For many diseases and disabilities, the earlier they are detected, the better the chances of recovery. In addition, a disease can often be prevented altogether if the specific risk factors or preliminary stages can be identified before it occurs. Preliminary stages of bowel or cervical cancer, for example, can develop over many years and initially be harmless tissue changes. Preventive or early detection examinations for pregnant women, newborns, children and adolescents, among others, are intended to detect certain diseases, health risks and undesirable developments as early as possible and to counteract them through early treatment.
Children and adolescents
During the health examinations for children (so-called U examinations) and adolescents (J examinations), the doctor examines the general state of health and checks whether certain serious illnesses are present and to what extent the child is developing according to its age. The number and contents of the examinations are specified by the G-BA in the Children’s Guideline and the Youth Health Examination Guideline. It is enshrined in law that children and adolescents up to the age of 18 are entitled to the corresponding examinations defined by the G-BA (these are currently U1 to U9 up to the age of 6 as well as J1).
During these examinations, a medical consultation also takes place, in which individual stresses and health risk factors of the child are also recorded and the parents are informed about how they can promote the development and health of their child and avoid risks. In addition, the doctor can issue a prevention recommendation if necessary and refer to regional parent-child services. Part of the examination is also a check of the vaccination status and advice on how to improve the child’s vaccination protection. When a child is admitted to the day care centre for the first time, evidence of a medical vaccination consultation must be provided.
For adults, there are regular screening examinations in order to detect certain diseases such as cardiovascular diseases or diabetes mellitus (diabetes) as well as some types of cancer in time and to be able to treat them as successfully as possible. In addition to the medical health examination, better known as a check-up, various cancer screening examinations are part of the scope of services provided by the statutory health insurance funds. The statutory health insurance funds or so-called central offices invite eligible persons in writing to three of these examinations: for the early detection of colorectal cancer, cervical cancer and breast cancer (mammography screening). Since the beginning of 2018, men over the age of 65 can also take advantage of a one-time ultrasound examination for the early detection of an abdominal aortic aneurysm (widening of the abdominal aorta). Since October 2021, men aged 35 and older have also had the opportunity to be tested once for the viral diseases hepatitis B and hepatitis C as part of the check-up. Participation in the screening is, of course, voluntary.
On the basis of the Prevention Act (PrävG) of 2015, the medical health examination or check-up is gradually being further developed by the responsible G-BA. During the examination, for example, health burdens and risk factors, such as lack of exercise and obesity, are now increasingly recorded and the vaccination status is checked. Based on the results of the examination, doctors can recommend measures for behavioural primary prevention to the insured, for example courses to reduce lack of exercise, nutrition or stress regulation. The medical certificate of prevention counselling serves as an important basis for the health insurance funds to decide whether to grant prevention measures. SHI-insured persons between the ages of 18 and 34 have a one-time entitlement to the check-up, insured persons from the age of 35 can take advantage of it every three years.
An overview of the recommended screening examinations for children and also adults is given in the tables.
On the basis of the Prevention Act of 2015, the medical health examination or “check-up” is gradually being further developed by the responsible Joint Federal Committee (G-BA). During the examination, for example, health burdens and risk factors, such as lack of exercise and obesity, are now increasingly recorded and the vaccination status is checked. Based on the results of the examination, doctors can recommend measures for behavioural primary prevention to the insured, for example courses to reduce lack of exercise, nutrition or stress regulation, and issue a medical certificate for this since 2017. The certificate serves as an important basis for the health insurance funds to decide whether to grant preventive measures. Since April 2019, women and men with statutory health insurance have a one-time entitlement to the “check-up” for the first time between the ages of 18 and 34. Insured persons aged 35 and over are now entitled to the “check-up” every three years.
Are all screening examinations covered by the health insurance?
All screening examinations recommended by the G-BA in its guidelines are covered by the statutory health insurance funds – they are generally free of co-payment. Some health insurance funds offer additional examinations that are not subject to co-payment. Ask your health insurance company or read the member magazine.
What services do the statutory health insurance funds offer for early detection?
If you regularly take part in early detection, your health insurance fund can grant you a bonus for this. In addition, the health insurance funds are obliged to inform their members at the beginning of a calendar year about all early detection measures that are relevant for them in that calendar year.