Self-pay longevity in Germany

Here is the short version: your statutory insurance pays for prevention and basic screening. A few of those checks happen to help with longevity goals. Most don't.

So let's split it into what you get, what's covered when there's a medical reason, and what you'll be paying for yourself.

The regular prevention catalogue:

• Health check-up (Check-up 35) every 3 years from 35: history, blood pressure, lipid panel (total cholesterol, LDL, HDL, triglycerides), fasting glucose, urine dipstick, plus a one-time hepatitis B/C test. Between 18 and 34 you get one check-up, with blood tests only if you have risk factors ^[14]. ApoB, Lp(a) and HbA1c are not included. Details in the Check-up 35 guide.
• Skin cancer screening from 35, every 2 years
• Colorectal cancer screening from 50: an iFOBT stool test (it checks for hidden blood in your stool) every 2 years, or two screening colonoscopies 10 years apart. Since 1 April 2025 the rules are the same for women and men, after a decision on 16 January 2025 by the G-BA (the body that decides what statutory insurance covers) ^[1].
• Breast cancer screening: mammography every 2 years, ages 50 to 75. The upper age used to be 69. Women aged 70 to 75 have been included since 1 July 2024. An amendment to Germany's breast screening ordinance (Brustkrebs-Früherkennungs-Verordnung), in force since 5 March 2026, now legally allows mammography for women aged 45 to 49 ^[8]. Whether the GKV actually pays for that group is a separate question. A G-BA decision was announced for October 2026 ^[19]. Even after a yes, invitations can only start once the patient leaflet is revised, which is planned for April 2027.
• Lung cancer screening (new since April 2026): a low-dose CT every 12 months for current and former heavy smokers aged 50 to 75 with at least 25 years of smoking and 15 pack-years (one pack-year means 20 cigarettes a day for a year) ^[9]. It is the only CT the GKV pays for as pure screening.
• Cervical cancer screening
• Prostate exam from 45
• Vaccinations per STIKO

Medications you get covered when there's a clear reason:

• Blood pressure drugs for confirmed hypertension
• Statins if you already have cardiovascular disease (your heart and blood vessels) or a high risk, meaning a 10-year event risk above 10 percent, plus a few special cases such as familial hypercholesterolaemia. A mildly raised risk alone is not enough ^[18]
• Metformin for type 2 diabetes
• HRT (hormone therapy) when menopause calls for it
• GLP-1 agonists for diabetes

What GKV does NOT cover:

• Expanded blood panels (ApoB, Lp(a), hsCRP, omega-3 index, full hormone panels, microbiome)
• Biological or epigenetic age tests (these read the chemical tags sitting on your DNA, which shift as you get older)
• Whole-body MRI as routine screening
• Coronary calcium score
• VO2 max tests outside a cardiology indication
• DEXA scan (unless osteoporosis is suspected)
• CGM (a continuous glucose monitor) without diabetes
• GLP-1 for weight loss without diabetes (excluded by law as a lifestyle drug)
• Longevity consultations at private practices
• IV therapies

Expect roughly €150 to €450 for a full longevity blood panel, €50 to €150 for a DEXA scan, €150 to €300 for a coronary calcium score, and €800 to €2,500 for a whole-body MRI in 2026. The cheap diagnostics carry the strongest evidence, the expensive imaging the weakest.

A longevity check-up is not a fixed product, it is a shopping basket. Every private practice bundles a different package, so here are the building blocks one by one, with real reference prices from large and mid-size German cities. The ranges are wide on purpose. The low end is a budget lab, the high end is a premium private practice for the exact same test. The "Does GKV pay?" column shows what statutory insurance does when your doctor has not documented a medical reason. "IGeL" (Individuelle Gesundheitsleistungen) means a self-pay service a practice offers on top of what the Kasse covers.

Cheap does not always mean useful. IGeL-Monitor rates a carotid ultrasound for stroke prevention and a screening ECG in people without symptoms as "tendenziell negativ" (leaning negative) ^{[21, 22]}.

The coronary calcium score comes with a footnote. The G-BA added CT coronary angiography (CCTA) to the GKV catalogue on 18 January 2024, and reimbursement kicked in on 1 January 2025. But that only counts if you have stable chest pain and a suspected CAD (coronary artery disease) ^[17]. The pure Agatston screening (the calcium score itself), the kind you book just to check, stays self-pay (an IGeL).

Short answer: usually not for longevity alone. Here is the longer version.

Private insurance (PKV) contracts vary a lot. Many plans do pay for noticeably more longevity-relevant stuff:

• Expanded lab diagnostics on a physician's order
• Non-physician services (a Heilpraktiker, the German non-medical practitioner) to some extent
• Longer prevention appointments
• Extra check-ups or imaging without a medical reason, but only if your tariff explicitly includes a prevention budget ^[15]

Still, PKV is usually not worth it just for longevity. Stretch the extra premium over a few decades and it tends to cost you more than the longevity benefit is actually worth.

Already in the GKV and want to bolt on a supplement? You have three options:

• Outpatient supplementary: often covers Heilpraktiker and expanded prevention
• Heilpraktiker supplementary: just for Heilpraktiker services
• Prevention supplementary: expanded GKV prevention

Typical premiums run €10 to €50 per month. They pay back anywhere from 50 to 80 percent, depending on the Tarif, often with caps that grow over the first years.

One tip before you sign: read the fine print. Check the waiting periods, the yearly caps, and which methods are actually covered. That last one trips people up.

For most people the sweet spot is a yearly expanded blood panel plus a wearable, a DEXA and VO2 max test, and a longevity check-up now and then: roughly €550 to €1,150 per year. Skip routine whole-body MRI unless you are genuinely high-risk, and screen every service against the evidence first.

Before you pay for anything, do one thing: look it up on IGeL-Monitor. It's run by the Medizinischer Dienst Bund, and at igel-monitor.de they publish independent benefit-harm ratings for self-pay services. As of 18 June 2026 they have rated 61 services: 0 positive, 3 leaning positive, 27 unclear, 25 leaning negative, 6 negative ^[3]. Not one rated service earns a clear positive.

A heads-up on the big-ticket ones. Whole-body MRI as a preventive screen isn't in the IGeL-Monitor catalogue at all. The closest entries are MRT der Brust zur Krebsfrüherkennung (rated "unklar" since the June 2025 reassessment) and MRT zur Früherkennung einer Alzheimer-Demenz ("tendenziell negativ"). The ACR (American College of Radiology) puts it plainly: there is no documented evidence that whole-body screening in people without symptoms or risk factors helps them live longer ^[13].

A few more that people ask about. HBOT (hyperbaric oxygen) for Long-COVID is rated "unklar." NAD+ IV drips, the Myers cocktail, and high-dose Vitamin C IV outside cancer care aren't in the catalogue at all. The critical takes on those come from GWUP (Germany's skeptics' society) and the skeptic literature, not from IGeL-Monitor, so check the specific service before you hand over your card.

Now, the part you came for. Here's a priority ladder that works for most people.

Tier 1. Baseline (free or already in GKV):

• Use regular GKV prevention
• No smoking, little alcohol
• Daily movement, strength training 2 to 3 times a week
• Track strength with a grip strength test. Many gyms and practices have a dynamometer (a hand-grip meter)
• 7 to 8 hours of sleep

Tier 2. Low effort, high value (€300 to €700 per year, plus a wearable):

• Yearly expanded blood panel (including ApoB, Lp(a), hsCRP, HbA1c, fasting insulin, vitamin D, B12, ferritin)
• DEXA every 2 to 3 years
• Yearly VO2 max test
• A wearable (Whoop, Oura, Garmin)

Tier 3. Medium effort (€500 to €1,500 per year):

• Yearly longevity private practice visit
• Coronary calcium score (every 5 years if normal)
• Epigenetic age test every 2 to 3 years
• IV vitamin therapy for documented deficiencies

Tier 4. High effort (€1,500 and up per year):

• Whole-body MRI only if risk-stratified (see below), not as routine
• A CGM (continuous glucose monitor) without diabetes
• NAD+ IV programs
• Off-label drugs (see rapamycin guide)

For most people, the sweet spot is Tier 1 plus Tier 2, with Tier 3 now and then. That lands around €300 to €800 per year, plus up to €20 to €30 per month (€240 to €360 a year) if you pick a subscription wearable like Whoop (Garmin needs no subscription). With a subscription wearable, call it roughly €550 to €1,150 a year.

Where your next euro should go, by budget

Another way to see it: by what's in your wallet. It works across Germany, Austria, and Switzerland (just swap in the local name for the GP check-up).

Switzerland has no free yearly general check-up like Austria's. Basic insurance (OKP/LAMal) covers defined prevention services, such as mammography from 50, colorectal screening and vaccinations, plus medically necessary care. For ordinary care you pay your deductible (Franchise) and a co-pay (Selbstbehalt). Organised screening programmes skip the Franchise. You pay only the 10% Selbstbehalt.

Supplementary plans at a glance (Germany, typical features as of 2026)

Treat these as rough guides, not promises. Always check the specific Tarif before you sign.

• Hallesche AE.3 (GKV top-up): Heilpraktiker costs 50%, up to €260 of invoices in year 1, €520 in year 2 and €780 from year 3. Don't mix this up with NK.Bonus. That's a full private insurance (Krankenvollversicherung), not a top-up, and it's closed to new customers right now. Hallesche's open full PKV line is NK.select S/L/XL, with NK.select FLEX as the option to switch plans.
• Münchener Verein and Barmenia also sell Heilpraktiker and outpatient top-ups. Check the current Tarif for the percentage, the caps and the premium.

Before you sign, look at three things: the waiting periods (often 3 to 8 months), the excluded methods (bioresonance is commonly out), and which labs are in-network.

Physician pathway

Want prescriptions (rapamycin off-label, HRT, GLP-1 on indication) plus lifestyle coaching in one place? Then skip the Heilpraktiker route. Go straight to a physician with a Zusatzbezeichnung in Naturheilverfahren or Ernährungsmedizin. Watch the labels here: Präventivmedizin is only a curricular Fortbildung (a course you complete), not a formal Zusatzbezeichnung. The Heilpraktiker longevity guide walks you through searching Ärztekammer-Suche and arzt-auskunft.de, plus what a typical first visit looks like.

Whole-body MRI: a risk-stratified rule

Whether whole-body MRI makes sense depends on your personal risk. Here is a simple rule. The whole-body MRI screening guide goes deeper on the trade-offs.

Consider whole-body MRI if this is true for you:

• Li-Fraumeni syndrome (you carry an inherited TP53 gene mutation): a yearly whole-body MRI is part of the Toronto Protocol, the surveillance plan for this syndrome ^[4]

Two situations often get lumped in, but they call for something else first:

• A strong family history of early cancer (2+ first-degree relatives with cancer before 55): start with genetic counselling. Whole-body MRI only makes sense if it confirms a syndrome whose surveillance plan includes it.
• Neurological symptoms need a targeted MRI of the brain or spine, not a whole-body scan. Your Kasse pays for that one.

BRCA1/2 carriers do not need whole-body MRI for standard surveillance. BRCA1 and BRCA2 are inherited gene changes that raise breast and ovarian cancer risk. The recommended plan is an annual breast MRI plus mammography, and steps that lower ovarian cancer risk. The US NCCN guideline on hereditary breast and ovarian cancer (HBOC) starts mammography at 30. The German S3-Leitlinie Mammakarzinom and the German HBOC consortium add breast ultrasound and start mammography at 40, every one to two years ^{[5, 6, 12]}.

For everyone else, here's the catch: when your real risk is low, false-positive findings are common. And a false alarm means anxiety, more tests, and sometimes a procedure you never needed. For truly low-risk people, that downside likely outweighs the upside. A focused coronary calcium CT and a DEXA give you far more useful evidence per euro.