Prevention through the health check-up
In Germany anyone with statutory health insurance is entitled to preventive screening examinations. Alongside services to detect cancer early, there is also the health check-up: this can be done once from the age of 18 onwards, and every 3 years from the age of 35. You can read here what the health check-up involves.
At a glance
- The health check-up is available to any adult with statutory health insurance.
- The health insurance provider assumes all the costs involved.
- The person insured can have the check-up once between the ages of 18 and 34, and every 3 years from the age of 35.
- It is particularly useful in detecting risks of cardiovascular diseases and type 2 diabetes at an early stage.
- In a concluding consultation the doctor will explain the person’s current health status, individual risks, and prevention options.
- The person must attend the appointment with an empty stomach and, if possible, bring their vaccination pass.
Note: The information in this article cannot and should not replace a medical consultation and must not be used for self-diagnosis or treatment.
What is the health check-up?
The health check-up, also known as the health examination for adults, is a preventive offering that the statutory insurance providers offer to anyone insured from the age of 18. The insured person can use the offering once up to the age of 34, and then regularly every 3 years. The 3 year interval has applied since 2019.
The check-up aims to detect risks for diseases such as heart attack, coronary heart disease and stroke at an early stage and to prevent them. The examination is also used to detect, early on, whether there is any lipid metabolism disorder or a condition such as high blood pressure or type 2 diabetes. Questions are also asked about the person’s underlying conditions and family illnesses, such as whether there have been increased instances of cancer within the family.
The health insurance provider assumes the costs of the check-up.
Important: Health examinations such as this check-up are not the same as diagnostic examinations that are done due to complaints or when illness is suspected. Anyone with statutory health insurance is always entitled to the latter when needed to detect or cure an illness, prevent its progression, or alleviate symptoms.
Health check-up: which questions are asked?
The doctor first asks about your lifestyle, your medical history, and illnesses in your family.
They will for instance ask whether:
- you have had a check-up before
- you have a chronic illness
- there have been any cases of cancer in the family
- conditions such as high blood pressure or type 2 diabetes occur in the family
- you smoke or drink alcohol and, if so, how much
- you do much activity and sport
- you suffer from stress or any other mental strain
The consultation is also used to determine your vaccination status because vaccinations are amongst the most important measures in preventing illness. So it is important that the patient brings their vaccination pass to the check-up.
What does the health check-up look at?
The doctor’s consultation is followed by a number of physical examinations. The entire body is examined for any indication of a chronic illness.
The examinations include:
- height and weight measurements
- chest examination
- lungs, heart and arteries listened to
- stomach palpated
- examination of musculoskeletal system, skin, nervous system and sensory organs
- pedal pulse checked
- mental symptoms recorded
Blood pressure is also measured. This, along with the cholesterol and blood sugar levels, can indicate risks of cardiovascular disease, for example coronary heart disease (hardening of the coronary arteries), heart attack and stroke.
Which laboratory tests are important for the health check-up?
The doctor takes a blood sample for the laboratory tests. This is used to determine blood fat levels and blood sugar. These results can be used to detect, for example, whether there is a possibility of type 2 diabetes or a lipometabolic disorder. However, in the case of adults aged from 18 to 34, these tests are only done if risk factors such as overweight, high blood pressure or other pre-existing conditions are present in the person or their family.
Important: To determine the blood sugar level, it is important that the patient comes to the examination with an empty stomach.
Insured people over the age of 35 can also have their blood tested for infections with hepatitis B and hepatitis C viruses. Early detection and treatment of these viral illnesses can prevent severe liver damage. A hepatitis B test is not necessary if someone has already been immunized against this illness. Blood tests for hepatitis B and hepatitis C viruses are included as part of the health check-up once only and are not repeated every 3 years. However, it is possible to get tested for hepatitis outside of the check-up to avoid waiting for the next appointment.
In addition to blood tests, a urine sample is taken during the check-up for insured people from the age of 35 so that protein, glucose and blood cell levels can be studied. This test provides indications of potential diabetes, as well as bladder or kidney diseases.
Health check-up: what does the consultation involve?
During the concluding medical consultation, the patient is given information about their current health status, their personal risk factors, and further therapeutic measures, if applicable. Patients also find out what they can do themselves to prevent particular illnesses.
It is important to follow the recommendations given. The more patients do for themselves, the more effect the measures will have. And many things can be incorporated into everyday life: anyone still able to walk well can use their car or public transport less. Or the plan might be to eat less meat, for example just once a week. It is also helpful to work together with one’s partner or friends to set and achieve goals.
Specific courses can help, too, for example if it is a case of more activity, balanced, healthy eating, effectively giving up smoking or dealing with stress. The doctors summarize the measures they suggest in a prevention recommendation. Insured persons can present this prevention recommendation to their health insurance provider. The provider then decides which costs they will assume for which measures.
If the examinations indicate a particular illness or an elevated risk of illness, the patient will be referred to a specialist if necessary.
What other prevention programs are there for adults?
As well as the health check-up, people with statutory health insurance are entitled to skin cancer screening – this may be done in conjunction with the check-up in certain cases – as well as tests to screen for bowel cancer.
Men are also entitled to tests to screen for prostate cancer. Women can make use of tests to screen for cervical cancer and breast cancer.
There is more information on the age from which, and how often, insured persons are entitled to these tests in the article on cancer screening.
Where can I get information from?
You can consult your doctor whenever you wish and arrange an appointment for an examination. You will also get detailed information from your health insurance provider.
- Bundesministerium für Gesundheit. Online-Ratgeber Krankenversicherung: Gesundheits-Check-up. Aufgerufen am 06.10.2020.
- Gemeinsamer Bundesausschuss. Richtlinie des Gemeinsamen Bundesausschusses über die Gesundheitsuntersuchungen zur Früherkennung von Krankheiten. Fassung vom 20. November 2020. Aufgerufen am 23.02.2021.
- Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen. gesundheitsinformation.de. Prävention: Lohnt sich ein regelmäßiger Gesundheits-Check-up? Aufgerufen am 16.11.2020.
- Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen. gesundheitsinformation.de. Welche Früherkennungsuntersuchungen werden von den gesetzlichen Krankenkassen bezahlt? Aufgerufen am 16.11.2020.
- Kassenärztliche Bundesvereinigung. Prävention. Aus Check-up wird Gesundheitsuntersuchung. Aufgerufen am 06.10.2020.
- Kassenärztliche Bundesvereinigung. Patientenflyer Check-up für Erwachsene. Aufgerufen am 06.10.2020.