Sick pay for self-employed workers in 2026: When is it payable and how much will you pay?

Quick overview

• Sickness insurance is voluntary for self-employed people.
• In 2026, the minimum payment is CZK 243 per month, but the sick pay itself is paid only from the 15th day of incapacity for work.
• You only qualify if you have been insured for sickness for at least 3 months immediately before the sick leave or quarantine.
• In addition, you must not be self-employed during the period of sick leave.
• Sick pay is therefore mainly paid to self-employed workers who do not have sufficient reserves or who would quickly lose income if they were ill for a longer period.

Not sure if sickness insurance is worth it or are you struggling with the CSSA, benefits or deductions? Describe your situation to us and we will help you.

What is sick pay?

Sickness benefit is one of the sickness insurance benefits that provides financial support to employees (and in certain cases to self-employed persons if they pay this insurance voluntarily) in situations where they are temporarily unable to work.

These benefits are paid in the event of illness, injury or quarantine. You may often see the terms sick leave or sick leave in connection with sick pay.

The rules on sickness insurance are governed mainly by the Sickness Insurance Act and the related regulations on social security contributions. In the case of self-employed persons, it is important to distinguish between participation in sickness insurance, payment of premiums and entitlement to a specific benefit. It is therefore not enough to be “self-employed” – you must voluntarily take out sickness insurance and pay it properly.

Sick pay can get you out of a jam, such as a long-term illness or an injury that prevents you from working for a long time. So if your savings account is only a few thousand and your other accounts aren’t much better off, it’s a good idea to choose one of the two, or combine the two options of paying voluntary sick pay and commercial insurance:

Voluntary sickness insurance for self-employed persons

Sickness insurance for self-employed persons works in a similar way to the classic compulsory sickness insurance for employees. However, the conditions are a bit stricter and the calculation of the advance payments and sickness benefits is different.

How do I apply for sickness insurance?

First of all, as a self-employed person, you must register for voluntary sickness insurance, as it is not automatic. You can apply through the district social security administration (OSSZ) under which you fall.

To do this, you need to visit the ePortal of the Czech Social Security Administration (ČSSZ), where you can fill in the online application form, or download the form, fill it in and deliver it to the relevant OSSZ (in person, by post or by mail). The application form can be submitted at any time during the year, for example when submitting income and expenditure statements.

If you are just starting a business, you can apply for sickness insurance when you set up your business. Just fill in the single registration form (used to register for the various duties of self-employed workers) and indicate in Part B of the form the date from which you want to take out voluntary sickness insurance.

The earliest date on which participation in the insurance starts is the date of application. Sickness insurance cannot therefore be paid retrospectively. If you forget to pay the advance payment of sickness insurance or pay it late (after the end of the following month), your participation in sickness insurance will cease and you will have to apply again.

In practice, we often see that the self-employed person starts to deal with sickness insurance only when she already has a health problem or knows that she is going to have a procedure. However, this is often too late. Participation in sickness insurance is not retroactive and the self-employed person must also meet a minimum period of participation in sickness insurance to qualify for sickness insurance.

If you are deciding whether to sign up now or later, we recommend not to delay the decision. For self-employed workers, insurance is not retroactive and if you sign up late you may lose your entitlement to benefits altogether. Do you need to check which procedure is safe for you? Take advantage of our socio-legal advice.

Amount of advance payments for sickness insurance

Sickness insurance premiums for self-employed persons (self-employed persons) are determined on the basis of the assessment base (AB), which self-employed persons choose themselves.

The amount of sickness insurance for self-employed persons is determined on a monthly basis chosen by the self-employed person. In 2026, the sickness insurance rate for self-employed persons is 2.7%. The minimum monthly premium base is CZK 9 000, so the minimum sickness insurance payment is CZK 243 per month.

The maximum monthly base for self-employed persons is based on the last income and expenditure statement. Simply put, you cannot pay sickness insurance on an arbitrarily high base unless your previous income matches it.

If the maximum base cannot be determined, for example when you start a business, it is based on half the average wage for the year. In 2026, this amount is CZK 24,484, which corresponds to a payment of CZK 662 per month.

Special rules apply to self-employed persons in the flat-rate scheme. For them, the maximum amount of advances is determined on the basis of the chosen flat-rate band:

At the same time, self-employed persons with a flat-rate scheme have to pay advances even if they have spent the whole month on sick leave, but they do not have to pay sickness insurance.

How to pay advance payments of sickness insurance

Sickness insurance is payable from the 1st to the last day of the month for which the premium is paid. For example, premiums for February must be paid no later than 31 March. In the month in which you sign up for sickness insurance, the premium is not due until the end of the following month.

Payments must be sent to the special bank account of the Social Security Institution designated for sickness insurance. You can find the account numbers of the individual Social Security Institutions on the website of the Social Security Institution for your place of business. Please use your personal identification number as the variable symbol.

If you have not paid your insurance premium by the due date, you can pay it by the end of the following month. This can be paid from the overpayment or together with the next premium payment. However, you can only pay the amount corresponding to the minimum monthly assessment. Otherwise, it will lapse.

A late or incorrectly marked payment can cause more problems for self-employed sickness insurance than it first appears. If you have been notified by the Social Security Administration that you are no longer covered or have been denied benefits, send us the documentation for our review. We will check whether you can defend yourself against the authority’s action.

If, on the other hand, an overpayment occurs (e.g. you pay more than your maximum assessment base), it will be calculated and refunded after the end of the calendar year (by the end of February of the following year at the latest). However, the amount up to CZK 432 will remain in your account as a reserve.

If you are entitled to sick pay for a full calendar month, you do not pay any insurance for that month. However, if you are sick for only part of the calendar month, you must pay the premium for that month. This includes the first 14 days of illness when you are not yet receiving sickness benefits.

A typical situation in practice: A self-employed person has been paying sickness insurance for several months but has sent one payment late or under the wrong variable symbol. When she subsequently became unfit for work, she discovered that her participation in the insurance had ceased and she was not entitled to the benefit. Therefore, it is not enough to just “send something” when it comes to sickness insurance for self-employed workers – you need to keep an eye on the correct account, variable symbol and payment date.

Conditions for granting sickness benefits

In addition to the general conditions applicable to employees, self-employed workers must meet specific requirements. In general, the conditions include:

• Participation in sickness insurance: entitlement to sickness benefits only arises if the self-employed person is covered by sickness insurance. Participation in the insurance starts on the date indicated on the application form, but not before the date on which the application form is submitted. The self-employed person must also meet the minimum period of participation in sickness insurance, which is set at 3 months immediately before the incapacity for work or quarantine.
• Incapacity for work: Sickness benefits are only granted if the occurrence of temporary incapacity for work is decided by the attending doctor by issuing a sick note and if the temporary incapacity for work or quarantine lasts longer than 14 calendar days.
• Interruption of business activity: during the period of incapacity for work or quarantine, the self-employed person may not engage in self-employment. Active business would then result in loss of entitlement to benefits.

The amount of sickness benefits

The amount of sickness benefits for self-employed persons is calculated on the basis of a reduced daily assessment base, which is derived from the income earned during the reference period:

• The assessment base is the sum of the monthly bases on which the self-employed person paid sickness insurance during the reference period.
• The reference period is usually the 12 calendar months preceding the month in which the incapacity for work arose. The reference period excludes months when the self-employed person did not pay sickness insurance or was not obliged to pay insurance premiums (e.g. was entitled to sickness benefits, maternity pay or long-term sick pay for the whole month).

A reduction is made from the calculated daily assessment base, which means that different parts of the assessment base are taken into account in different proportions:

The amount of sick pay per calendar day is based on the reduced daily assessment base.

In 2026, the sick pay is:

• 60 % from the 15th to the 30th day of incapacity for work
• from the 31st to the 60th day 66 %
• and from the 61st day 72 % of the reduced daily assessment base.

Commercial sickness insurance

If you don’t want to pay for voluntary sickness insurance from the state, you can still take advantage of commercial sickness insurance. This is offered by some commercial insurers and you can set up your payout after 15, 30 or 60 days of sickness, depending on their offer.

As a rule, you will need to provide proof of the previous year’s tax return. The amount of the payments should be set so that if you are unable to earn money, it will not mean a significant drop in income and will allow you to pay all the mandatory payments (rent, utilities, mortgage, etc.) and still make a reasonable living.

Termination of voluntary sickness insurance

If you decide to end your voluntary sickness insurance, you must apply to the district social security office. You can submit it in person, send it by post or by mail, or use the ePortal of the Social Insurance Institution.

Participation in sickness insurance ends on the date you indicate in the opt-out form, but not before the date you submit the opt-out form. The insurance cannot be terminated retrospectively, so it is necessary to submit the withdrawal in time.

Sick leave – employee vs. self-employed

To put this information into context, let’s look at how sick pay and sickness insurance payments differ for employees and self-employed workers:

Obligation to participate in sickness insurance

• Employees: Sickness insurance is compulsory for employees with earnings above the qualifying income and automatically starts on the date of entry into employment that triggers participation in the insurance (e.g. employment contract or employment agreement with income above the set limit of CZK 11,500).
• Self-employed persons: sickness insurance is voluntary for self-employed persons. Participation in the insurance is only triggered by an application and starts at the earliest on the date of the application.

Payment of insurance premiums

• Employees: Sickness insurance for employees is paid by the employer and is determined as the product of the assessment base and the percentage rate. An additional 0,6 % is deducted from the employee’s salary.
• Self-employed persons: self-employed persons pay their own premiums on the basis of their own decision. The amount of the premium is based on the assessment base chosen by the self-employed person.

Conditions for entitlement to sickness benefit

• Employees: Employees are entitled to sickness benefits if they have been insured for sickness for at least the duration of their employment (i.e. immediately from the first day of participation in sickness insurance).
• Self-employed workers: Self-employed workers must have been insured for sickness for at least three months before the incapacity for work arose in order to qualify for benefits. Without this condition, they are not entitled to sickness benefits.

Sickness benefit payments

• Employees: For the first 14 days of incapacity for work, employees receive wage compensation from their employer (from the 15th day onwards, the state pays sick pay).
• Self-employed workers: Self-employed workers are not entitled to wage compensation because they do not have an employer. Therefore, they only receive sickness benefits, which the state starts paying from the 15th day of incapacity for work.

The amount of sick pay

• Employees: The amount of sick pay is based on their income for the reference period. Employees with higher incomes receive higher benefits.
• Self-employed persons: for self-employed persons, the amount of sick pay depends on the assessment base they set when paying their insurance premiums. If the self-employed pay the minimum premium, their sickness benefits will be significantly lower than for employees.

Voluntary sick pay for the self-employed – yes or no?

As the above information shows, you will only get sickness benefits if you pay voluntary sickness insurance. Whether or not this is worthwhile is up to each of us. If you don’t have enough saved up to get by comfortably for a few months, then sick pay is probably more important to you than if you have saved up.

However, it’s important to remember that even if you are able to come out of savings for a few months, you could still use at least some sort of option in case of illness. For example, even paying the lowest voluntary sickness benefit of CZK 243 will allow you not to pay social security and health insurance contributions in the event of long-term illness.

Summary

Sickness insurance is voluntary for self-employed persons in 2026 and the minimum payment is CZK 243 per month. You are only entitled to sick pay if you have been insured for at least 3 months before the sickness absence or quarantine, you have been issued with a sick leave and you are not personally engaged in business activity during the illness. Sick pay is only paid from the 15th day of incapacity for work and the amount depends on the assessment base you choose, so the minimum premium also means lower benefits. The insurance is mainly worthwhile for self-employed workers without sufficient financial reserves, with high fixed costs or with a business that is immediately stopped by illness. Commercial insurance can be an alternative or supplement, but you always need to compare the cost, waiting period, exclusions and actual benefit.