Germany quietly became the cheapest place in the world to buy a serious health check

An American buying a comprehensive annual health assessment pays $7,500 to enter at Biograph, or a reported $19,500 a year for Fountain Life’s APEX membership. A Swiss equivalent, if you count the residential clinics, runs to a reported CHF 31,800 for a week at Clinique La Prairie. A German pays €1,400 in Essen or €1,900 in Berlin. The workup is not ten times smaller.

This gap is not widely discussed, partly because German providers are bad at marketing internationally and partly because the country’s private medical sector has historically served its own patients rather than an export market. It is becoming visible now because the Berlin end of the market has started publishing its prices in English.

Two German models

The older model is organ-targeted. Preventicum in Essen, one of the longer-running private check-up centres, builds packages around an internal medical examination, comprehensive laboratory diagnostics, 4D ultrasound and rest and stress ECG, with MRI of two organs where the clinical picture and prior agreement indicate it.1 Reported packages run roughly €1,400 to €2,000.

This is closer to guideline practice than anything else sold privately. Imaging follows indication rather than preceding it, which is how radiology is supposed to work and which produces markedly fewer incidental findings than scanning everything. It is also a harder product to sell, because “we will image what your history suggests” is less compelling than “we will image all of you”.

The newer model compresses everything into one day and tiers by modality. YEARS in Berlin sells Core at €1,900 over six hours: 87 biomarkers with spiroergometry, echocardiography, vascular ultrasound, a cognition test, lung function and body composition, and no imaging, no liquid biopsy and no genetics. Evolve at €7,600 adds 3T whole-body MRI and a multi-cancer liquid biopsy at 120-plus biomarkers. Ultimate at €16,900 adds genome sequencing, epigenetic clocks and microbiome analysis at 230-plus, with three annual physician check-ins.6

To its credit, the Berlin operation says this out loud. Its Radical transparency section states that whole-body MRIs find abnormalities in many healthy people which would never have caused symptoms, publishes sensitivity, specificity and positive predictive value for its screening methods, and answers the question of whether the programme is study-backed with only partly, together with an undertaking to say where the evidence is thin.7 Providers are not generally in the habit of publishing the limitations of what they sell.

The two approaches disagree about something real. Organ-targeted imaging accepts that it will miss things in order to avoid manufacturing problems. Whole-body imaging accepts that it will manufacture some problems in order to miss fewer things. Our assessment of whole-body MRI screening remains grade C on the evidence, which means the second position is not vindicated by trial data. It also means the argument is live rather than settled, and a buyer choosing between them is making a genuine judgement rather than picking the better clinic.

Why the prices are what they are

Four structural reasons, none of which are about generosity.

Imaging capacity is cheap in Germany relative to the United States. An MRI hour costs a fraction of the American equivalent, and the density of scanners means providers are not bidding for scarce slots.

Physician fees are constrained even privately. The GOÄ fee schedule sets the terms for private billing, and while multipliers apply, the ceiling is far below what a US concierge practice charges for equivalent clinician time.

The statutory system covers the baseline. Because Check-up 35 already provides blood pressure, lipids, glucose and a consultation free of charge every three years,4 German private providers cannot sell those as the product. They have to sell the increment, and competing on increments disciplines pricing in a way that selling a whole examination does not.

Customer acquisition is cheaper. The German market has no equivalent of the American direct-to-consumer health spend, and providers here have not had to price in the marketing budgets that the US memberships carry.

The residential wing

Germany also hosts the other end of the market. Lanserhof Tegernsee is the flagship of the residential method clinics, with reported seven-night entry pricing from €8,435 including accommodation and the Classic medical programme,2 and Sylt from €6,480. LANS Medicum in Hamburg runs the same brand’s outpatient check-ups without the residential element.5

These belong in a different comparison. A week at Tegernsee is a behavioural intervention with medical supervision, and judging it by modality count misses what it is for. Someone who will genuinely change how they eat and sleep only when removed from their own life is buying something a six-hour diagnostic day cannot provide, and vice versa.

What this means for someone outside Germany

Medical travel for diagnostics is a smaller decision than medical travel for treatment. A single-day assessment requires one trip, produces a portable report, and carries none of the follow-up complications that make cross-border surgery difficult. The relevant question is whether the report will be usable by your own physician at home, which comes down to whether the imaging is on standard protocols and the laboratory work is accredited.

On price alone the arbitrage is substantial. A Londoner or New Yorker comparing a €1,900 Berlin day against a $7,500 American membership entry is looking at a difference large enough to cover the flight several times over. Whether that person needs that many modalities at once is a separate question, and the honest answer for most healthy people under 45 is probably not.

The German market’s real advantage is that it makes the choice legible. Prices are published, the statutory baseline is known, and the two competing philosophies are both available at prices where you can afford to disagree with one of them.