Wegweiser Self-employed people · Rights & protection Deutsch

🤒 Illness and income replacement for self-employed people

No employer keeps paying if you fall ill. What sickness benefit optional tariffs, waiting periods and private cover mean for you.

Continued pay (Entgeltfortzahlung) § 44 SGB V Sickness benefit (Krankengeld) Optional tariff (Wahltarif) § 53 SGB V Waiting period (Karenzzeit) Daily sickness allowance (Krankentagegeld) Business interruption insurance

In brief

As a self-employed person you have no statutory entitlement to continued pay when you are ill – the Entgeltfortzahlungsgesetz (Continued Remuneration Act) applies exclusively to employees. Whether you receive money from your health insurance fund when ill depends on your insurance status: compulsorily insured self-employed people have in principle no entitlement to sickness benefit (Krankengeld), people with voluntary statutory insurance can buy it through an optional tariff. Anyone without such a tariff bears the full risk of loss of income themselves and should think about private cover.

Step by step

  1. Check your insurance statusClarify whether you are compulsorily insured, voluntarily insured under the statutory scheme or privately insured.
  2. Ask about an optional tariffWith voluntary statutory insurance, ask your health insurance fund which optional tariffs with a sickness benefit entitlement under § 53 para. 6 SGB V are offered.
  3. Take out an optional tariffAsk about the fund's minimum commitment period before you take out the tariff.
  4. Note the waiting periodAfter the tariff starts, a waiting period may apply before payment is actually made when a claim arises; the exact length depends on the fund and tariff.
  5. Check alternativesIn addition or as an alternative, consider private daily sickness allowance insurance or business interruption insurance, and fix the start of benefits (waiting days) and the benefit period in the contract.
  6. Report in case of illnessHave your incapacity for work certified by a doctor and report to the fund or insurer on time in accordance with the statutes or the insurance contract.

Deadlines

no entitlement without an election declaration
Entitlement to sickness benefit is in principle excluded for self-employed people, except with an election declaration under § 53 para. 6 SGB V§ 44 para. 2 SGB V
several years, depends on the fund
Minimum commitment period of sickness benefit optional tariffs – actual length not uniform nationwide, ask the fund concerned§ 53 para. 6 SGB V, statutes of the health insurance fund
depends on fund/tariff
Waiting period until benefits start in the optional tariff – not set uniformly by lawStatutes of the health insurance fund, no nationwide deadline in the SGB V
Watch out – common mistakes
  • “Statutory health insurance” does not automatically mean “entitlement to sickness benefit” – compulsorily insured self-employed people as a rule have no entitlement without an optional tariff.
  • An optional tariff can no longer be taken out retroactively if an illness or incapacity for work already exists.
  • The waiting period is often underestimated: even with an optional tariff the fund often only pays after several weeks – the liquidity gap at the beginning is often not planned for.
  • The minimum commitment period is overlooked: early termination of the optional tariff is usually not possible, which causes problems when moving into permanent employment or switching funds.
  • Private daily sickness allowance insurance is often assumed to come without a health check and waiting periods – in fact it usually involves a risk assessment with possible exclusions of benefits for pre-existing conditions.
  • Business interruption insurance is confused with daily sickness allowance: the former rather covers business costs/fixed costs, not directly personal living costs.
In depth · legal basis, figures and practice – for advisers and professionals

Legal bases

§ 44 SGB V regulates sickness benefit and in principle excludes self-employed people (paragraph 2), except with an election declaration. § 53 para. 6 SGB V obliges health insurance funds to offer an optional sickness benefit tariff to people who are self-employed as a main occupation. The Entgeltfortzahlungsgesetz (§ 1 EFZG) applies only to employees and trainees, not to self-employed people.

Practice for advisers

Clients should compare the optional tariffs of different funds, as the start of benefits, minimum commitment and contribution level differ considerably between funds. When advising on the coverage gap, a combination of a reserve for the waiting period plus an optional tariff or private daily sickness allowance insurance is advisable. Business interruption insurance is relevant in particular for self-employed people with high fixed costs (rent, staff, leasing), regardless of the personal sickness benefit question.

Distinction from private health insurance

People with private health insurance must agree daily sickness allowance separately and individually; without a corresponding tariff component there is likewise no entitlement.

Waiting periods – example values, not a fixed norm

In practice, waiting periods such as “from the 15th, 22nd or 43rd day of incapacity for work” circulate – these are not set uniformly nationwide by law but depend on the fund and tariff, and should therefore be mentioned only as an example, not as a fixed figure. Before making a specific recommendation, always check the tariff of the fund concerned.

Who is responsible
  • The statutory health insurance fund concerned (optional tariffs under § 53 para. 6 SGB V)
  • GKV-Spitzenverband (framework rules)
  • Private health insurers (daily sickness allowance, business interruption insurance)
Further reading
Health insurance for self-employed peopleParental allowance for self-employed peopleBusiness insurance for self-employed people

Quick questions

Worum geht es bei „Illness and income replacement for self-employed people“?
No employer keeps paying if you fall ill. What sickness benefit optional tariffs, waiting periods and private cover mean for you.
Which deadlines and figures matter?
  • no entitlement without an election declaration: Entitlement to sickness benefit is in principle excluded for self-employed people, except with an election declaration under § 53 para. 6 SGB V (§ 44 para. 2 SGB V)
  • several years, depends on the fund: Minimum commitment period of sickness benefit optional tariffs – actual length not uniform nationwide, ask the fund concerned (§ 53 para. 6 SGB V, statutes of the health insurance fund)
  • depends on fund/tariff: Waiting period until benefits start in the optional tariff – not set uniformly by law (Statutes of the health insurance fund, no nationwide deadline in the SGB V)
What should I do first?
  • Check your insurance status: Clarify whether you are compulsorily insured, voluntarily insured under the statutory scheme or privately insured.
  • Ask about an optional tariff: With voluntary statutory insurance, ask your health insurance fund which optional tariffs with a sickness benefit entitlement under § 53 para. 6 SGB V are offered.
  • Take out an optional tariff: Ask about the fund's minimum commitment period before you take out the tariff.
What do I need to watch out for?
  • “Statutory health insurance” does not automatically mean “entitlement to sickness benefit” – compulsorily insured self-employed people as a rule have no entitlement without an optional tariff.
  • An optional tariff can no longer be taken out retroactively if an illness or incapacity for work already exists.
  • The waiting period is often underestimated: even with an optional tariff the fund often only pays after several weeks – the liquidity gap at the beginning is often not planned for.
Evidence
  • § 44 SGB V, gesetze-im-internet.de/sgb_5, retrieved September 2026.
  • § 53 SGB V, gesetze-im-internet.de/sgb_5, retrieved September 2026.
  • § 1 EFZG (Entgeltfortzahlungsgesetz), gesetze-im-internet.de/entgfg, retrieved September 2026.
  • Specific waiting periods for sickness benefit optional tariffs depend on the fund and tariff; no nationwide deadline provision found in the statute, see Sources and methodology.
  • Minimum commitment period of optional tariffs under § 53 SGB V – existence confirmed, exact length not conclusively verified against the statutory text.
As of

As of: September 2026 · Sources and method

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