What screening tests does German public health insurance cover?

• General check-up (also referred to as “Check-Up-35”): The doctor will ask you about your lifestyle, vaccination status and your and your family’s medical history. You will have your blood pressure checked, and your blood and urine will be tested for things like blood fat and sugar levels. The aim is to identify risk factors and diseases like cardiovascular (heart and blood vessel) disease, diabetes, kidney disease and cancer at an early stage. In Germany, people who have public health insurance can have a general check-up once between the ages of 18 and 35. After that, they‘re eligible every three years. It is also possible to get tested for hepatitis B and C once after you’ve turned 35.
• Dental check-ups: People aged 18 or over can have a twice-yearly dental check-up to see whether they have any tooth/gum problems. They can also have tartar removed (scaling) once a year and periodontitis screening once every two years.
• Skin cancer screening: This screening test involves the doctor examining your entire body to look for changes in the skin. The aim is to detect skin cancer like malignant melanoma as early as possible. This examination is also offered every two years to people who are 35 years or older.
• Test for hidden blood in the stool: This test is designed to detect colorectal (bowel) cancer at an early stage. A stool sample is tested for blood that cannot be seen by the naked eye (occult blood). Traces of blood like this can be a sign of cancer or polyps in your bowel. If the test finds blood, you‘ll be sent for a colonoscopy to find out the cause. Everyone who is between 50 and 54 and has public health insurance is entitled to one of these tests every year. Those aged 55 and above can have one every two years unless they decide to have a colonoscopy.
• Colonoscopy: The aim of this examination is to detect colorectal cancer early and to prevent it. It is available twice to men aged 50 and above and women aged 55 and above. There must be at least ten years between the two colonoscopies. If you decide to have a colonoscopy, you won‘t need a stool test for ten years afterwards.
  

• Chlamydia screening: Chlamydia are bacteria that can be transmitted sexually. Chlamydia infection can increase the risk of complications during pregnancy and lead to infertility. All women under 25 years of age are offered chlamydia screening once a year so that chlamydia infections can be detected and treated early. This is done by testing a urine sample for these bacteria in a laboratory.
• Cervical cancer screening: This involves a smear test known as a “Pap test," in which a cell sample is taken from the cervix and examined for abnormalities in a lab. Women between the ages of 20 and 34 are entitled to one Pap test per year. Women aged 35 and above can have a combined Pap and HPV test every three years. The HPV test looks for a certain type of virus that can cause cervical cancer.
• Breast examination by touch (palpation): This is done to find breast cancer early. A doctor looks closely at both breasts and the nearby lymph nodes and feels for any abnormalities. Women aged 30 or older are entitled to have this examination once a year.
• Mammography screening: This screening test also aims to detect breast cancer as early as possible. It involves x-raying both breasts. Women between the ages of 50 and 69 care entitled to one of these screening tests every two years.
• Screening during pregnancy: These tests check to see whether the unborn child is developing normally and whether the mother is healthy. Pregnant women can have a check-up every four weeks. In the last two months of pregnancy, they‘re entitled to one every two weeks. These check-ups usually include physical examinations such as examining the stomach by touch, regular blood tests and ultrasound scans. A range of other tests are also offered, including for gestational diabetes (diabetes that occurs during pregnancy), HIV and chlamydia.

• Prostate and genital examination: The doctor feels the prostate and external genitals to detect prostate cancer or diseases of the sexual organs early. Men aged 45 years or older can have this examination once a year.
• Abdominal aortic aneurysm (AAA) screening: This examination is available once to men over the age of 65. A healthcare professional measures the diameter (width) of the abdominal aorta using an ultrasound device. The aim is to detect large aneurysms in enough time to stop them tearing and becoming fatal.

• Standard check-ups for children (U-Untersuchungen): These aim to find out early if children have any diseases or developmental problems. Children can have ten of these screening examinations – the first one is done directly after birth, the last one at the age of five (U1 to U9, including U7a).
• Standard check-up for teenagers (J-Untersuchung): This is a physical examination for teenagers between the ages of 13 and 15, including the option to have any recommended vaccinations. Teenagers can go to this check-up on their own and discuss personal matters (like problems at school) openly. As always, the doctor is not allowed to share any of this information with others.
• Screening for tooth, jaw and mouth diseases: This check-up aims to detect diseases of the teeth or gums. Children up to the age of six are entitled to six of these examinations in total. Children and teenagers between the ages of 6 and 18 can have two of these examinations per year.

A complete list of all screening tests can be found on the website of the German Federal Joint Committee (G-BA). Some public health insurers also cover other screening tests in addition to the ones required by law. To find out more, contact your insurer.