Healthy living Prevention through the health check-up

The health check-up, also known as the health examination for adults, is a preventive service offered by statutory health insurance funds to everyone aged 18 and over. People with statutory health insurance can have the check-up once up to the age of 34, and then regularly every 3 years. 

The check-up aims to identify the risk of 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 lipid metabolism disorders and conditions such as high blood pressure or type 2 diabetes at an early stage. Questions are also asked about underlying conditions and family illnesses, such as whether there is a history of cancer in the family.

The health insurance funds cover the costs of the check-up.

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 get enough physical activity and sport
• you suffer from stress or any other psychological difficulties

The consultation is also used to verify your vaccination status because vaccinations are among the most important ways of preventing illness. For this reason, it is important to bring your certificate of vaccination to the check-up.

The consultation with a doctor is followed by a physical exam. The doctor examines the entire body for any indication of chronic illness.

The examinations include:

• measurement of height and weight
• examination of the chest
• listening to the lungs, heart and arteries
• palpation of the abdomen
• examination of the musculoskeletal system, skin, nervous system and sensory organs
• checking the foot pulse
• recording of psychological symptoms

Blood pressure is also measured. Together with cholesterol and blood sugar levels, it can indicate the risk of cardiovascular disease. Examples include coronary heart disease (a build-up of blood lipids and plaque in the coronary arteries), heart attack and stroke.

The doctor takes a blood sample for laboratory testing. This is used to determine blood fat levels and blood sugar. These results can be used to detect, for example, whether there is a risk of type 2 diabetes or a lipid metabolism disorder. However, in adults aged 18 to 34, these tests are only performed if risk factors such as being overweight, high blood pressure, or other pre-existing conditions are present in the patient or in their family history.

People over 35 with statutory health insurance are also entitled to blood tests for infections with hepatitis B and hepatitis C. Early detection and treatment of these viral illnesses can prevent severe liver damage. A hepatitis B test is not necessary if you have already been vaccinated 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. 

In addition to blood tests, a urine sample is taken during the check-up for insured people from the age of 35 to measure the levels of protein, glucose and blood cells. This test provides indications of potential diabetes, as well as bladder or kidney disease.

During the final medical consultation, the doctor will discuss your current health status, personal risk factors, and any further treatment that may be needed. You will also be told what you can do yourself to prevent particular illnesses. 

It is important to follow the recommendations given. The more you do to improve your health, the more effective these measures will be. Many small changes can be incorporated into everyday life. If you can walk without difficulty, you could decide to use your car or public transport less often. Or you could decide to eat meat only once a week, for example. It can also be helpful to work together with your partner or friends to set and achieve goals.

Specific courses can also help, for example, with increasing physical activity, eating a more balanced, healthy diet, successfully giving up smoking or managing stress. The doctors summarize the measures they suggest in a prevention recommendation. You can then submit this prevention recommendation to your health insurance fund. The relevant health insurance fund then decides which costs it will cover for which measures.

If the examinations indicate a particular illness or an elevated risk of illness, you will be referred to a specialist if necessary.

In addition to the health check-up, people with statutory health insurance are also entitled to skin cancer screening and bowel cancer screening. Skin cancer screening can be performed at the same time as the check-up if the doctor has the required qualifications.

Men are also entitled to prostate cancer screening. Women can have cervical cancer screening and breast cancer screening.

More information about the ages from which, and how often, people with statutory health insurance are entitled to these tests in the article on cancer screening.

You can consult your doctor at any time and arrange an appointment for an examination. Detailed information, for example about the health check-up, is also available from your health insurance fund.