Self-Pay Longevity in Germany

GKV pays for prevention and screening. Some of those services overlap with longevity goals. Most don't.

The regular prevention catalogue:

• Health check-up from age 35, every 3 years: history, blood pressure, basic blood panel, urine
• Skin cancer screening from 35, every 2 years
• Colorectal cancer screening: iFOBT stool test yearly ages 50 to 54, then every 2 years from 55, or screening colonoscopy from age 50. Men and women now get equal access since 1 April 2025 (G-BA Beschluss vom 16.01.2025).
• Breast cancer screening: mammography every 2 years, ages 50 to 75. The upper age was raised from 69 to 75, with participation starting 2024-07-01. The Zweite Verordnung zur Änderung der Brustkrebs-Früherkennungs-Verordnung appeared in BGBl. 2026 I Nr. 53 (signed 27 February 2026, gazetted 4 March 2026, in force 5 March 2026). It opens the legal door to mammography for women aged 45 to 49. The G-BA decision on actual GKV coverage for that cohort is targeted for October 2026.
• Cervical cancer screening
• Prostate exam from 45
• Vaccinations per STIKO

Basic medications that are covered:

• Blood pressure drugs for confirmed hypertension
• Statins for cardiovascular risk (heart and blood vessels)
• Metformin for type 2 diabetes
• HRT (hormone therapy) when indicated in menopause
• 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 (chemical tags on your DNA that shift with age)
• Whole-body MRI as routine screening
• Coronary calcium score
• VO2 max tests outside a cardiology indication
• DEXA scan (unless osteoporosis is suspected)
• CGM (continuous glucose monitor) without diabetes
• GLP-1 for obesity without diabetes (mostly not)
• Longevity consultations at private practices
• IV therapies

Here are reference prices from large and mid-size German cities. Ranges reflect the gap between budget labs and premium private practices.

Expanded lab diagnostics:

• Full longevity blood panel (30 to 60 markers): €150 to €450
• ApoB, Lp(a): €25 to €80
• Full hormone panel: €150 to €300
• Omega-3 index: €40 to €80
• Microbiome analysis: €250 to €500
• Epigenetic age test: €250 to €500
• Heavy metal test: €100 to €250

Imaging:

• DEXA scan: €50 to €150
• Coronary calcium score (Agatston CT screening): €150 to €300. Quick note: G-BA added CT coronary angiography (CCTA) to the GKV catalogue (Beschluss 18 January 2024). EBM reimbursement took effect 1 January 2025 for stable-chest-pain workup with suspected CAD. Pure Agatston screening still stays self-pay (IGeL).
• Carotid intima-media measurement: €70 to €180
• Whole-body MRI: €800 to €2,500
• Cardiac MRI: €400 to €800

Functional diagnostics:

• Spiroergometry (the lab test where you breathe into a mask while cycling or running flat-out, measuring VO2 max directly): €150 to €300
• Resting and stress ECG: €50 to €150

Interventions:

• IV vitamin therapy: €60 to €250 per session
• NAD+ IV: €200 to €500 per session
• IHHT: €30 to €80 per session
• Cryotherapy chamber: €20 to €50 per session
• Hyperbaric oxygen therapy: €100 to €300 per session

Consultations:

• Longevity private practice first visit: €200 to €500
• Follow-ups: €100 to €300
• Heilpraktiker first consultation: €80 to €200

Online services:

• Blood panel plus coaching subscriptions: €50 to €200 per month
• Wearable-based programs: €20 to €100 per month

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

• Expanded lab diagnostics on a physician's order
• Non-physician services (Heilpraktiker) to some extent
• Longer prevention appointments
• Some imaging even without a specific medical reason

PKV is usually not worth it just for longevity. Over decades the extra premium tends to cost more than the longevity benefit is worth.

If you're GKV-insured and want to add a supplement, three options exist:

• 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. Reimbursement is usually 70 to 80 percent up to a yearly cap (for example €1,000).

Before you sign, check the contract terms. Look at waiting periods, yearly caps, and which methods are actually covered.

Check each self-pay service with IGeL-Monitor before buying. IGeL-Monitor (igel-monitor.de), operated by the Medizinischer Dienst Bund, publishes independent benefit-harm assessments. As of mid-2026, around 60 services are fully assessed (0 positiv, 3 tendenziell positiv, ~31 tendenziell negativ or negativ, ~26 unklar), plus several in-progress entries. Verify the current tally on igel-monitor.de's IGeL-A-Z index before quoting an exact number.

Whole-body MRI as preventive screening is not 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"). ACR and European radiology societies note no strong evidence that whole-body MRI screening reduces mortality in healthy people.

HBOT for Long-COVID is rated "unklar." NAD+ IV, Myers cocktail, and high-dose Vitamin C IV outside oncology are not in the IGeL-Monitor catalogue. Critical assessments of these come from GWUP and skeptic literature, not IGeL-Monitor. Check the specific service before paying.

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
• 7 to 8 hours of sleep

Tier 2. Low effort, high value (€200 to €500 per year):

• 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
• Continuous CGM without diabetes
• NAD+ IV programs
• Off-label drugs (see rapamycin guide)

For most people: Tier 1 plus Tier 2, and Tier 3 now and then. Cost lands around €300 to €800 per year, plus €20 to €30 per month for a wearable. That's roughly €700 to €1,200 a year.

Master DACH decision table by annual budget

A plain, budget-driven view of where to spend next. Works across Germany, Austria, and Switzerland (adjust for local GP check-up names).

€0 / year:

• GKV Vorsorge (Germany, every 3 years from age 35) and Austrian Vorsorgeuntersuchung (free annually). Swiss LAMal has no equivalent free annual check-up: basic insurance only covers medically necessary GP visits after Franchise/Selbstbehalt.
• Sit-rise test: stand from the floor without using hands (strong mortality predictor)
• Grip-strength self-assessment (handheld dynamometer ~€40 one-time, or a simple squeeze test)
• Rockport walk test: brisk 1-mile walk, used to estimate VO2 max

€200 / year:

• Expanded blood panel IGeL (ApoB, Lp(a), hsCRP, fasting insulin, HbA1c): ~€150
• Home Omega-3 Index test (dried blood spot): ~€45
• Remainder: basic vitamin D testing or top-ups

€500 / year:

• Everything from €200, plus:
• DEXA scan: ~€50 to €120
• VO2 max test (sports medicine centre): ~€100 to €200
• Polar H10 chest strap + HRV4Training: ~€100 one-time
• Basic supplements on known deficiencies (Vitamin D, omega-3, creatine)

€1,500 / year:

• Everything from €500, plus:
• Yearly epigenetic test: TruDiagnostic TruAge Complete (€500 plus EU import VAT) OR GlycanAge (€300, lab in Zagreb, Croatia, EU-internal shipping)
• One longevity physician visit (physician with Zusatzbezeichnung Naturheilverfahren or Ernährungsmedizin, or with a Präventionsmedizin Fortbildung): ~€300

€3,000+ / year:

• Everything from €1,500, plus:
• Whole-body MRI if medically indicated (see risk stratification below)
• NAD+ IV if you prefer it
• Full longevity private-practice membership (quarterly visits, labs included)

Zusatzversicherung quick table (Germany, typical features as of 2026)

Features are indicative, not guaranteed. Always verify the specific Tarif before signing.

• Hallesche Naturheilkunde-Zusatztarife (e.g. NaturPRIVAT): ~€20 to €40/mo, covers Heilpraktiker and some IGeL, annual cap ~€1,000 to €1,500. Note: NK.Bonus is a full Krankenvollversicherung (PKV), not a Zusatztarif. Different product class, and currently closed to new business. Hallesche's open PKV-Vollversicherung line is NK.select S/L/XL with NK.select FLEX switching.
• Münchener Verein Kompakt: ~€15 to €30/mo, Heilpraktiker-focused, cap ~€1,000
• Barmenia ambulante Zusatztarife: ~€10 to €25/mo, basic IGeL supplement, cap ~€500 to €1,200

Check waiting periods (often 3 to 8 months), excluded methods (bioresonance is commonly excluded), and which labs are in-network before you sign.

Physician pathway

Want prescriptions (rapamycin off-label, HRT, GLP-1 on indication) alongside lifestyle coaching? Skip the Heilpraktiker route. Go directly to a physician with a Zusatzbezeichnung in Naturheilverfahren or Ernährungsmedizin. Präventivmedizin is only a curricular Fortbildung, not a Zusatzbezeichnung. See the Heilpraktiker longevity guide for how to search Ärztekammer-Suche and arzt-auskunft.de, plus what a typical first visit looks like.

Whole-body MRI: a risk-stratified rule

Forget the blanket line about "whole-body MRI adds little for low-risk people." Use this clearer rule instead.

Consider whole-body MRI if any of the following apply:

• Li-Fraumeni syndrome (germline TP53 carrier): annual whole-body MRI is part of the Toronto Protocol
• Strong family history of early cancer: 2+ first-degree relatives with cancer before age 55
• Prior neurological symptoms requiring imaging on a clinical basis

BRCA1/2 carriers do not need whole-body MRI as part of standard surveillance. The indicated protocol per NCCN HBOC and the German S3-Leitlinie Mammakarzinom is annual breast MRI (with mammography from age 30), plus risk-reducing strategies for ovarian cancer.

Otherwise: base rates of false-positive findings lead to anxiety, further testing, and sometimes invasive procedures. For truly low-risk people, those harms likely outweigh the upside. A focused coronary calcium CT and a DEXA give you far better evidence per euro spent.