Sickness benefit for persons with health insurance in the event of illness of the child Unfortunately this specification of service has not yet been completely translated.

Gesetzlich versicherte Eltern haben für die Versorgung Ihres erkrankten und versicherten Kindes unter Umständen Anspruch auf Krankengeld und Freistellung. Das ist dann der Fall, wenn sie dadurch der Arbeit fernbleiben, da eine andere im Haushalt lebende Person das Kind nicht betreuen kann und das Kind das 12. Lebensjahr noch nicht vollendet hat oder behindert ist.


medical certificate


Preconditions
In order to be entitled to sick pay and time off in the event of illness of your child, all the following points must be met: the doctor certifies the need for supervision, care or care of the sick child, another person living in the household cannot do this and the child has not yet reached the age of twelve. a medical certificate must confirm the necessity of caring for the child, for legally insured persons there is the doctor's model 21: "Medical certificate for the receipt of sick pay in the event of illness of a child no other person living in the household can take over the care (also working or self-ill) the child has not yet reached the age of 12 or is disabled the child is insured with a statutory health insurance fund for the payment by the health insurance company, an application must be completed. They are working and are entitled to sick pay themselves. The entitlement to child sickness benefit exists for all insured persons in the statutory health insurance. If both spouses are privately insured, there is no entitlement to child sickness benefit according to § 45 SGB V. If one spouse is privately and the other spouse is legally insured, it is crucial that the child has statutory health insurance. In the event that the children are assigned to the spouse who is privately insured, the children do not fall within the scope of application, as its provisions are only binding on legally insured persons. This applies regardless of whether the other spouse is still legally insured because there is no family insurance for their children. If both parents are legally insured, but in different health insurance companies, the health insurance company pays the caregiver the sick pay, regardless of where the child is insured.

Hints
Furthermore, in the case of caring for and caring for a serious and incurable illness of his child, a parent is entitled to sickness benefit that is not subject to the above-mentioned time limit. The claim exists if your child is disabled and dependent on help and suffers from a disease according to a medical certificate, which is progressive and has already reached a well-advanced stage, in which a cure is excluded and palliative care is necessary or desired by a parent and which can only be expected to have a limited life expectancy of weeks or a few months.
After issuing the medical certificate, submit a written application to your health insurance company for sick pay. The easiest way is to go to your health insurance company with the medical certificate and fill out the application there as part of a consultation. Submit the medical certificate to the health insurance company and your employer in writing an application for exemption. It is important that the health insurance company recognizes your entitlement to benefits before you want to assert your claim for exemption. Because if the conditions for a right to leave are not fulfilled, your employer has the right to count the already granted time off from work performance against a later exemption claim for the supervision, care or care of your sick child. Therefore, first go to your health insurance company to clarify your entitlement to benefits before submitting an exemption to your employer.

Responsible for the content
The Senator for Health, Women and Consumer Protection

Last update or date of publication
01.12.2020