Hallesche daily sickness allowance: optimise income protection during incapacity for work
22.06.25
3
Minutes
Katrin Straub
Managing Director at nextsure
A longer illness can threaten your financial security if your income suddenly stops. Hallesche's daily sickness benefit provides important cover here. Find out how you can maintain your standard of living even when you are ill.
The topic in brief and concise terms
Hallesche sickness benefit closes the income gap that arises after six weeks of continued salary payment when the lower statutory sick pay begins.
Hallesche offers plans with simplified health questions and a fair moratorium clause, which can also cover known pre-existing conditions after two years.
For self-employed people, daily sickness allowance is essential, as they often do not have an automatic entitlement to statutory sickness benefit; Hallesche offers special tariffs for this from the 22nd day.
Laying the foundations: understanding the need for sickness daily allowance
Many employees underestimate the financial gap after the six-week period of continued pay ends. Statutory sickness benefit often covers only around seventy per cent of gross income. For the self-employed, this basic cover often disappears entirely, making private protection essential. Hallesche sickness daily allowance is designed to bridge this difference and secure ongoing costs such as rent or loan repayments. A careful review of your own cover situation is the first step.
The amount of sickness daily allowance should not exceed the average net income of the past twelve months. With Hallesche, for example, a daily benefit of up to €30 can be insured, which corresponds to €900 per month. This helps close the gap to the sickness benefit paid by the statutory health insurance fund, which in 2025 is capped at around €129 per day. The correct adjustment of the sickness daily allowance is crucial.
Hallesche offers specific tariffs for different occupational groups. These include the KT tariff for employees and self-employed people, FKT for freelancers, MKT for doctors and dentists, and KTAR for managing directors of a GmbH. The start of benefits varies; for employees it is often the 43rd day, while for the self-employed it can begin earlier, for example from the 22nd day. This flexibility enables tailored protection.
Check the terms: handling the start of cover and health questions with Hallesche
Hallesche offers simplified health questions for its daily sickness allowance, as does the Krankengeld.plus product. In addition to height and weight, the main question is whether there was a continuous period of incapacity for work of more than 21 days in the last two years. This makes access easier for many applicants. A BMI between 17 and 30 is a prerequisite for acceptance under the simplified process.
A so-called moratorium clause is also part of the terms. This means that no benefits are paid for periods of incapacity for work within the first two years after the start of insurance if there is a causal link to an illness for which you were treated and were incapacitated for work in the two years before applying. However, after these two years have elapsed, full insurance cover applies, including for these original diagnoses, provided no new incapacity for work arises as a result. It is important to know the difference between sickness benefit and daily sickness allowance precisely.
The general waiting periods are usually three months, but are waived in the event of accidents. For psychotherapy and dental treatments, special waiting periods of eight months may apply. One advantage is that Hallesche waives its ordinary right to terminate, which gives you additional security. The question of how long daily sickness allowance is paid is also regulated by contract.
Target groups in focus: finding tailored solutions for employees and the self-employed
For employees insured under the statutory health insurance scheme (GKV), Hallesche daily sickness allowance is an important supplement. It bridges the gap that arises after six weeks of continued salary payment due to the lower sickness benefit provided by the GKV. Hallesche’s Krankengeld.plus tariff is designed specifically for employees insured under GKV and offers a daily rate of up to EUR 30. One advantage is that it also pays out when a child is ill, provided the GKV also provides benefits in this case.
Self-employed people and freelancers often have no statutory entitlement to sickness benefit or must opt in actively and pay higher contributions. For them, private daily sickness allowance insurance is essential. Hallesche offers special tariffs such as KT or FKT for this purpose, with benefits often starting from as early as day 22. The amount of daily allowance that can be insured is based on the pre-tax profit over the last twelve months. For self-employed people, daily sickness allowance is a must.
Hallesche allows the daily sickness allowance to be adjusted in the event of income increases without a new health check within two months. This applies in particular to employees. The tariffs are designed so that no unexpected jumps in premiums in later life are to be expected due to tiered models, as they are calculated with ageing reserves. This ensures better predictability of costs over many years.
Optimise scope of services: Note important details and exclusions
Hallesche's sickness benefit is also paid on Sundays and public holidays, as soon as and for as long as there is an entitlement to sickness benefit from the health insurance fund or accident benefit. An important aspect is that the sickness benefit is paid tax-free. Hallesche provides benefits in the event of partial incapacity for work as part of a reintegration programme for up to eight weeks, provided certain requirements are met. This applies to employees with full insurance cover from Hallesche.
The alcohol clause is not applied by Hallesche, so incapacity for work caused by alcohol is generally also covered. Benefits may be payable for inpatient withdrawal treatment if the insurer has approved this in advance. Please note that for spa and rehabilitation measures, sickness benefit is often only paid after a prior period of incapacity for work of at least four weeks. Should the private health insurance not pay sickness benefit, swift action is required.
No ordinary right of termination by Hallesche.
Contract cancellable monthly without a minimum term.
Benefits also when caring for a sick child under the Krankengeld.plus tariff.
Adjustment without a medical examination if income increases (within two months, for employees).
Worldwide cover is provided for temporary stays in other European countries for acute illnesses requiring inpatient treatment.
Premiums are calculated with ageing reserves, which avoids larger jumps in later life.
Cover usually ends when you start drawing a retirement pension, and at the latest when you reach the age of 65; however, there may be options to extend it until the age of 70. Combining it with income protection insurance is often sensible.
Use expert knowledge: Understand the legal framework and current rulings
The Insurance Contract Act (VVG) forms the legal basis for sickness daily benefits. An important principle is the prohibition of enrichment under § 200 VVG. This states that the insurance benefit may not exceed the previous net income. Nevertheless, the daily rate agreed once is generally binding. For self-employed professionals, § 18(1) no. 1 of the Income Tax Act (EStG) is relevant when it comes to defining the occupational groups that can be insured under the FKT tariff.
Recent rulings, such as that of the Federal Court of Justice (BGH) of 12 March 2025 (case no. IV ZR 32/24), strengthen policyholders' rights. The BGH ruled that insurers may not subsequently reduce sickness daily benefits without an explicit agreement, even if income has fallen. Clauses allowing unilateral reductions have often been classified as lacking transparency and invalid.
Our expert tip: Check your policy terms carefully, especially if the contract is amended. If your sickness daily benefits were possibly reduced unlawfully in the past, claims for additional payments may exist (note limitation periods!). A sickness daily benefits insurance without a waiting period is rare, but the terms vary.
Hallesche waives the ordinary right of cancellation. This is an important point, as some insurers could cancel after a claim. Hallesche's tariffs, such as Krankengeld.plus, can also often be cancelled on a monthly basis, giving you flexibility. These customer-friendly arrangements offer additional security and predictability for your financial future.
Recommended actions: Your path to optimum cover with Hallesche sickness benefit
Analyse your individual needs carefully. Calculate the difference between your net income and the expected statutory sickness benefit. Take into account all ongoing expenses. For self-employed people, covering the lost profit is crucial. A daily benefit of €30 can already make an important difference.
Compare the different Hallesche tariffs (KT, FKT, MKT, KTAR, Krankengeld.plus) in terms of when benefits start, the amount of daily sickness benefit and the specific conditions for your occupational group. Pay attention to the health questions and the significance of the moratorium clause. An honest answer to the health questions is essential for any later entitlement to benefits.
Check whether a simplified health assessment is available, as offered for example with the Krankengeld.plus tariff. This can make taking out the policy much easier if you meet the requirements (e.g. no incapacity for work for more than 21 days in the last two years). Make use of the option to adjust the sickness daily allowance when your salary increases, so that you remain optimally covered at all times.
Seek independent advice to find the solution that suits you best. At nextsure, we will be happy to support you in analysing your individual situation and arranging the best possible cover through a sickness daily allowance from Hallesche or another provider. Comprehensive advice can help you avoid pitfalls and gain long-term financial security. Remember that good cover gives you peace of mind in an emergency, so you can focus fully on your recovery.
More useful links
Wikipedia provides basic information on sickness daily allowance.
The Federal Statistical Office provides official data on sickness absence in Germany.
Statista provides statistics on the number of days of incapacity for work, broken down by diagnosis.
The Techniker Krankenkasse (TK) offers its health report on incapacity for work in 2023.
The Institute of German Economy (IW) analyses sickness absence in Germany in a detailed article.
Statista presents statistics on the main causes of incapacity for work.
The BKK Dachverband publishes monthly statistics on sickness absence.
The Federal Institute for Occupational Safety and Health (BAuA) provides information on the costs of incapacity for work.
Wikipedia explains sickness benefit in Germany.
Wikipedia provides details on continuation of pay in the event of illness.
FAQ
How much sickness daily allowance should I insure with Hallesche?
Sick pay insurance should close the gap between your net income and statutory sick pay. It must not exceed your average net income over the last twelve months. A precise calculation of your fixed costs and income is advisable.
What waiting periods are there for Hallesche sickness daily allowance?
General waiting periods are usually three months, but do not apply in the event of accidents. For certain treatments such as psychotherapy, special waiting periods of eight months may apply.
What is the moratorium clause for Hallesche's sickness daily allowance?
The moratorium clause stipulates that no benefits are payable for incapacity for work due to pre-existing conditions that were treated in the two years before the start of the contract and led to incapacity for work during the first two years of the contract. Thereafter, full cover applies.
Can I adjust the Hallesche sickness daily allowance if my salary increases?
Yes, if your income increases, you can usually adjust the daily sickness benefit at Hallesche within two months without a new health check, especially as an employee.
Does Hallesche Krankentagegeld also provide cover abroad?
Yes, during a temporary stay in another European country, daily sickness benefit is paid for the duration of medically necessary inpatient treatment in a public hospital in the event of acute illnesses or accidents.
What happens to Hallesche sickness benefit when receiving an old-age pension?
The daily sickness allowance generally ends when retirement pension is received, at the latest upon reaching the age of 65. There may be options to extend it up to the age of 70.
