Preventive medical examination

Preventive checkups are the most strategically important aspect of a supplementary health insurance plan, even if they do not account for the highest individual reimbursement amounts. They shift the focus from reactive treatment to preventive early detection—thereby reducing long-term healthcare costs and employee absenteeism. Statutory health insurance covers a fixed list of basic preventive care services but does not include many modern and advanced screenings. It is precisely this gap that supplementary health insurance (bKV) fills.

What the GKV Covers for Preventive Care

The basic coverage package under statutory health insurance includes:

• Health checkup starting at age 35 (every 3 years): medical history, complete blood count, urinalysis, blood pressure
• Skin cancer screening starting at age 35 (every 2 years)
• Mammograms for women ages 50 to 69 (every 2 years)
• Colorectal cancer screening starting at age 50 (colonoscopy starting at age 55)
• Dental checkups every six months
• Childcare (U1 through U9, J1, J2)

This is a solid foundation, but that’s all it is: a foundation. Many modern early-detection approaches are not included, and the minimum age requirements for some screenings (such as colorectal cancer screening, which begins at age 50) exclude at-risk groups.

What supplementary health insurance typically covers

Supplementary health insurance plans expand the basic health insurance coverage package to include a wide range of benefits, which may vary depending on the plan:

• Comprehensive Health Checkup: Annual comprehensive examination including lab tests, stress ECG, lung function tests, and ultrasound of internal organs
• Screening for conditions below the statutory health insurance age limits: colorectal cancer screening starting at age 40, mammograms starting at age 40, prostate exams starting at age 40
• Modern imaging techniques: MRI, CT, 3D mammography — when medically indicated
• Hormone and Metabolic Screenings: Comprehensive hormone status analyses, metabolic profiles
• Early cancer detection using modern methods: HPV tests, tumor marker tests, and skin screenings with dermatoscopy
• Vaccinations not covered by the statutory health insurance calendar: travel vaccinations, TBE, and some flu vaccinations for certain age groups
• Preventive IGeL services: Individual health services that are medically justified but not covered by statutory health insurance
• Eye Care: Glaucoma Screening, Intraocular Pressure Measurement

The Business Case for Prevention

Preventive health screenings offer employers tangible economic benefits. The IGA Report 28 estimates the ROI of workplace health promotion at 1:2.7—meaning a savings of 2.70 euros for every euro invested, primarily through reduced absenteeism and long-term illness. Employees in Germany are absent an average of 19 to 22 days per year, and workplace health promotion—of which encouraging preventive care is a central component—can reduce absenteeism by up to 25 percent.

Specifically, this means: If a company with 100 employees has an average of 20 days of absenteeism per employee (i.e., 2,000 days of absenteeism per year), and a well-implemented supplementary health insurance plan with a focus on prevention reduces this figure by 10 percent (to 1,800 days of absenteeism), that equates to 200 additional working days. With average labor costs of 250 euros per day, this results in savings of 50,000 euros per year—with a supplementary health insurance investment of typically 30,000 to 60,000 euros annually for a company of this size.

Why it's difficult to activate preventive care

Despite its clear benefits, preventive care is one of the least utilized categories in most supplemental health insurance plans. There are two reasons for this:

First: The mental barrier. People who feel healthy are reluctant to see a doctor. Preventive care competes with time constraints, scheduling conflicts, and the discomfort that some people feel about visiting the doctor. Unlike when dealing with an existing health issue, there is no immediate reason to take action.

Second: The invisibility of the benefits. When a screening test turns up nothing, it seems like a waste of time in hindsight—even though that is actually the best possible outcome. This psychological paradox has a lasting negative impact on the culture of preventive care.

Both barriers can be overcome, but it requires targeted communication.

FAKTOR MENSCH : Our most effective measure for encouraging preventive care is surprisingly simple: We recommend that employers set aside half a day or a full day once a year as a “Health Day”—a day when employees are allowed to take paid time off for preventive care, and when HR actively coordinates appointments with partner clinics. This solves three problems at once: The time barrier disappears, the hurdle of booking one’s own appointment is eliminated, and social normalization (everyone is doing it now) boosts participation. In our projects, this single initiative regularly increases preventive care utilization by 40 to 60 percent—and is usually the most visible activation of supplementary health insurance benefits in a year.

Target-group-specific health promotion communication

Different target groups respond differently to various retirement planning topics. Here are a few typical patterns:

• Companies with 30 to 40 employees: Skin cancer screenings, stress and burnout prevention, and fitness checkups are most effective
• Employees aged 40 to 55: Cardiovascular screening, prostate/mammography, and colorectal cancer screening are key
• Employees over 55: Comprehensive annual checkups, age-specific preventive care (osteoporosis screening, eye exams, memory tests)
• Young parents: Planning for your children’s future and managing your own stress are particularly important

Demographic segmentation of communication is far more effective than generic calls for everyone to participate in preventive care.

Privacy in Pre-submission

Many employees hesitate to file health insurance claims out of concern that their data might be shared with their employer. The legal reality is that the employer is not informed of which health insurance benefits were claimed, nor of any diagnoses or test results. The claims process is handled entirely between the employee and the insurer.

It is particularly important to actively communicate this distinction when it comes to preventive care services—because people tend to view them as more sensitive than services like eyeglasses or dental cleanings.

Conclusion

Preventive health screenings are the most strategically valuable—yet most challenging to communicate—component of a company health insurance plan. With effective communication and organizational support—such as through Health Days or targeted campaigns—preventive care becomes the backbone of a long-term, effective workplace health strategy. Employers who invest in this area will see a clear return on investment not in the first year, but in the second and third years of the supplementary health insurance plan—through reduced absenteeism, higher employee satisfaction, and earlier treatment of chronic conditions.