Daily sickness benefit for the self-employed: optimising financial security in the event of illness
21.06.25
10
Minutes
Katrin Straub
Managing Director at nextsure
A longer period of incapacity due to illness can quickly become an existential threat for the self-employed. Without an employer continuing to pay wages, there is an immediate gap in income. Find out how you can make provision with the right daily sickness benefit.
The topic in brief and concise terms
Self-employed people need specific cover for loss of earnings during illness, as there is no automatic continuation of pay; sickness daily allowance bridges this gap.
The amount of daily sickness benefit should be carefully calculated to cover ongoing private and business expenses; statutory sickness benefit alone is often not enough.
Private sickness daily allowance insurance offers flexible options in terms of benefit amount and waiting period, is tax-free on payout, but the premiums are only tax-deductible to a limited extent.
Quick Facts: The key facts about sickness benefit for self-employed people
Self-employed people do not automatically have entitlement to continued pay when ill. A private daily sickness benefit insurance policy or an optional tariff in the statutory health insurance scheme (GKV) is therefore often essential. Daily sickness benefit protects your income if you are unable to work for longer than six weeks. The amount of statutory sick pay is generally seventy per cent of gross earnings, but a maximum of EUR 128.63 per day (as of 2025). Private cover can bridge this gap and can be tailored to individual needs. Pay attention to the waiting periods, which can range from three to eight months depending on the tariff.
Practical section: Understanding sickness benefit for the self-employed and using it correctly
Cover with self-employed daily sickness allowance is essential for entrepreneurs. Imagine your monthly net income is 4,000 euros. If you are ill and do not have cover, this income stops from the first day. With a statutory sickness benefit option, you receive seventy per cent of your contributory earnings from the 43rd day. At an income at the contribution assessment ceiling, that would be a maximum of 128.63 euros per day. A private daily sickness benefit insurance policy can close this gap earlier and more comprehensively. For example, you could agree a daily allowance of 133 euros to cover your monthly 4,000 euros. The cost of this varies; a 35-year-old self-employed person could get a tariff for around 30 euros per month if payments start from the seventh week. More information on the difference between sickness benefit and daily sickness allowance can be found in our blog. This flexibility is a major advantage of private provision.
Calculating the optimal daily sickness benefit: an example calculation
Calculating your need for self-employed sickness benefit correctly is crucial. Let’s assume your average monthly net income over the last twelve months is €3,500. Your monthly fixed costs (rent, insurance, personal expenses) amount to €2,500. To cover these costs, you need sickness daily benefit of at least €83.33 per day (€2,500 / 30 days). Statutorily insured people with an optional tariff receive seventy per cent of their income from the 43rd day, which would correspond to €2,450 per month (around €81.67 per day) on gross income of €3,500. This creates a shortfall of just under €2 per day for fixed costs alone. Many self-employed people completely underestimate the first six weeks, during which no statutory sickness benefit is paid at all. A private daily sickness benefit insurance policy can close this gap and also pay earlier. Consider whether you regard a daily sickness benefit insurance policy as useful. Choosing the right waiting period, i.e. from when the daily benefit is paid, has a significant impact on the premium.
Legal basis and current court rulings on daily sickness benefit
Sickness benefit for self-employed people is regulated in the Fifth Book of the Social Code (SGB V). Self-employed people whose main occupation is self-employment can opt for a statutory sickness benefit entitlement from the seventh week by submitting a declaration of choice to their health insurance provider (§ 44(2) SGB V). For this, they pay the general contribution rate, which is 0.6 percentage points above the reduced rate. They are bound by this choice for three years. An important ruling by the Social Court in Frankfurt confirmed that sickness benefit for voluntarily insured statutory policyholders is definitively set and cannot subsequently be adjusted in line with higher income, unlike contributions. This underlines the need to calculate the amount of sickness benefit correctly from the outset. For privately insured persons, a private daily sickness benefit insurance is the only option, as they are not entitled to statutory sickness benefit. Contributions to private daily sickness benefit insurance can be claimed for tax purposes as retirement provision expenses, although the maximum amount is often already exhausted by health insurance contributions. The private daily sickness benefit paid out is tax-free.
Expert tips for structuring your sickness daily allowance insurance
When choosing self-employed daily sickness benefit insurance, there are several factors to consider. Our expert tip: look for the option of indexation without a new medical assessment, so you can adjust your daily benefit to rising income. Many insurers offer such an adjustment of the sickness daily benefit. Choose the waiting period carefully; a longer waiting period (e.g. from day 43) significantly reduces the premium, but requires larger reserves for the first six weeks. For founders, who often have lower income in the first few years, a tariff with a lower initial daily benefit and a later increase option can make sense. Check the claims conditions carefully: some tariffs, for example, do not pay if the business continues to operate despite your illness and still generates profits. Also clarify how long sickness daily benefits are paid; up to 78 weeks within three years for the same illness is common.
Here are some important aspects you should consider:
Amount of the daily benefit: should cover ongoing costs and ideally provide a buffer.
Waiting period: When should the benefit start? Days 15, 22 or 43 are common.
Benefit period: How long will payments be made in the event of a claim?
Guaranteed insurability: Can the daily benefit be increased without a new medical assessment?
Territorial scope: Does the cover also apply abroad?
Waiver of the insurer’s ordinary right of cancellation: important for long-term security.
These considerations help you design tailored cover.
Sickness benefit and taxes: What self-employed people need to know
The tax treatment of self-employed sickness allowance is an important aspect. Contributions to private daily sickness allowance insurance can be claimed as other pension expenses in your tax return. However, there are upper limits (EUR 1,900 for employees and civil servants, EUR 2,800 for self-employed people who pay their health insurance in full themselves), which are often already used up by contributions to health and long-term care insurance. The daily sickness allowance paid out by a private insurer is completely tax-free and is also not subject to progression. This means it does not increase the tax rate for your other taxable income. In contrast, statutory sick pay is also tax-free, but is subject to progression, which can lead to a higher tax burden on other income. For an accurate assessment of your tax situation, advice is advisable. Find out more about affordable statutory health insurance for the self-employed.
A common mistake is underinsuring self-employed sickness benefit. Many calculate only the absolutely necessary private expenses and forget operating fixed costs, which continue even when they are ill. Another pitfall is the assumption that the business can simply be continued by employees or partners in the event of illness, without this affecting entitlement to sickness benefit. Some policy conditions provide for benefit reductions or exclusions if the insured person still earns income from their self-employed activity despite being unable to work, or if the business continues to generate profits. The situation is particularly critical for founders without significant income in the start-up phase, as there is often no entitlement to statutory sick pay and the basis for calculating a private daily allowance is lacking. Be sure to clarify what happens if the private health insurance does not pay sickness benefit. A careful review of the insurance conditions before taking out the policy is therefore essential.
Pay attention to the following points to avoid problems:
Honest health declarations: Incorrect information can lead to loss of insurance cover.
Timely notification of incapacity for work: Be sure to observe the insurer's deadlines.
Sufficient amount of daily allowance: Check and adjust regularly.
Understanding the benefit triggers: When exactly does the insurer pay?
Clarification of the situation when the business continues to operate: Does this affect payment?
Forward planning protects against unpleasant surprises.
Combining with other insurance policies: a comprehensive safety net
The self-employed sickness daily benefit is a building block of your cover. It applies in the event of temporary incapacity for work. But what if an illness or accident leads to permanent occupational disability? This is where the occupational disability insurance (BU) comes in. The two insurances complement each other ideally. The sickness daily benefit insurance generally pays for up to 78 weeks. If it turns out that you are likely to be unable to work in your occupation for longer than six months, the BU insurance provides a monthly pension. It is important to align the benefit triggers and definitions of incapacity for work and occupational disability in the respective contracts. Good advice helps to avoid overlaps or gaps. You should also consider accident insurance, which pays lump-sum benefits or a pension in the event of disability caused by an accident. In this way, you create a multi-layered safety net for different scenarios. Our mission at nextsure is to offer you tailored and easy-to-understand insurance solutions.
Your next step towards optimal protection
Securing your income as a self-employed person in the event of illness is not a minor matter, but a foundation for your financial stability. With a well-calculated self-employed daily sickness benefit, you can focus on your recovery without having to worry about ongoing costs. Choosing the right tariff, whether statutory or private, requires a careful analysis of your individual situation and needs. Take into account your income, expenses, any reserves and your risk appetite. Remember that cover set too low will not be sufficient in an emergency, and cover set too high is unnecessarily expensive. Professional advice can help you find the optimal balance and avoid pitfalls. Take the opportunity to have your situation assessed individually. Request an individual risk analysis now: Have your insurance situation checked free of charge and receive concrete suggestions for optimisation.
More useful links
Wikipedia offers a comprehensive overview of daily sickness allowance in Germany.
The Federal Ministry of Health provides detailed information on sickness benefit.
The Federal Ministry of Labour and Social Affairs provides information on incapacity for work.
The Federal Ministry of Finance explains the tax treatment of daily sickness allowance.
FAQ
What is the difference between sickness benefit and daily sickness allowance for self-employed people?
Sickness benefit is a benefit of statutory health insurance that self-employed people can opt into by paying a higher contribution rate (payment usually starts from the 43rd day). Daily sickness allowance is a private insurance policy that can be structured more flexibly in terms of amount and benefit start date, and is also available to those insured privately.
How long is sickness benefit paid?
The benefit period for sickness benefit is tariff-dependent. Statutory sickness benefit is paid for the same illness for a maximum of 78 weeks within three years. Private tariffs often follow this, but may also differ.
What happens if I’m ill for a longer period as a self-employed person?
If you are unable to work for longer than the chosen waiting period, the sickness daily allowance insurance pays the agreed daily allowance. If occupational disability occurs, ideally a separate occupational disability insurance policy applies.
Are contributions for sickness allowance tax-deductible?
Yes, contributions to private daily sickness benefit insurance can be claimed for tax purposes as other precautionary expenses, however the maximum amounts are often already reached by health and long-term care insurance contributions.
As a self-employed person with private health insurance, do I need daily sickness benefit insurance?
Yes, absolutely. Self-employed people with private health insurance are not entitled to statutory sickness benefit and therefore rely on private daily sickness allowance insurance to protect against loss of earnings in the event of illness.
Can I adjust the amount of my sickness benefit later?
Many private daily sickness benefit insurance policies offer guaranteed insurability options. This allows you to adjust the insured daily benefit in certain events (e.g. an increase in income) without a new health assessment.
