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Sickness Insurance Benefits

The following benefits are granted from the sickness insurance scheme for self-employed persons:

  • sickness benefits
  • maternity benefits in cash

The self-employed person is entitled to sickness benefits if he/she has been assessed as temporarily unable to work or has been quarantined, provided the temporary work inability or quarantine lasts for more than 21 calendar days.

 

Conditions for entitlement to sickness benefits

The general conditions applicable to employed persons also apply to self-employed persons. In addition, the following conditions for entitlement to sickness benefits apply:

  • a self-employed person does not personally carry out an independent gainful activity during the time of inability to work (quarantine),
  • the period of participation of the self-employed person in sickness insurance has lasted for at least three months immediately preceding the day of the origination of the inability to work (quarantine);

The entitlement to benefits arises if the conditions for entitlement to benefits are satisfied during the period of insurance or if the temporary inability to work starts within the protection period of 7 calendar days from the day of terminating the insurance. If the duration of the insurance was shorter, then the protection period is equal to the number of calendar days for which the insurance lasted. The period of protection does not ensue from insurance of the work of self-employed persons who enjoy an old-age pension or disability pension for a third-degree disability.

 

Conditions for entitlement to maternity benefits in cash

The general conditions applicable to employed persons also apply to self-employed persons and in addition, the following applies:

  • the self-employed person must not personally carry out an independent gainful activity when receiving maternity benefits in cash,
  • the period of participation of the self-employed person in the sickness insurance scheme must be at least 180 days during one year before the day when the payment of maternity benefits in cash started,
  • at the same time the insurance period must have lasted for at least 270 calendar days during the last two years before the day when the payment of maternity benefits in cash started.

 

Calculation of sickness benefits for self-employed persons

Sickness and maternity benefits are determined on the basis of the daily assessment base which is calculated as the assessment base for the decisive period divided by the number of calendar days of the decisive period.

If any excluded days are included in the decisive period the number of calendar days of the decisive period is reduced by them. Calendar days in those calendar months in which the self-employed person does not pay sickness insurance premiums or in which the self-employed person does not participate in sickness insurance are excluded. The assessment base is the total of the monthly bases.

The decisive period is usually the 12 calendar months before the calendar month in which the social event occurred. The calculation of sickness benefits for self-employed persons is carried out by the same method as the calculation for employees’ benefits.

 

 

Latest modifications 26. 1. 2012