Early detection: you are entitled to these preventive examinations

A family doctor sits at a table and talks to a patient whose picture shows only his back

Early detection of certain diseases is an important preventive measure. If you notice them regularly, you are doing something to preserve your health and improve your chances of recovery. The earlier serious diseases are detected, often the better the options for responding to them medically.

People with statutory health insurance are entitled to a whole range of regular early detection examinations. These depend on gender and age and are granted at different intervals in each case.

  • from the age of 18 until the age of 35 (women and men): a one-time general check-up
  • from 20 years of age (females): once a year a genital examination for early detection of cancers
  • up to 25 years (females): annual testing for chlamydial infection
  • from the age of 30 (Women): In addition to cancer screening, there is an annual breast and skin examination. Make sure that you are instructed in breast self-examination for regular early detection in the process.
  • from 35 years (women): every three years a combined screening consisting of cytological examination and HPV test
  • from 35 years (women and men): A general health check-up every three years for early detection of kidney disease, cardiovascular disease and diabetes, for example.
  • Within the check-up: from autumn 2021 also unique screening for hepatitis B and hepatitis C virus infection. This is to detect undetected infections and treat them at an early stage to prevent late consequences. If the last check-up was less than three years ago, the screening can also be done separately for a transitional period.

Each fund may also provide for other examinations as voluntary benefits in its bylaws. You should clarify this with your health insurance company on a case-by-case basis.

Important vaccinations for adults and at what intervals you get them

In addition, public health insurance companies pay for various protective vaccinations for men and women of all ages. Long-term protection against infections is also included in the preventive services. The statutory health insurance companies cover the costs of all vaccinations recommended by the STIKO. However, each health insurance fund can include other vaccination offers as voluntary benefits in its statutes. You should clarify this in individual cases with your health insurance company.

Recommended booster vaccinations include z.B.:

  • Tetanus (tetanus) and Diphtheria every ten years
  • Whooping cough (Pertussis) once in adulthood (18 to 60 years)
  • Measles Once, if you were born after 1970, are older than 18, and have an unclear vaccination status or were vaccinated against measles only once in childhood.
  • from 60 years of age one-time vaccination against Pneumococcus
  • Annual Flu shot for chronically ill persons, pregnant women, persons over 60 years of age and people with increased risk of infection, for example medical personnel.
  • Shingles (herpes zoster), if you are either over 60 years old or have an underlying disease such as diabetes or asthma and are 50 years or older.
  • TBE for all those who stay in risk areas within Germany and may come into contact with ticks. Which areas within Germany belong to the risk areas can be found in the current notes in the Epidemiological Bulletin of the Robert Koch Institute. You can view the 2019 issue here.

Screening for children and adolescents

From birth to adulthood, a series of examinations for early detection and prevention are provided at the expense of health insurance companies. These include:

  • In the first six years of life A total of ten investigations on the program, in which sensory, respiratory and digestive organs, skeleton and musculature and congenital metabolic disorders can be examined and possible developmental and behavioral disorders can be detected. These are the so-called U-examinations U1 to U9, incl. U7a. Several regular vaccinations – including for diphtheria, tetanus, pertussis, polio, measles, mumps, and rubella – round out the preventive care offered to the youngest children. Parents receive an examination booklet after birth, in which all important examinations are listed.
  • For adolescents between the ages of 12 and 15, there is a further examination on the Check of physical condition and mental development (Youth health examination/J1). Detailed information on this can be found on the website of the Federal Joint Committee.
  • In addition the costs of the Vaccination against cancer of the cervix (HPV vaccination) for girls between the ages of nine and 14 is covered after a medical consultation. The Standing Commission on Vaccination (STIKO) recommends vaccination against HPV not only for girls aged 9 to 14, but since June 2018 also for all boys of this age. Adolescents who have not been vaccinated against HPV by age 15 should receive the vaccination as soon as possible and before age 18. Make up for your birthday.

Bonus programs

With bonus programs, health insurance companies try to make regular participation in preventive medical examinations more attractive to their insured persons. Those who can provide evidence of regular preventive medical checkups receive a financial allowance or other bonuses. Insured persons must register for the bonus program and have their examinations stamped by their doctor.

Bonus booklet at the dentist

If, for example, a dental prosthesis is due, all health insurers reward regular check-ups with financial subsidies. Therefore, it is important that the regular preventive examinations are recorded as evidence in the bonus booklet. Normally, health insurance companies only pay half of the costs for standard dental prostheses. Those who have their teeth checked at least once a year for five consecutive years receive a subsidy of 60 percent; those who can provide evidence of ten years of regular preventive care in their bonus booklet are even reimbursed for 65 percent of the costs.

You can find more information about this on our portal kostenfalle-zahn.

Individual health services (IGeL)

In addition, many medical practices advertise special tests and (preventive) examinations, which they offer at private cost, since these are not included in the statutory benefits catalog and the insurance companies do not cover the costs for them.

These are so-called IGeL services (individual health services). Their benefit is controversial in many cases. The IGel monitor evaluates frequently offered examinations on the basis of scientific findings. Patients should therefore check additional services that are not covered by their health insurance fund before agreeing to them and consult with their health insurance fund to determine the extent to which additional treatments that are subject to a charge make sense in individual cases. Whether the health insurance companies cover the costs should be clarified in advance – because the amounts for services that have already been paid privately are usually not reimbursed afterwards.

You can find more information on this topic in our FAQ on IGeL services.

The two most frequently performed IGeL services are intraocular pressure measurement for early glaucoma detection and ovarian ultrasound for early cancer detection. According to the IGeL Monitor 2020 survey, these two IGeL services are once again at the top of the list. The IGel Monitor notes that for both services, the potential harm outweighs the benefit. Specialist societies and professional associations also tend to advise against these two services.

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