Which screening tests are paid for by statutory health insurance funds in Germany?
Screening tests aim to detect diseases before they cause any symptoms. This can be an advantage if treatment started at this point leads to a better health outcome than if treatment is only started after symptoms have occurred. But screening tests can be harmful, too. This is why they should always be tested in terms of the benefits and harmful effects they may have. In Germany, there is no obligation to have screening tests.
People who have statutory health insurance in Germany can have the following screening tests paid for by their insurance:
- Health check-up” (in German: “Gesundheits-Check-up”): This examination aims to detect cardiovascular problems, diabetes and kidney diseases early on. The examination includes measuring blood pressure and testing blood and urine. Everybody who is 35 years of age or older can have this health check-up every three years. People between the ages of 18 and 35 years are elligible to have it once.
- Skin cancer screening: 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. 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 aims to help detect bowel cancer early. A stool sample is tested for blood that cannot be seen by the naked eye (occult blood). All people with statutory health insurance between the ages of 50 and 54 are entitled to have this test once a year.
- Endoscopy of the bowel: An endoscopy of the bowel is used for bowel cancer screening and prevention. From the age of 55, people can have a total of two endoscopies with at least ten years between the two tests. Alternatively, they can choose to have a test for hidden blood in the stool, as described above, every two years. If blood is found in stool and endoscopy of the bowel needs to be done, the health insurance fund will pay for it.
Additional screening tests are offered specifically to women, men or children:
- 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.
- Screening test for cervical cancer: This test includes a smear test (Pap test), in which cells are taken from the cervix. The cells are then examined in a laboratory, to try to detect any abnormal changes early on. All women aged 20 years or older can have this test once a year.
- Clinical breast examination: This examination is done to find breast cancer early. A doctor looks closely at both breasts and the neighboring lymph nodes and feels for any abnormalities. Women aged 30 or older are entitled to have a clinical breast examination once a year.
- Mammography screening: Mammography screening also aims to detect breast cancer as early as possible. In this examination, both breasts are x-rayed. Women between the ages of 50 and 69 can have this examination every two years.
- Examination of prostate and genitals: In this 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.
- Screening examinations for children (In German: U-Untersuchungen): These screening examinations aim to find out early if children have any diseases or developmental problems. Children are entitled to 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).
- Screening examination for teenagers (In German: J-Untersuchung): The goals of this screening examination include detecting problems in school, behavioral disorders and habits that are harmful to the teenagers’ health. Teenagers between the ages of 12 and 14 can have this examination once.
- Screening for tooth, jaw and mouth diseases: This examination aims to detect diseases of the teeth or gums in children. Children and teenagers up to the age of 18 can have this examination twice a year. Children up to the age of six are entitled to three examinations a year.
All screening examinations include a consultation with the doctor where the examinations are explained in detail. Besides the screening tests explained above, there are other specific offers like dental check-ups that adults can have twice a year, or pregnancy check-ups.
Früherkennung. Bundesministerium für Gesundheit (BMG). 21.12.2016.
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