Does private health insurance in Germany pay for check-ups and vaccinations?

Which check-ups does private health insurance cover?

Private health insurance covers all check-ups and cancer screening in the statutory programmes, because its standard conditions count them as an insured event, just like treatment for an illness.[1] The programmes are set by the Federal Joint Committee (Gemeinsamer Bundesausschuss, G-BA), the body that defines public health benefits, and they fix who is entitled, at what age and how often.[2] The table shows where a good private tariff pays beyond these limits.

Two programmes are for risk groups: current and former heavy smokers from 50 to 75 can have a yearly low-dose CT scan of the lungs, and men from 65 a one-time ultrasound of the abdominal aorta. Private health insurance pays for both.

For children, the check-ups run from the U1 at birth to the U9 at about five, and the J1 follows at 13 to 14. Each child has its own tariff, so the child's conditions are the ones that count. The U11 and the J2 for teenagers are not part of the programmes, and a good private tariff pays for them. For the check-ups in pregnancy, see what private health insurance covers in pregnancy and birth.

Two additions are on the way. Mammography is due to start at 45, expected from 1 August 2027 with invitations from January 2028, and a new children's check-up at 9 to 10, the U10, starts six months after its decision is published, so not before 2027.[2] Private health insurance pays for both as soon as they are part of the programmes, because its conditions follow them.

How do private and public health insurance differ for check-ups?

Public health insurance pays for check-ups only within the statutory programmes, and a good private tariff pays beyond them: more often, outside the age limits and for tests that the programmes do not include.[2] For a public patient, any check-up outside the programmes is an IGeL (individuelle Gesundheitsleistungen, individual health services) that you pay for yourself, for example a PSA blood test for prostate cancer, an ultrasound of the breast or a skin cancer screening one year after the last. A good private tariff pays for these as preventive care.

The same applies at the dentist. Public health insurance pays for removing tartar once a year, while professionelle Zahnreinigung (professional teeth cleaning) is not a public benefit, so public patients pay for it themselves unless their Krankenkasse gives a subsidy.[3] A good private tariff pays for professional teeth cleaning two to three times a year.

Every private tariff covers the programmes, so tariffs differ in what they pay beyond them, and that is what to compare before you sign. We show you which of the tariffs that suit you pay for a check-up every year, for extra tests and for teeth cleaning. Is private health insurance worth it in Germany? weighs the whole picture, and our comparison of PKV and GKV sets the two systems side by side.

Is the Check-up 35 covered by private health insurance?

Yes. Check-up 35 is the common German name for the general health check-up (allgemeine Gesundheitsuntersuchung) that everyone can have every three years from the age of 35, and private health insurance pays for it as part of the statutory programmes.[2] Between 18 and 34 you can have one check-up. After a check-up, the next one is due three calendar years later, so if you have one in 2026, the next is due in 2029.

Your doctor goes through these steps:

• Medical history: your own health, illnesses in your family and your lifestyle.
• Physical examination: a full examination, including your blood pressure.
• Laboratory tests: from 35, a blood test for cholesterol and blood sugar and a urine test; between 18 and 34, the blood test only if you have a higher risk.
• Vaccinations: a check of which vaccinations are due.
• Advice: what your results mean, and further tests if something needs a closer look.

From 35 you can also have a one-time test for hepatitis B and C as part of a check-up. A good private tariff pays for a check-up every year rather than every three years, and in a free call we show you which of the tariffs that suit you include it.

Does private health insurance pay for vaccinations?

Private insurers generally pay for the vaccinations recommended by STIKO (Ständige Impfkommission), the standing vaccination committee at the Robert Koch Institute, according to their association.[4][5] Public health insurance pays for the same vaccinations by law.[6] Vaccinations are not part of the standard conditions of private health insurance, so each tariff lists the vaccinations it pays, and before you sign we show you whether a tariff's conditions name the STIKO vaccinations.

For adults, STIKO recommends, for example, a tetanus and diphtheria booster every ten years and, from 60, a yearly flu vaccination and vaccinations against shingles and pneumococcal disease. For children and teenagers, its schedule runs from the first months of life to the HPV vaccination between 9 and 14.

STIKO also publishes advice on travel vaccinations. Public health insurance pays for them only when the trip is for work or training, or when a public insurer offers them as an extra benefit.[6] A good private tariff also pays for vaccinations for a holiday abroad, such as yellow fever or typhoid. Already privately insured? We check for free what your tariff covers before you book the trip.

Do check-ups count against my deductible or premium refund?

Whether check-ups and vaccinations count against your deductible or premium refund depends on your tariff. There are tariffs in which vaccinations do not count against your deductible (the Selbstbeteiligung) or cost you your no-claims premium refund (Beitragsrückerstattung),[5] and there are tariffs that treat check-ups the same way. Where a check-up does count, its bill works like any other: within the deductible you pay it yourself.

You also decide at the end of the year which bills to submit. If you pay a check-up yourself and claim nothing else, you keep your premium refund. In a free call we compare how this works across the tariffs that suit you, together with the deductible that fits your budget.

How do we help you find a tariff with good preventive cover?

We check the whole market for you, and our comparison shows for every tariff which check-ups and vaccinations it pays beyond the programmes and whether they touch your deductible or premium refund. In a free 30-minute call on Zoom, in English, we go through the tariffs that suit you, and the call, the comparison and everything after it cost you nothing. Already privately insured? We check for free what your tariff covers and whether another tariff with your insurer would suit you better.