April 30, 2026, 8:17 am | Read time: 6 minutes
Most parents are familiar with the so-called “U-examinations.” These are preventive check-ups that assess the healthy development of children and are covered by statutory health insurance. However, the preventive care catalog of statutory health insurance for children and adolescents is much more extensive. In some areas, there is a gap in coverage. FITBOOK and pediatrician Dr. Ronny Jung explain what the insurance covers and which examinations you should check with your own insurance provider.
U and J: What Does Statutory Health Insurance Cover?
The so-called U-examinations (U1 to U9) and the youth examination J1 are standard services of statutory health insurance.
- U-examinations (U1 to U9): from birth to age 6
- Youth examination J1: ages 12 to 14.
This means the costs are always covered. It’s different for U10, U11, and J2. These are not standard services of statutory health insurance.
- U10: ages 7 to 8
- U11: ages 9 to 10
- J2: ages 16 to 17
However, many insurance providers (such as TK, AOK, KKH) cover these examinations as additional services outside of standard care.1 Billing for these examinations is not automatic with every provider, and not every pediatric practice offers them. Therefore, it’s advisable to check with your insurance provider and pediatric practice beforehand to see if these examinations can be performed and if the insurance will cover them.
Also Covered: Blood Tests and Screenings for Newborns
In addition to the U-examinations, statutory health insurance covers other important screenings in the first days of life. This includes the expanded newborn screening via blood test. These are designed to detect congenital metabolic defects, hormonal disorders, and defects in the blood, immune, and neuromuscular systems as early as possible. A screening for cystic fibrosis is also included. Other covered services are screenings for severe congenital heart defects using pulse oximetry and newborn hearing screenings.2
These examinations are extremely important, according to Dr. Ronny Jung, pediatrician and board member of the German Society for Pediatric and Adolescent Medicine (DGKJ). “Early detection and intervention can help prevent some disorders from developing and better ensure healthy development,” the expert explains to FITBOOK.
Often Forgotten: It’s Not Over After U9
Participation rates in U-examinations in Germany are very high, over 95 to 99 percent, according to a report from the Robert Koch Institute.3 However, many parents overlook the J-examinations, as the numbers suggest. “That’s where it falls apart,” laments pediatrician Jung. “J1, we’re at about 30 percent, and J2, only 6 percent,” he says. “Many parents may feel their child is out of the woods, but that’s not the case. There are other developmental issues, including physical development during puberty and psychological aspects: media, bullying, school performance, addiction.”
Dr. Jung sees a problem in the current system of insurance services for children in the time gap between U9 and J1, between ages six and twelve. “A lot happens during this time,” emphasizes the physician. U10 and U11, which fall into this period, are only additional services outside of standard care. The Joint Federal Committee and professional politics have been discussing and debating for years how best to close this preventive care gap.4
Preventive Care Is More Than Just Diagnostics
Preventive care in the examinations categorized under U and J is not just about weighing, measuring, and taking blood, emphasizes Dr. Jung. “The U-examinations are also important for parents because they can address questions related to the various developmental phases of the child.” It’s about closely monitoring the child’s development, advising on all areas of preventive care, and properly steering preventive measures, such as through early intervention and therapy.
Missed a Standard Examination? Don’t Worry, Just Catch Up
If you miss or skip one of the standard examinations, don’t worry about getting into trouble at the practice for a late visit. “We don’t make anyone feel guilty,” promises Dr. Jung. Statutory health insurance usually covers the U-examination even if the official period is slightly exceeded. Most U-examinations have set “tolerance periods” (often several weeks to months). Within this timeframe, you can catch up on the examination, and the insurance will cover it.5 But even if an examination can no longer be billed as a regular preventive service to the insurance, it is still medically advisable. “Then the examination is conducted as a preventive measure, with the same content,” says Dr. Jung. His tip: To make it easier to keep appointments reliably, many practices offer reminder systems for parents via special apps or SMS.
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Dental Examinations as an Important Part of Preventive Care
Not only does the pediatric practice play a role in preventive care, but dental care is also part of the service catalog, starting very early. Between the 6th and 34th month of life, statutory health insurance covers three dental early detection examinations for dental, oral, and jaw diseases. These include examining the child, advising parents, and providing guidance on daily tooth brushing. Additionally, during this period, there is a twice-per-calendar-half-year entitlement to fluoride varnish for enamel hardening.6
From the 34th month to the sixth year, three more dental early detection examinations follow, along with an entitlement to fluoridation. And even after that, preventive care doesn’t end: Between ages six and 18, there are annual measures of dental individual prophylaxis to prevent dental diseases. From age 12, these appointments are documented in the bonus booklet, which is important later for higher subsidies for dental prostheses.7
Pediatrician Dr. Anne Heinz explains in the FITBOOK video what is behind chalk teeth:
Vaccinations: “Life Celebration” Thanks to Immunization
Vaccination is also a topic during the various U and J examinations: The pediatrician informs about the vaccinations covered by statutory health insurance and records the administered vaccinations in the child’s vaccination card.
The standard vaccinations recommended by the Standing Committee on Vaccination (STIKO) for children and adolescents include vaccinations against rotaviruses, diphtheria, tetanus, whooping cough (pertussis), polio (poliomyelitis), Haemophilus influenzae type b (Hib), hepatitis B, meningococcal B, meningococcal ACWY, pneumococcal, measles, mumps, rubella, chickenpox (varicella), and human papillomavirus (HPV). In infancy, there is also preventive care against RSV infections.8 Some of these vaccinations have combination vaccines, meaning doctors can vaccinate against multiple diseases with one shot. The exact timing can change with updated recommendations, so the current vaccination schedule is the best guide for planning appointments accurately.