimum of six weeks of continued salary payment. A key requirement is often choosing the statutory sickness benefit as a basis. The premiums for these elective tariffs are in addition to the regular health insurance contribution. Here is an overview of the main options:
Sickness Benefit Tariff KGS 22: Coverage from the 22nd to the 42nd day of incapacity for work. The premium is one point zero percent of the contribution-based earnings.
Sickness Benefit Tariff KGS 92: Coverage from the 92nd day of incapacity for work. The premium for this is zero point four percent of the earnings.
Sickness Benefit Tariff KGK 15: Specifically for artists and publicists, coverage from the 15th to the 42nd day. A flat premium of eight euros per month applies for this.
All these tariffs have a binding period of three years to the tariff and Barmer. Our expert tip: Carefully consider from when you need coverage in case of illness to choose the right tariff. The question of how long sickness benefit is paid is central to this.
Contributions and benefits of Barmer's sickness allowance in detail
The amount of sickness benefit from the Barmer choice tariffs is usually seventy per cent of your income. There is a statutory upper limit, which will be €128.63 per day in 2025. The premiums for the choice tariffs are percentage surcharges on your contribution-based income or flat rates. For example, the KGS 22 tariff costs an additional one per cent. The KGS 92 tariff costs 0.4 per cent. These contributions are calculated up to the contribution assessment ceiling. While you receive sickness benefit, you do not have to pay premiums for the choice tariff. An adjustment of the daily sickness benefit in case of income changes is often possible. It's important to note the three-month waiting period when signing up for a new choice tariff if you are already self-employed; this does not apply in the event of accidents.
Calculating Individual Needs: How to Determine the Right Amount
To determine the appropriate amount for your daily sickness benefit, you should be well-acquainted with your monthly fixed costs. List all unavoidable expenses such as rent, loans, insurance, and living expenses. 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. An example: With fixed costs of 2,500 euros and sick pay of 1,700 euros, the gap amounts to eight hundred euros. Therefore, the daily rate should be at least 26.67 euros (800 / 30). Observe the prohibition on enrichment: The daily sickness benefit combined with other income replacement benefits must not exceed your net income. For self-employed individuals, calculating the average profit over the past twelve months is a good basis. There are also options without a waiting period, although these are usually more expensive.
Expert tips: What to watch out for when concluding and in the event of a claim
Before concluding a Barmer sickness benefit insurance policy, you should carefully review the insurance conditions. Pay attention to the definition of incapacity for work and any exclusions. The waiting or qualifying periods are also important; at Barmer, the qualifying period for those already self-employed is three months when taking out a new optional tariff. Always report an incapacity to work to your health insurance and the insurer promptly. Adhere to all deadlines for submitting proof. Our expert tip: Keep a comprehensive record of your medical history and doctor visits. This can be crucial in case of issues, such as when the private health insurance does not pay the sickness benefit. Combining this with a disability insurance can be beneficial, as sickness benefits end upon entry into disability.
The following points are important when selecting and managing claims:
Check the exact conditions for eligibility, especially the definition of incapacity for work.
Ensure the agreed benefit amount meets your needs (at least eighty percent of your net income).
Find out about the applicable waiting and qualifying periods (often three months).
Clarify what evidence is required in the event of a claim and what deadlines apply.
Note the maximum benefit duration (usually 78 weeks by law).
Consider options for premium adjustment if your income changes.
Compare the costs of different tariffs (e.g., KGS 22 with one point zero percent premium).
Inquire about the cancellation conditions of the optional tariff (often three years' commitment).
A careful selection and understanding of contract details ensures you have the necessary financial support in an emergency.
Legal foundations: SGB V and its relevance for daily sickness allowance
The Fifth Book of the Social Code (SGB V) governs statutory health insurance in Germany. For sickness benefits, paragraphs 44 et seq. of SGB V are particularly relevant. § 44 SGB V defines the entitlement to sickness benefits. It specifies that insured persons are entitled in cases of incapacity for work or inpatient treatment. Full-time self-employed individuals often only have this entitlement through a declaration of choice. The amount and calculation of the statutory sickness benefit are stipulated in § 47 SGB V. It amounts to seventy percent of the gross income, up to a maximum of ninety percent of the net income, capped by the contribution assessment ceiling. Barmer's optional tariffs for daily sickness allowance build on or supplement these statutory regulations. Understanding these basics helps you better assess the necessity and structure of your private daily sickness allowance. Knowledge of these paragraphs is important for making a well-informed decision.
Your next step towards financial security in case of illness
Safeguarding your income during prolonged illness is an important part of your financial planning. The Barmer sick pay insurance offers flexible solutions for this, particularly for the self-employed and certain groups of employees. With a careful analysis of your needs and the selection of the appropriate tariff, you can effectively close any coverage gaps. Remember that even a loss of twenty per cent of net income can cause significant financial difficulties. Take advantage of the opportunity to receive individual advice. Comprehensive coverage provides you with the peace of mind to focus entirely on your recovery in the event of illness. Request your individual risk analysis now.
Request now your individual risk analysis: Have your insurance situation checked free of charge and receive specific suggestions for optimisation.
More useful links
Statistisches Bundesamt (Destatis) provides information on sickness absence statistics in Germany.
GKV-Spitzenverband offers a report on patient advisory services in Germany.
Bundesgesundheitsministerium informs about health reporting and monitoring.
Deutsche Rentenversicherung publishes a rehabilitation report.
WIdO (Wissenschaftliches Institut der AOK) provides the Absence Report 2024 on employee retention and sickness-related absences.
Gesetze im Internet presents Paragraph 48 of the Social Security Code V (SGB V) on sickness benefit.
Bundesanstalt für Arbeitsschutz und Arbeitsmedizin (BAuA) provides information on the costs of incapacity for work.
BARMER offers its health report.
Statistisches Bundesamt (Destatis) provides information on the cost of illness.
FAQ
From when does Barmer's sickness benefit pay?
This depends on the selected elective tariff. The tariff KGS 22 pays from the 22nd day, KGS 92 from the 92nd day, and KGK 15 (for artists/publicists) from the 15th day of incapacity for work. The statutory sickness benefit usually takes effect from the 43rd day.
How long does Barmer's sickness benefit pay?
The sickness benefit (also from the elective tariffs) is paid for the same illness for a maximum of 78 weeks within three years. Specific elective tariffs may provide for shorter benefit durations for certain periods (e.g. KGS 22 up to the 42nd day).
Is there a waiting period for Barmer's sickness benefit?
Yes, if you are already self-employed and newly book an elective tariff, a three-month waiting period applies. This is waived if the incapacity to work is caused by an accident.
Is Barmer's sickness benefit taxable?
Private sickness benefit is generally tax-free and not subject to progression proviso. The statutory sickness benefit, however, is.
Can self-employed individuals insure sickness benefit with Barmer?
Yes, Barmer offers special elective tariffs for sickness benefit aimed at those who are self-employed, such as the tariffs KGS 22 and KGS 92, as well as KGK 15 for artists and publicists.
What happens if my income changes?
The premiums for Barmer's elective sickness benefit tariffs KGS 22 and KGS 92 are based on your contributable income. If your income changes, you should inform Barmer to ensure the correct contribution level and, if applicable, benefit entitlement. Adjusting the insurance cover is often possible.
