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Start the family check →Health questions
Health questionsDuty of disclosureRelease from confidentialityDuty to report later changesBreach of obligationsPre-existing conditions
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BenefitsClaimCancelling your policyBack to statutory insuranceTerminated without noticeThe health questions are one of the most important steps when you apply for private health insurance. They are not a medical examination. You answer specific health questions on the application.
To help you prepare, we provide the coordinated health questions of the insurers as an overview. What counts for the contract is always the current application form of the insurer in question.
Download the health questions in private health insurance as a PDF
Usually acceptance on standard terms, because the injury has healed and no follow-up risk remains.
Usually standard terms, because healed and without follow-up risk.
Usually standard terms. If complaints remain, a risk surcharge is possible.
Usually standard terms. With repeated episodes, a risk surcharge is possible.
Mild, well controlled allergies usually count as non-critical and are often accepted without conditions.
If healed without after-effects, a risk surcharge is more likely.
Teeth that have not been replaced often lead to a surcharge or a benefit exclusion in the dental area. Replaced teeth are usually unproblematic.
During ongoing treatment, an exclusion usually applies. Afterwards, regular acceptance is possible.
A risk surcharge is more likely than standard terms.
Manifest chronic diagnoses tend to lead to a risk surcharge rather than acceptance on standard terms. Severe cases can lead to rejection.
Ongoing or recently completed psychological treatment usually leads to rejection or to the application being deferred. A benefit exclusion is rarely an option in that case.
Regular acceptance is usually not possible. A benefit exclusion is then not an option, because the contract is not concluded at all.
Many insurers accept asthma with a risk surcharge. Some providers do not insure asthma and exclude it. A rejection is rather rare.
Well controlled high blood pressure is usually accepted with a risk surcharge. High readings, several medications or damage to the cardiovascular system make the assessment clearly worse.
An underactive thyroid that is well controlled with medication is often accepted with a moderate risk surcharge. Some insurers assess it more mildly than others.
Endometriosis usually leads to a risk surcharge. With active treatment, the assessment is stricter.
Mild cases are often accepted with a surcharge. With regular treatment with cortisone or modern active substances, a higher risk surcharge for skin conditions is likely.
Mild acne usually has no consequences. Cases that need treatment, especially with prescription medication, often lead to a surcharge for the skin area.
A single event that healed without after-effects often leads only to a small surcharge, sometimes also to standard terms.
Regular acceptance is usually not possible. The course and the time since treatment are decisive.
These diagnoses are among the common reasons for rejection. Excluding individual benefits does not replace regular acceptance in that case.
Chronic bowel diseases are among the common reasons for rejection, but the assessment varies from insurer to insurer.
A documented ADHD diagnosis often leads to rejection, especially with ongoing medication.
Treated sleep apnea often leads to rejection, especially with ventilation at night.
Information about drug use generally leads to rejection. The time since the last use is decisive.
Typical outcome based on more than 5,000 applications with health questions that we have supported. This is not a promise. Only an anonymous enquiry to several insurers gives you a binding answer for your case.
If you expect an examination like one at a public health office, you can relax. There is no doctor's appointment, no blood test and no exercise ECG. The whole assessment runs through the health questions on the application. Depending on the insurer, these can be more than twenty individual questions about current and past treatments, diagnoses, medication and sick notes. Only if your answers raise questions does the insurer ask for medical reports.
The questionnaire covers your current state of health as well as treatments, diagnoses and medication in recent years. How far back the questions go depends on the type of treatment:
Anything before these periods usually does not have to be stated, unless it concerns chronic conditions. Within the periods, the opposite applies. Even a single doctor's visit for back pain or a prescription for hay fever belongs on the application if the question asks for it.
The list of questions can be quite long and differs from insurer to insurer. What is usually the same is that the questions are worded precisely and require detailed answers. Almost all providers ask about health disorders, illnesses, current and general complaints and the after-effects of accidents. It is important that you also state conditions that a doctor is not treating at the moment or never treated.
When you apply for comprehensive health insurance, you are usually asked for your height and weight. From the last three years, the questions cover illnesses, chronic conditions, complaints, after-effects of accidents, implants, prostheses or organic, physical or mental impairments, as well as outpatient examinations, operations and treatments. From the last five years, the insurer asks about inpatient treatment, health resort stays or rehabilitation, and psychotherapeutic or psychiatric treatment. There are also questions about an unfulfilled wish to have children, a recognized disability, an HIV infection, cancer or tumors, missing or replaced teeth, impaired sight or hearing, medication, drug use and addiction.
If you answer yes to a question, you have to give further details, just as complete and correct as for the regular questions. Insurers want illnesses, injuries, treatments, complaints and consultations named in more detail, together with the results of treatments or the course of illnesses, regardless of whether they have healed or left impairments. As a rule, the insurer also asks for the names of the treating doctors, facilities and alternative practitioners.
Unlike statutory health insurance, which bases its contributions on income, a private insurer calculates the premium according to your individual risk. Age at entry, scope of the plan and state of health determine which costs the insurer expects. The health questions give the insurer the data for this.
In recent years we have supported more than 5,000 applications with health questions, and every day we see how differently insurers assess the same case. What costs a surcharge with one insurer goes through without a surcharge with other providers.
A pre-existing condition does not automatically lead to rejection. What matters is how the insurer assesses the individual health risk.
If a condition has healed, left no after-effects or is not relevant to the risk from the insurer's point of view, acceptance on standard terms is possible. If the risk is higher but still calculable, the insurer can ask for a risk surcharge or exclude certain clearly defined areas of benefits from cover.
In some cases an application is also deferred, for example if treatment is still ongoing, reports are missing or the further course cannot yet be judged conclusively from a medical point of view. Rejection mainly comes into question if, from the insurer's point of view, the risk can no longer be calculated economically.
If no regular plan is offered, the Basistarif can be a statutory fallback. People who are eligible for it generally have a right to be accepted. Its benefits are comparable in type, scope and level to the benefits of statutory health insurance.
The most frequent diagnoses on German applications are not exotic special cases but widespread conditions. This is exactly why insurers have established routines for assessing them. The following experience values from our advice work show the usual range of the risk surcharge. They do not replace a fixed catalog, because every insurer assesses according to its own standards:
| Common condition | Typical risk surcharge |
|---|---|
| High blood pressure, well controlled | moderate surcharge, from around €45 |
| Back pain, occasional, without findings | often no consequences, with recurring treatment €50 to €100 |
| Underactive thyroid, well controlled | €25 to €60 per month |
| Overweight | depending on the ratio of height to weight, from no surcharge to a clear surcharge |
| Hay fever and controlled allergies | from no surcharge to around €40 |
| High cholesterol, controlled with medication | small to moderate surcharge |
| Migraine, occasional | small surcharge |
| Type 2 diabetes | clear surcharge, with secondary conditions also rejection |
| Depression or psychotherapy, ongoing or recent | often rejection |
In all cases, the diagnosis alone does not decide, its course does. A documented stable condition noticeably improves the assessment. A new or untreated condition makes it worse.
Your answers must be complete and truthful. Otherwise the pre-contractual duty of disclosure under § 19 VVG gives the insurer far-reaching rights. It can adjust the contract afterwards, terminate it or contest it, depending on whether the information was left out through negligence or on purpose. In the case of fraudulent deception, the contract can be contested without any time limit.
The risk typically shows at the most expensive moment, namely when a large bill is submitted and the insurer looks at the case more closely. A strategy of keeping quiet therefore almost always fails exactly where you need the cover most.
If you are unsure how a pre-existing condition will be assessed, you do not have to test it on a formal application. With an anonymous risk enquiry, the insurer checks your health information without your name and tells you on which terms it would accept you. This avoids a rejection before it happens, because the anonymous enquiry is not recorded anywhere.
Especially with high blood pressure, past psychotherapy or an orthopedic history, this is the safer way, because you can compare the answers of several insurers calmly.
No. The only basis is the insurer's questionnaire. Only with more extensive pre-existing conditions does it occasionally ask for medical reports, if you release your doctors from confidentiality. There is no physical examination.
What matters is whether the information was left out through negligence or on purpose. Under § 19 VVG, the insurer can adjust the contract, terminate it or contest it. If you are unsure, review your medical reports in advance and, if in doubt, state the condition.
On the application, the insurer first relies on your information. In a claim, it may check and, if you have released them from confidentiality, request documents from doctors, hospitals and your previous health insurer. Any differences then come to light.
Get all your questions answered, free of charge and without obligation.
Personal advice from our specialists. Response time: under 24 hours.
From the age of 55, admission to private health insurance is often possible only with restrictions. A late switch can also mean higher premiums.
It matters to us that a switch pays off for you in the long run. That is why we do not recommend a consultation when your answers already show that the conditions are rather unfavorable.
Not sure, or want to correct your answers? Feel free to contact us. We will help you assess your situation.
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