Sickness benefit (Krankengeld) is not automatic for the self-employed. If you work as a freelancer or business owner and are voluntarily insured with a statutory health insurer (gesetzliche Krankenversicherung), you receive it only if you choose it through a declaration of election (Wahlerklärung). This guide explains how the procedure works, what to clarify with your insurer and when the choice can pay off.
Short answer: Self-employed people working full-time who are voluntarily insured only receive sickness benefit if they elect it through a declaration of election. One insurer’s form from 2026 gives 70 percent of profit as the benefit, a binding period of three years and a start from the 43rd day of incapacity to work (Last updated: November 2026).
The most important points
- According to the insurer’s form, there is no entitlement to sickness benefit without the declaration of election.
- The benefit starts on the 43rd day of incapacity to work, according to the form.
- The benefit is based on contribution-liable profit, not on turnover. The form sets 70 percent of that profit.
- According to the form, the election binds you for three years. After that it continues until you revoke it in writing at the end of a calendar month.
- The option has a price, because your contribution rises. Set the additional contribution against the benefit you might receive.
Why the self-employed are a special case
Sickness benefit replaces your income when you are ill and cannot work. Employees have an entitlement arising from their employment contract. The self-employed have no employer who continues to pay their income. For this reason the law provides for a declaration of election, with which the benefit is added by choice. The table below sets out the rules of one insurer’s form.
| Feature | Without declaration | With declaration (per form) |
|---|---|---|
| Entitlement to sickness benefit | Not provided for in the form | Yes, from the 43rd day of incapacity to work |
| Calculation | Not applicable | 70 percent of contribution-liable profit |
| Maximum per day | Not applicable | 135.63 euros gross (based on a monthly ceiling of 5,812.50 euros, 2026) |
| Duration | Not applicable | At most 1.5 years per illness within three years |
| Binding period | Not applicable | Three years, then extended until written revocation |
The rules of your own insurer’s statutes and offers may differ from this form. Look at the documents of your own insurer before you sign anything.
What the optional tariff regulates
Optional tariffs (Wahltarife) are governed by § 53 SGB V (in German). That section describes that insurers may provide for optional tariffs in their statutes, for example with a deductible (Selbstbehalt) or a premium refund (Prämie). Which tariffs exist and which conditions apply is therefore decided by each insurer. This is why different insurers offer different options.
In practice, the election is not a standard product. Two insurers can charge the same contribution rate but attach different conditions. Ask for the rules in writing and compare them with the declaration of election you are asked to sign.
The contribution: why the reduced rate matters
People without an entitlement to sickness benefit pay a reduced contribution rate. Under § 243 SGB V (in German), members without an entitlement to sickness benefit pay 14.0 percent instead of the general rate of 14.6 percent. The insurer’s additional contribution (Zusatzbeitrag) is added in both cases. The election therefore changes the contribution, and you should know the difference.
| Contribution component | Rate (as of 1 January 2026) | Applies to |
|---|---|---|
| General contribution rate | 14.6 percent | Members with an entitlement to sickness benefit |
| Reduced contribution rate | 14.0 percent | Members without an entitlement to sickness benefit |
| Additional contribution | Set by each insurer, average 2026 at 2.9 percent | Added to both rates |
The insurer’s form on which this guide relies states total rates of 18.59 percent with and 17.99 percent without sickness benefit. These figures apply to that form and that insurer only. Ask your insurer how the contribution changes with a declaration of election.
When the election can pay off
There is no fixed rule of thumb. A simple comparison with your own assumptions helps. It shows whether the additional contribution is in proportion to a possible period of incapacity.
Assume your contribution-liable profit is 3,000 euros a month (assumption). According to the form, the benefit is then 70 percent, or 2,100 euros a month. That comes to 70 euros per calendar day (assumption: 2,100 euros divided by 30 days). An absence of 30 days after the 42nd day would therefore yield about 2,100 euros of sickness benefit. Set against this the additional contribution you pay over the full three-year binding period.
What matters is how likely a longer period of incapacity is for you and what your profit actually turns out to be. With high fixed costs or physically demanding work the result can look different from desk-based work. The calculation does not replace a personal assessment, but it structures the decision.
Questions to ask your health insurer
- Which optional tariffs or sickness benefit options do you offer, and where are they set out in your statutes?
- From when does my declaration take effect if I am already ill?
- How long am I bound, and how do I revoke the election?
- What is my contribution with and without the declaration, and which additional contribution applies to me?
- Does the election remain in place if I change my health insurer?
Frequently asked questions
Do I receive sickness benefit without an optional tariff?
According to the insurer’s form, no. Without a declaration of election, the self-employed have no entitlement to sickness benefit. Check this at the start, because an election made during an existing period of incapacity only takes effect after that period ends.
Can I revoke the election at any time?
No. According to the form, the election binds you for three years. A revocation must be made in writing and takes effect at the end of a calendar month, at the earliest at the end of the binding period. After that the election continues until you revoke it.
Does this also apply to students?
Students often have their own rules, because they are insured under different provisions. The basics for students are explained in Krankengeld für Studierende: Gibt es das? (in German). Anyone who works self-employed after graduation should check both topics separately.
Is maternity benefit included?
The insurer’s form states that women who have elected sickness benefit are entitled to maternity benefit equal to sickness benefit. It is paid for six weeks before the birth, on the day of birth and for eight weeks afterwards, in individual cases for twelve weeks. Check your own insurer’s documents to see whether this applies to you.
Do I have to change insurer to receive sickness benefit?
No. Whether an optional tariff exists is decided by each insurer in its statutes. Changing insurer can be an option, but it should not be done only because of sickness benefit. Compare the contribution, the binding period and the services first.
What to do now
- Estimate your expected profit from self-employment for the current year.
- Ask your insurer in writing for the documents on the sickness benefit tariff and the contribution effects.
- Set the additional contribution over three years against the possible sickness benefit, using your own assumptions.
- Submit the declaration in time. The form gives two weeks after starting self-employment as the deadline for an election from the start of insurance.
Related articles
- Krankenkasse 2027: What changes for insured persons and students (in German)
- Optional tariffs of health insurers for young insured persons (in German)
- Sickness benefit for students: does it exist? (in German)
- Self-employed while studying: trade, tax and health insurance (in German)
Sources: Declaration of election for sickness benefit for full-time self-employed persons, BKK Scheufelen (dated 23 March 2026); § 53 SGB V, optional tariffs (gesetze-im-internet.de); § 243 SGB V, reduced contribution rate (gesetze-im-internet.de); GKV-Spitzenverband, fact sheet on calculation parameters 2026 (as of 1 January 2026)
Last updated: November 2026. This guide is general information, not individual advice.
