Sickness benefit in the statutory health insurance; application for self-employed persons

Even if you are self-employed, you can insure yourself at the general contribution rate with statutory sick pay entitlement from the 7th week onwards, just like employees who are subject to compulsory insurance. To do so, you must submit an election declaration to your health insurance fund.

Description

Prerequisites

  • The declaration of election only applies to a case of illness occurring in the future.
  • If you are incapacitated for work at the time of submitting the application or if the incapacity for work occurs between the date of submission and the effective date of the application, the application shall take effect from the date on which you are again capable of work.

Procedure

You can submit the application for statutory sick pay (declaration of election) in writing and - for many statutory health insurance funds - in person at the office or online.

  • Make the application informally. This means you must tell your health insurance company in your own words that you want to increase your contribution rate in order to receive sickness or maternity benefits.
  • Some public health insurers offer you forms for declaring your choice.
  • Your health insurance fund will confirm receipt of your letter or the form and your future entitlement to sickness or maternity benefits.

Special notes

If you have health insurance through the Künstlersozialkasse (KSK), you are automatically entitled to sick pay.
The various health insurance companies offer different optional tariffs that allow you to receive sick pay before the 43rd week. For more information, please contact your statutory health insurance fund.

Deadlines

  • The declaration of election can be submitted to your health insurance fund at any time. Entitlement to sickness benefits begins at the start of membership in your health insurance fund when you submit the declaration of election with your membership application.
  • The declaration of election is valid for 3 years.
  • If you do not cancel the corresponding plan before the end of the 3 years, it will be renewed for 12 months.
  • You cannot cancel your declaration of election even if you change health insurers.
  • It is not possible to switch to private health insurance during the 3 years.

Processing time

Processing usually takes 3 to 7 working days.

For rapid processing and decision-making, your health insurance fund must be provided with the necessary information as well as any required documents in a complete and meaningful manner.
The health insurance company decides on applications promptly, whereby the statutory processing period is adhered to in order to protect patients' rights.
Please note that the processing time indicated is an average value for all health insurance funds. It may vary in individual cases.
The exact processing time also depends on the complexity of the individual case and may be longer accordingly. The same applies if documents or records are sent to you or your health insurer by mail.

Required documents

  • Required document/s

    • Income tax assessment notice
    • In special cases, further documents may be required. Please contact your health insurance company for more information.

Forms

  • Form, Bavaria-wide: Zum Antrag einer Wahlerklärung über den Kassen-Navigator des GKV-Spitzenverbands
    Please note

    This form has to be signed and sent to the responsible authority. You can sign the form manually and send it by email/fax or sign the form electronically with your qualified electronic signature an send it by (secure) email. If the responsible authority has set up a De-Mail account, you can also send the form by De-Mail using an sender-confirmed message.

Fees

  • You do not have to pay anything for the processing of your election declaration.

Remedy

  • Opposition.
  • Action before the Social Court

Status:11.04.2023

Responsible for editing:Bundesministerium für Gesundheit

  • Online transactions, Bavaria-wide
  • Online transactions, locally limited
  • Form, Bavaria-wide
  • Form, locally limited
  • Prefillable Form, Bavaria-wide
  • Legal bases, Bavaria-wide
  • Legal bases, locally limited
  • Fees, Bavaria-wide
  • Fees, locally limited
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