*Source: https://www.years.co/en/erstattung*

Cost reimbursement

# Will your insurer reimburse YEARS?
YEARS diagnostics are reimbursable under many German private health policies and occupational bKV tariffs. What is possible for your specific policy, we clarify in a free 15-minute conversation.

Check your reimbursement Free consultation

Allianz MeineGesundheit

Gold standard

Preventive care clause

„Vorsorgeuntersuchungen werden unkompliziert ohne einen abgeschlossenen Vorsorgekatalog erstattet."

Translation: “Preventive examinations are reimbursed without complication and without a closed catalogue of covered services.” The German wording above is the binding one.

Source Allianz AVB, as of 04/2025

Reimbursement typically possible with

Allianz Hallesche Continentale DKV HanseMerkur AXA Signal Iduna vitolo Württembergische NÜRNBERGER ARAG Generali

Reimbursement Check

## How much will your insurance cover?
Three short questions. Then we show you what is realistic in your situation.

1

How are you insured?

Private Health Insurance (PKV)

You are privately insured (e.g. Debeka, Allianz, DKV).

Statutory + supplementary insurance

E.g. outpatient private add-on, preventive add-on, "comfort" plans.

Statutory + employer-paid bKV

Employer health insurance, e.g. Allianz, Hallesche, Continentale.

Statutory Health Insurance (GKV)

Statutory only, no add-on or employer cover.

Health insurance knowledge hub

## Will your check-up be reimbursed?
Whether your health insurer reimburses YEARS depends on your policy. Here you can understand your route in a few minutes, without the insurance jargon.

GKV

### German statutory health insurance
Pays for treatment in case of illness and for preventive care within the statutory catalogue. Preventive diagnostics at the depth of a YEARS programme are not part of it.

Supplementary

### Outpatient supplementary insurance
A private addition to your statutory cover that you take out yourself. Depending on the policy, outpatient private services and preventive care are reimbursed. You are asked about your health when you sign up.

bKV

### Occupational health insurance
Your employer provides you with an annual health budget. In group contracts with no health questions and no waiting period. Up to the budget amount, 100 % is reimbursed.

PKV

### German private health insurance
Full cover instead of the statutory fund. Many policies reimburse outpatient diagnostics and preventive care, depending on the policy and the deductible.

The tick means: via this route, reimbursement of YEARS is possible in principle. Whether it applies to your specific policy is decided by your insurer’s catalogue of benefits.

Why YEARS reimbursement advice

## With most private policies, Core is largely reimbursed.

### Most of it usually reimbursed
YEARS performs private medical diagnostics and issues diagnoses as well as exclusion diagnoses, including GOÄ-compliant billing. With most private policies a large share of the cost is reimbursed. We deliberately name no figure: how much your insurer covers is set by your contract, and we do not know it.

### Programme recommendation included
We do not only help with reimbursement. In the consultation we answer every question about YEARS and recommend the programme that fits your situation, your goals and your policy.

### Details in the consultation
We deliberately do not recommend submitting a request to your insurer in advance — in practice it often reduces the reimbursement. Which billing codes apply and what you get back, we clarify transparently in the consultation.

The route via your employer

## A budget your employer pays for.
For people with statutory cover, occupational health insurance is the most direct route to regular reimbursement. Your employer signs the contract, you get a budget.

€600 – 1,500

Health budget per person per year, depending on the tier

from €9.95

Premium per person per month, paid by the employer

100 %

Reimbursement up to the budget amount

none

Health questions, waiting periods or exclusions in the group contract

### How the reimbursement works

- 1 Your employer signs a group contract; you sign nothing and contribute nothing.
- 2 You come to YEARS and receive a GOÄ-compliant invoice with your name, the services, the billing codes and the date.
- 3 You submit the invoice via your insurer’s app or by email; the deadline is three years.
- 4 Up to the budget amount, 100 % is reimbursed, and the budget is topped up again every year.

Depending on the insurer, group contracts are possible from around three to ten employees. Source: better health benefits, as of August 2026 .

The uncomfortable part

## Why it gets more expensive if you wait.
With every privately arranged supplementary or individual policy you are asked about your state of health. That is the point at which most routes narrow.

### What you are asked
Treatments and diagnoses from recent years, ongoing therapies, medication. Existing treatments can lead to exclusions of individual benefits or to a rejection.

### What that means in practice
The earlier you sort this out, the better your chances. If you postpone signing up until a diagnosis is on the table, the route via private supplementary insurance is often already lost.

### The exception: the group contract
Via occupational health insurance this assessment is usually waived. Because the employer insures an entire group, there are typically no health questions, no waiting periods and no exclusions. Ongoing treatments are covered too.

Tax

## Why the budget is worth more than a pay rise.
Up to 50 euros per person per month, the health budget is free of tax and social security contributions as a benefit in kind (§ 8 Abs. 2 S. 11 EStG). For your employer, the premiums are additionally deductible as a business expense. Considerably more of the budget therefore reaches you than of an equivalent gross amount in your salary.

Whether occupational health insurance falls under the benefit-in-kind exemption in an individual case depends on how the contract is set up. This page does not replace tax advice.

### Worked examples
Calculated with the list price of YEARS Core and an occupational policy with an open preventive care clause. Not a reimbursement guarantee.

Standard budget, YEARS Core

Budget €1,200 Programme Core · €1,900 Your own share €700

The following year the budget is topped up again and covers the follow-up check.

Premium budget, YEARS Core

Budget €1,500 Programme Core · €1,900 Your own share €400

The most common set-up when the check-up is meant to run annually.

Entry-level budget, YEARS Core

Budget €600 Programme Core · €1,900 Your own share €1,300

Outpatient supplementary insurance can reduce the remainder further, depending on the policy.

Three policies with an open preventive care clause, each with its own calculator: Allianz MeineGesundheit , Hallesche FEELfree_plus , Continentale ConCEPT Choose Max .

No budget at your company?

## You can be the one who raises it.
Many employers simply do not know occupational health insurance exists. Through our partner you can trigger an assessment for your company. The approach can be anonymous on request, so your name appears nowhere. If you would rather handle it yourself, you get a handout you can use to put the numbers in front of your employer.

Have my employer approached

Frequently asked questions on health insurance

## What people with statutory cover ask most often.

Does German statutory health insurance pay for a longevity check-up? No. Statutory health insurance covers treatment in case of illness and preventive care to the extent set out in the statutory catalogue of benefits — for example the check-up from age 35 every three years. Preventive diagnostics at the depth of a YEARS programme, with an extended biomarker profile, imaging and medical interpretation, are not included. That does not mean you have to pay for the check-up entirely out of pocket for good. Via outpatient supplementary insurance, occupational health insurance through your employer, or a switch to private health insurance, YEARS becomes reimbursable depending on the policy. Which of these routes fits your situation is quickest to establish in a short consultation.

What is occupational health insurance? Occupational health insurance, bKV for short, is private supplementary cover that your employer takes out and pays for on behalf of the workforce. It gives you an annual health budget that you use for services the statutory fund does not cover, or covers only in part: dental treatment, glasses, osteopathy, non-medical practitioners and preventive care. Budgets are usually between 600 and 1,500 euros per person per year. Up to the budget amount, 100 percent is reimbursed. You sign nothing and contribute nothing. Unlike a privately arranged supplementary policy, the group contract usually does away with the health assessment.

Do I need a health assessment for occupational cover? As a rule, no. Because the employer insures an entire group, insurers typically waive health questions, waiting periods and exclusions in the group contract. Ongoing treatments are covered too. That is the decisive difference from a supplementary policy you take out yourself: there you are asked about your state of health, and existing diagnoses can lead to exclusions of individual benefits or to a rejection. So if you are already in treatment, the route via your employer is usually the only one still open to you. The specific terms depend on the insurer and the group contract.

How do I submit my YEARS invoice? YEARS bills according to the German medical fee schedule (GOÄ). You receive an invoice showing your name, the services rendered with their GOÄ codes and the date: exactly the details insurers need for a reimbursement. You submit this invoice via your insurer’s app, or by email or post. You have until the end of the statutory three-year limitation period to do so. With occupational health insurance, 100 percent is reimbursed up to the amount of your annual budget, provided the service is included in your policy’s catalogue of benefits. We do not recommend submitting a request in advance, because in practice it often reduces the reimbursement.

What happens to occupational cover if I change jobs? Cover from occupational health insurance ends in principle with the employment relationship, because the contract exists between your employer and the insurer. Many policies do, however, offer continuation: you take the contract over privately and then pay the premium yourself, usually without a further health assessment. That is precisely what makes occupational cover interesting in the long run if you have a pre-existing condition. You keep access that you might no longer obtain privately. Whether your policy provides for continuation, and on what terms, is set out in the contract conditions and should be clarified before you move.

Is outpatient supplementary insurance worth it for preventive care? That depends heavily on the policy. There are outpatient supplementary policies that reimburse private preventive services and private outpatient treatment, and there are ones that essentially mirror the statutory catalogue and contribute little towards a check-up of this depth. You pay the premiums yourself, and you are asked about your state of health when you sign up. The advantage over the occupational route: the cover belongs to you and stays with you when you change jobs. In practice the two complement each other well, because the employer-funded budget reduces the own share that the supplementary policy leaves open. What adds up for you can be worked through in a short conversation.

Together with

×

### 15 minutes, and then you know which route fits you.
better health benefits advises on supplementary insurance, occupational health insurance and private health insurance. In the setup check you go through your situation and find out what each route costs.

Book the 15-minute setup check Free and without obligation. YEARS is not an insurance broker and receives no commission. The advice is provided by better health benefits.

The legal basis

## Which insurer pays what, and on what condition
The question is usually answered with a yes or a no. In fact there are five carriers with five different conditions, and the statutory entitlement is regulated more precisely than most people assume.

Carrier | What is covered | Condition | For a YEARS program |

Statutory health insurance (GKV) | The health examination under § 25 (1) of the German Social Code Book V and cancer screening under § 25 (2), to the extent defined by the Federal Joint Committee. | Entitlement from age 18. Once between 18 and 34, then every three years from the completed 35th year. From 35, urine testing plus blood glucose and cholesterol are added, along with a one-off hepatitis B and C screening and a check of vaccination status. | Does not cover a YEARS program. Statutory insurance pays the statutory minimum scope, not extended diagnostics. |
Private health insurance (PKV) | Whatever the policy says. Outpatient preventive care is included in many policies, but the scope differs considerably. | Billed under the German medical fee schedule (GOÄ). What matters is the benefits agreed in the policy, any deductible, and whether preventive care without suspicion of illness is included. Only the insurer can give a binding answer. | Partly or largely reimbursable depending on the policy, because YEARS bills under GOÄ. |
Employer-funded health insurance (bKV) | A budget funded by the employer that can be used for outpatient services including preventive care. | The precondition is that the employer has taken out such cover. Group contracts usually waive the health assessment. The budget is tied to the employment relationship. | In practice the most important route for people with statutory insurance, because it does not depend on their own insurance status. |
Outpatient supplementary insurance | Benefits above the statutory catalogue, including preventive examinations depending on the policy. | Taken out before the need arises, usually with a health assessment and a waiting period. Anyone signing up only when a concrete need exists is generally subject to an exclusion. | Depends on the policy. Annual reimbursement caps are the usual limiting mechanism. |
Beihilfe (civil servants) | Early detection examinations under the allowance regulations of the respective employer. | The scope follows the federal or respective state regulation and differs between employers. Together with the supplementary policy, this determines the reimbursable share. | To be assessed together with the private supplementary policy, not separately from it. |

### The three conditions the law sets
§ 25 (3) of German Social Code Book V names three conditions that must be met for statutory insurance to cover an early-detection examination at all. They explain why certain procedures are not in the catalogue — and they are the same hurdle we apply to our own procedures.

1

#### The condition must be effectively treatable
Detecting early what cannot then be treated any better brings no advantage. The law therefore requires an effective treatment first, not a measurement method first.

2

#### The pre-clinical or early stage must be detectable
There must be a procedure that reliably shows the condition before symptoms appear. A test that only responds late, or is frequently false positive, does not meet this.

3

#### Enough qualified physicians and facilities must exist
Screening only makes sense if the subsequent work-up is available everywhere. A finding without accessible work-up creates worry rather than benefit.

### Sources

- § 25 SGB V — Gesundheitsuntersuchungen Basis for the entitlement from age 18 (para. 1), cancer screening (para. 2), the three preconditions (para. 3) and the Federal Joint Committee’s responsibility for target groups, age limits and frequency (para. 4).

- Gesundheitsuntersuchungs-Richtlinie des Gemeinsamen Bundesausschusses Source for the intervals (once between 18 and 34, every three years from 35) and for the scope from 35 including urine, blood glucose, cholesterol, a one-off hepatitis screening and vaccination status.

This overview is a general orientation, not legal or insurance advice. Only your insurer can say bindingly what your contract covers.

## Common questions on coverage

Which insurers cover preventive health examinations, and under what conditions? + Five carriers come into question, with different conditions. Statutory health insurance covers the health examination under § 25 of German Social Code Book V: once between 18 and 34, then every three years from 35, to the extent set by the Federal Joint Committee guideline. Private health insurance reimburses according to the policy, billed under the German medical fee schedule. Employer-funded cover provides a budget, conditional on the employer having taken it out. Outpatient supplementary insurance only applies if taken out before the need arose, usually with a health assessment and waiting period. For civil servants, the Beihilfe allowance applies under their employer’s regulation. Extended preventive programs are not covered by statutory insurance.

Why does German statutory insurance not pay for a whole-body MRI as screening? + Because § 25 (3) of Social Code Book V names three preconditions that are not met for it. The provision requires that the condition be effectively treatable, that its pre-clinical or early stage be detectable by diagnostic means, and that enough qualified physicians and facilities exist for the work-up. For whole-body imaging in people without symptoms it has not been established that it reduces mortality or morbidity, and it regularly produces incidental findings with no treatment consequence. This is not an administrative argument but the same hurdle we apply to our own procedures on our evidence page. That is also why we do not advertise MRI as a statutory benefit.

What is included in the statutory check-up? + Under the Federal Joint Committee’s health examination guideline it includes a medical consultation to record risks, a physical examination, a check of vaccination status against the recommendations of the Standing Committee on Vaccination, and preventive counselling. From the completed 35th year, urine testing plus blood glucose and cholesterol are added, along with a one-off screening for hepatitis B and C. Between 18 and 34, lipid profile and fasting glucose are only billable where a corresponding risk profile exists. Cancer screening runs under § 25 (2) on its own intervals and is not part of this appointment. The appointment itself is free of charge for you and needs no referral.

Is a privately paid check-up worthwhile when statutory insurance already offers one? + That depends on what else you want to know. The statutory check-up is designed around a few well-established questions and is sensible within that frame: blood pressure, blood glucose, lipids, vaccination status. Anyone wanting an extended biomarker profile, functional diagnostics or imaging beyond that will not get it there. Whether that additional scope contributes anything in your situation is a medical question, not a question of volume. Use your statutory entitlement in any case; it is paid for and replaces nothing you add privately. In the free intro call we will also tell you when it is enough in your case.

Ready when you are

## Your YEARS check-up is ready for you.
Book your appointment directly — or talk to us first. Free, no obligation, and we answer every question you have on reimbursement and programme.

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Disclaimer

The policy clauses named on this page come from the general terms and conditions of the respective providers, as of May 2026. Policy conditions can change. The final reimbursement decision always rests with the insurer.

We do not know with 100 % certainty in advance what your insurer will reimburse — that is precisely why the free consultation exists. Binding statements are best clarified directly with your insurer; in the conversation we help you ask the right questions.

YEARS is a private clinic for preventive medicine in Berlin. We bill in line with GOÄ. We are not an insurance broker and receive no commission from health insurers.

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