Barmer sickness benefit: optimising your financial protection in the event of prolonged illness
31.03.25
3
Minutes
Katrin Straub
Managing Director at nextsure
An accident or a serious illness can quickly lead to weeks of incapacity for work. For many self-employed people and certain groups of employees, this means a direct loss of income. Find out how Barmer sickness benefit can help protect your financial security.
The topic in brief and concise terms
Barmer sickness benefit offers self-employed people and certain employees flexible optional tariffs (e.g. KGS 22 from day 22, KGS 92 from day 92) to protect against loss of income in the event of illness, as a supplement to statutory sick pay.
Statutory sick pay is around 70% of gross income, up to a maximum of 90% of net income, and is usually paid from the 7th week for up to 78 weeks, often leaving a 20% gap compared with net income.
Choosing the right daily sickness allowance plan requires a careful analysis of your own financial situation and the point from which cover is needed; premiums vary (e.g. KGS 22: 1.0% of income).
Financial stability during illness: Understanding the need for sickness daily allowance
Incapacity for work affects many people unexpectedly and severely. Employees usually receive six weeks of continued pay. After that, statutory sickness benefit kicks in. This amounts to around seventy per cent of gross salary, but at most ninety per cent of net salary. For high earners, the gap to previous net income can quickly exceed one thousand euros. Self-employed people and freelancers are often hit harder; they frequently have no income replacement from day one. The Barmer Krankentagegeld provides an important form of cover here. This financial provision is crucial in order to continue covering ongoing costs. Without such cover, longer-term illness can quickly lead to existential problems. Proper planning secures your standard of living even in the event of illness. A suitable daily sickness benefit insurance policy is therefore essential for many.
Statutory sick pay vs. private daily sickness benefit: know the differences
The statutory sickness benefit is a benefit provided by statutory health insurance (GKV). It is paid after continued pay, usually from the seventh week, for a maximum of 78 weeks within three years for the same illness. Private daily sickness allowance, by contrast, is a voluntary supplementary insurance. It closes the gap left by statutory sickness benefit. For people with private insurance, it is often the only form of income protection in the event of illness. The main difference lies in the level of benefits and flexibility. You can better tailor the daily sickness allowance to your net income. Barmer offers various optional daily sickness allowance tariffs. These provide cover from as early as the 43rd day. A clear difference between sickness benefit and daily sickness allowance is the contractual basis.
Barmer sickness benefit option tariffs: options for individual cover
Barmer offers various optional plans for sickness daily allowance to meet different needs. These are aimed primarily at self-employed people and employees without at least six weeks of continued pay. An important prerequisite is often choosing statutory sickness benefit as the basis. The premiums for these optional plans are charged in addition to the regular health insurance contribution. Here is an overview of the main options:
Sickness benefit plan KGS 22: Benefits from the 22nd to the 42nd day of incapacity for work. The premium is one point zero per cent of contributory income.
Sickness benefit plan KGS 92: Benefits from the 92nd day of incapacity for work. The premium for this is zero point four per cent of income.
Sickness benefit plan KGK 15: Specially for artists and publicists, benefits from the 15th to the 42nd day. A flat-rate premium of eight euros per month applies.
All of these plans have a binding period of three years to the plan and to Barmer. Our expert tip: Check carefully from when you will need cover in the event of illness in order to choose the right plan. The question, how long sickness daily allowance is paid, is central here.
Contributions and benefits of BARMER daily sickness allowance in detail
The level of sickness benefit from Barmer optional tariffs is usually seventy per cent of your earned income. There is a statutory upper limit, which in 2025 is €128.63 per day. The premiums for the optional tariffs are percentage surcharges on your contributory income or flat-rate amounts. For example, the KGS 22 tariff costs an additional 1.0 per cent. The KGS 92 tariff costs 0.4 per cent. These contributions are calculated up to the contribution assessment ceiling. While you are receiving sickness benefit, you do not have to pay any premiums for the optional tariff. An adjustment of sickness daily allowance in the event of income changes is often possible. The three-month waiting period is important when taking out an optional tariff for the first time if you are already self-employed; this does not apply in the event of accidents.
Who is Barmer sickness allowance particularly important for?
The Barmer Krankentagegeld is particularly relevant for groups of people who receive no continued pay or only a short period of it. This mainly includes self-employed people and freelancers. For them, incapacity for work often means an immediate 100% loss of income. Employees in temporary or irregular employment also benefit. Statutory insured persons with a higher income can close the gap to statutory sick pay with additional sick pay. This often covers only around eighty percent of net income. Privately insured employees also need private daily sickness benefit insurance, as they are not entitled to statutory sick pay. Daily sickness benefit for the self-employed is often essential. The Barmer tariffs offer flexible solutions here.
Calculating individual needs: How to determine the right amount
To find the right amount of your daily sickness allowance, you should know your monthly fixed costs precisely. 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 sickness benefit). The difference divided by thirty gives the daily amount required. For example: with fixed costs of €2,500 and sickness benefit of €1,700, the shortfall is €800. The daily amount should therefore be at least €26.67 (800 / 30). Note the principle of indemnity: When combined with other earnings replacement benefits, your daily sickness allowance must not exceed your net income. For self-employed people, calculating the average profit over the past twelve months is a good basis. There are also options with no waiting period, but these are usually more expensive.
Before taking out a Barmer daily sickness benefit tariff, you should examine the insurance conditions carefully. Pay attention to the definition of incapacity for work and any exclusions. Waiting and deferment periods are also important; at Barmer, the deferment period for existing self-employed people is three months when taking out a new optional tariff. Always report incapacity for work to your health insurance fund and the insurer without delay. Meet all deadlines for submitting evidence. Our expert tip: Keep a complete record of your medical history and doctor visits. This can be crucial if problems arise when the private health insurance does not pay the daily sickness benefit. Combining it with an occupational disability insurance policy can make sense, as daily sickness benefit ends when occupational disability occurs.
The following points are important when choosing a policy and in the event of a claim:
Check the exact conditions for entitlement to benefits, especially the definition of incapacity for work.
Pay attention to the amount of the agreed benefit and whether it covers your needs (at least eighty per cent of net income).
Find out about the applicable waiting and deferment periods (often three months).
Clarify which supporting documents are required in the event of a claim and which deadlines apply.
Note the maximum benefit period (usually 78 weeks by law).
Check options for adjusting contributions if income changes.
Compare the costs of the different tariffs (e.g. KGS 22 with a 1.0 per cent premium).
Find out about the cancellation terms of the optional tariff (often a three-year commitment).
A careful selection and knowledge of the contract details will ensure you receive the necessary financial support in an emergency.
Legal basis: SGB V and its relevance to sickness daily allowance
The Fifth Book of the Social Code (SGB V) regulates statutory health insurance in Germany. For sickness benefit, in particular sections 44 ff. SGB V are relevant. Section 44 SGB V defines entitlement to sickness benefit. It stipulates that insured persons are entitled to it in the event of incapacity for work or inpatient treatment. Self-employed persons whose main occupation is self-employment often have this entitlement only through an election declaration. The amount and calculation of statutory sickness benefit are set out in section 47 SGB V. It amounts to seventy per cent of gross income, up to a maximum of ninety per cent of net income, capped by the contribution assessment ceiling. Barmer's optional tariffs for daily sickness benefit build on these statutory provisions or supplement them. Understanding these basics helps you better assess the necessity and design of your private daily sickness benefit. Knowledge of these sections is important for a well-founded decision.
Your next step towards financial security in the event of illness
Protecting your income in the event of a prolonged illness is an important part of your financial planning. The Barmer sickness benefit offers flexible solutions for this, especially for self-employed people and certain groups of employees. By carefully analysing your needs and choosing the right tariff, you can effectively close any cover gap. Bear in mind that even a loss of twenty per cent of net income can cause considerable financial difficulties. Take advantage of the opportunity to receive personalised advice. Comprehensive cover gives you the peace of mind to focus fully on your recovery if you fall ill. Request your individual risk analysis now.
Request your individual risk analysis now: Have your insurance situation reviewed free of charge and receive concrete suggestions for improvement.
More useful links
Federal Statistical Office (Destatis) provides information on sickness absence statistics in Germany.
National Association of Statutory Health Insurance Funds provides a report on patient advisory services in Germany.
Federal Ministry of Health provides information on health reporting and monitoring.
German Pension Insurance publishes a rehabilitation report.
WIdO (Scientific Institute of the AOK) offers the 2024 Absence Report on employee retention and sickness-related absenteeism.
Laws on the Internet provides Section 48 of Book V of the Social Code (SGB V) on sickness benefit.
Federal Institute for Occupational Safety and Health (BAuA) provides information on the costs of incapacity for work.
BARMER offers its Health Report.
Federal Statistical Office (Destatis) provides information on the costs of illness.
FAQ
From when does Barmer pay sickness daily allowance?
This depends on the chosen optional tariff. Tariff KGS 22 pays from day 22, KGS 92 from day 92 and KGK 15 (for artists/publicists) from day 15 of incapacity for work. Statutory sickness benefit normally applies from the 43rd day.
How long does Barmer pay sickness benefit?
Sickness benefit (including under optional tariffs) is paid for the same illness for a maximum of 78 weeks within three years. The specific optional tariffs may provide shorter benefit periods for certain time frames (e.g. KGS 22 up to the 42nd day).
Is there a waiting period for BARMER sickness benefit?
Yes, if you are already self-employed and book an optional tariff anew, there is a three-month waiting period. This does not apply if the incapacity for work is caused by an accident.
Is Barmer sickness daily allowance taxable?
Private sickness benefit is generally tax-free and is not subject to the progression proviso. Statutory sickness benefit, on the other hand, is.
Can self-employed people take out sickness benefit insurance with Barmer?
Yes, Barmer offers special optional tariffs for sickness benefit, aimed at self-employed people whose main occupation is self-employment, 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 sickness benefit optional tariffs KGS 22 and KGS 92 are based on your earnings subject to contributions. If your income changes, you should inform Barmer to ensure the correct contribution amount and, if applicable, entitlement to benefits. An adjustment to the insurance cover is often possible.
