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Health care in Germany

Health care in Germany

Which screening tests are paid for by statutory health insurance funds in Germany?

In Germany, many tests and examinations are paid for by statutory health insurers. Along with general health check-ups for children and adults, there are some that are specifically for women or specifically for men. Before having a test or examination, the doctor will explain it to you in detail.

The aim of tests is to detect diseases or risk factors early on. This can be an advantage if treatment is more effective when started before symptoms have occurred.

But screening tests can be harmful, too. So it's a good idea to carefully consider the pros and cons. In Germany, there is no obligation to have tests.

Screening tests for adults

  • General health check-up (in German: “Gesundheits-Check-up” or "Check-Up-35"): Here the doctor asks you about your lifestyle, vaccines, and what health problems you and your family have (had). He or she will take your blood pressure, as well as a blood and urine sample. These samples are tested for things like blood lipids (fats in your blood) and sugar. The aim is to detect signs of risk factors and diseases early on – including cardiovascular disease, diabetes, kidney disease and cancer. You can have this general health check-up once between the ages of 18 and 35. After that, you can have one every three years. If you like, you can also be tested for hepatitis B and hepatitis C once after you reach the age of 35.
  • Dental check-ups: From the age of 18, you can go to the dentist twice a year to detect any problems with your teeth or gums. You can have plaque and tartar removed from your teeth (scaling) once a year, and once every two years.
  • Skin cancer : In skin cancer screening, the doctor examines the entire body to look for changes in the skin. The aim is to detect skin cancer like malignant melanoma as early as possible. You can have this examination every two years from the age of 35 years.
  • Test for hidden blood in the stool: This test is done to discover bowel cancer early on. A stool (poo) sample is tested for blood that can't be seen just by looking at it. Known as occult blood, this hidden blood may be a sign of cancer or in the bowel. If blood is detected, the doctor will advise you to have an examination to take a look at the inside of your bowel (a colonoscopy) and find out where the blood is coming from. All 50 to 54-year-olds who have statutory health insurance in Germany can have this kind of stool test once a year. From the age of 55 you can have one every two years, unless you decide to have a colonoscopy instead.
  • Colonoscopy: This examination is done to discover bowel cancer early on and prevent it from developing in the first place. You can have a total of two colonoscopies – with at least ten years between them – from the age of 50 if you're a man, and from the age of 55 if you're a woman. If you decide to have a colonoscopy, there's no need to have a stool test to look for hidden blood over the following ten years.

Screening tests for women

  • Chlamydia : Chlamydia are bacteria that can be spread through sexual contact. A chlamydia can increase the risk of complications during pregnancy and lead to infertility. Women under the age of 25 are offered chlamydia once a year so that chlamydia infections can be detected and treated early. The test involves giving a urine sample that is then checked for these in a laboratory.
  • Screening test for cervical cancer: In this test, known as a smear test or Pap test, cells are scraped from the cervix. The cells are then examined in a laboratory, to try to detect any abnormal changes early on. Women between the ages of 20 and 34 can have a free smear test once a year. From the age of 35, they are offered a combined test (a smear test and an HPV test) every three years. The HPV test looks for certain human papillomaviruses that can cause cervical cancer.
  • Clinical breast examination: This examination is done to find breast cancer early. A doctor looks closely at both breasts and the nearby lymph nodes, and feels for anything unusual. Women aged 30 and older can have a free clinical breast examination once a year.
  • Mammography: Mammography examinations aim to detect breast cancer as early as possible. They involve x-raying both breasts. Women between the ages of 50 and 69 can have a mammography every two years.
  • Screening in pregnancy: Various tests and examinations are offered in pregnancy to see whether the unborn child is developing normally and the woman is healthy. Pregnant women can have a check-up every four weeks throughout the pregnancy, and every two weeks in the last two months. The check-ups include physical examinations like feeling the woman's belly, regular blood tests and ultrasound scans. Other types of are offered too, such as tests for gestational diabetes, HIV and chlamydia.

Screening tests for men

  • Examination of prostate and genitals: In this examination, the doctor feels the prostate and external genitals to detect prostate cancer or diseases of the sex organs early. Men aged 45 years or older can have this examination once a year.
  • Screening for aneurysms in the belly: Men over the age of 65 can have a screening examination to look for aneurysms in the belly (abdominal aortic aneurysms). This involves doing an ultrasound scan to measure the width of the abdominal aorta. The abdominal aorta is the part of the aorta (the largest blood vessel in the body) that runs through the belly. The aim is to discover large aneurysms (bulges) in the aorta early on, before they could burst and lead to death. Men can have this examination once.

Screening tests in children

  • Standard check-ups for children (In German: U-Untersuchungen): The aim of these examinations is to find out early if children have any diseases or developmental problems. Children are entitled to have ten standard check-ups – the first one is done straight after birth, the last one at the age of five (U1 to U9, including U7a).
  • Standard check-up for teenagers (In German: J-Untersuchung): Teenagers can have this check-up between the ages of 12 and 14.The doctor does a physical examination, asks about their health, and checks whether their vaccines are up to date. The appointment gives teenagers the opportunity to talk about personal problems, too – such as problems at school. They can talk to the doctor alone, and can trust him or her: the usual patient confidentiality rules apply here too.
  • Screening for tooth, jaw and mouth diseases: This examination aims to detect diseases of the teeth or gums. Children up to the age of six can have a total of six dental check-ups a year. Children and teenagers between the ages of 6 and 18 can have this check-up twice a year.

A complete list of all offers can be found on the website of the German Federal Joint Committee (G-BA). Some statutory health insurers offer other types of , too. Your insurer can inform you about those.

Bundesministerium für Gesundheit (BMG). Online-Ratgeber Krankenversicherung: Welche Früherkennungsuntersuchungen werden empfohlen? 2016.

Gemeinsamer Bundesausschuss (G-BA). Früherkennung von Krankheiten. 2021.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Which screening tests are paid for by statutory health insurance funds in Germany?

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Updated on February 9, 2022

Next planned update: 2025

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Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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