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Prevention and longevity practices offer medical consultations that promise more time, more diagnostics and often a holistic view. They frequently go by terms such as functional or regenerative medicine. What you get depends above all on the qualifications of the doctor and on how properly the billing is done.

In short

Medical services in such practices are mostly private or self-pay services, billed according to the German Scale of Fees for Physicians. In a large cohort study, the concept of functional medicine was associated with a small improvement in self-rated physical health after 6 months; a small randomized study in type 2 diabetes found no advantage. “Functional medicine” is not a recognized medical specialist designation. Look for specialist and additional qualifications, written cost information and a contract before treatment begins.

What is offered

Typical are long initial consultations, extensive laboratory profiles, advice on nutrition, exercise and sleep, and the coordination of further procedures. The functional medicine approach aims to look for causes behind symptoms and to take lifestyle into account more than is possible in a short consultation covered by statutory health insurance. That is an understandable need, especially with unclear or chronic complaints.

In addition, there are prescriptions, referrals and the interpretation of findings from other doctors. A second opinion before major surgery is a good example: for certain planned procedures, people with statutory health insurance are entitled to one anyway, from a doctor who is not supposed to perform the procedure herself.

What it costs and who pays

Medical services outside the statutory health insurance catalog are billed according to the German Scale of Fees for Physicians. For individual health services (IGeL), the 2.3-fold rate is usually customary, up to 3.5-fold only for particular difficulty or particular effort. Flat-rate fees are not permitted. The IGeL-Monitor estimates that people with statutory health insurance spend at least 2.4 billion euros per year on such services.

Important: the health insurance fund pays for many examinations as soon as there is a concrete suspicion of disease. A call to your health insurance fund before signing is worthwhile.

How to recognize a reputable offer

Check the qualifications via the doctor search of the state medical association. There are recognized additional designations that fit this field, for example nutritional medicine, sports medicine, naturopathic treatment, geriatrics or special pain therapy. “Functional medicine”, “regenerative medicine” or “longevity medicine”, on the other hand, are not training designations of the medical associations.

Before a self-pay service, the practice must inform you in text form about the expected costs. Under the rules for individual health services, a written contract is also required, and an invoice at the end. No one may pressure you into a service or put you under time pressure. Services without proven benefit may not be presented as worthwhile. A good sign is when the doctor tells you on her own initiative what the health insurance fund would cover.

What is well supported

The framework is clearly regulated and reliable: cost information, contract, billing according to the fee scale and the entitlement to a second opinion for certain procedures.

On the concept of functional medicine there is a large cohort study from the Cleveland Clinic with 7,252 patients. After 6 months, self-rated physical health improved more at the functional medicine center than at primary care centers, by 1.59 versus 0.33 points on a scale with a mean of 50.

What the studies show

Cleveland Clinic: cohort study

Retrospective analysis of 7,252 adults, 1,595 of them at the center for functional medicine, compared across 398 statistically matched pairs. The primary endpoint was self-rated physical health after 6 months, and it was met. After 12 months, the difference from the primary care centers was no longer significant.

Type 2 diabetes: randomized pilot study

Open-label study over 24 months; 34 patients additionally received functional medicine care with intensive lifestyle change and individual supplements, 37 only standard treatment. The primary endpoint, stopping insulin without worse blood glucose values, was reached by 15.8 versus 11.1 percent, not a significant difference. Quality of life did not differ either.

Where the data stop

The overall concept has hardly been tested in randomized studies. The positive paper is a retrospective analysis from the center that offers the method, and the effect is small. The only randomized study found was small, open-label and negative. There are no data for hard endpoints such as disease events or life expectancy. What an individual practice delivers therefore depends less on the label than on the qualifications and working methods of its doctors.

Status, approval and legal

Private medical services are billed according to the German Scale of Fees for Physicians. The German Civil Code requires cost information in text form if coverage by the health insurance fund is not assured. The rules for individual health services require a written contract and an invoice. People with statutory health insurance are entitled to an independent second opinion for certain planned procedures. Qualifications are awarded by the state medical associations.

Safety

The risks lie less in the consultation than in what follows: overdiagnosis with incidental findings, further examinations, preparations or infusions with their own side effects, and costs. Do not stop an ongoing therapy because a self-pay practice suggests a different path; clarify this with the treating doctor.

Frequently asked questions about medical services

What is functional medicine?

A treatment concept that aims to look for causes behind symptoms and to take lifestyle into account more. It is not a medical specialist designation in Germany. Studies on the overall concept are few; a cohort study showed small improvements in quality of life, a small randomized study no advantage.

Does health insurance pay for services in a longevity practice?

Mostly not; these are predominantly private or self-pay services. If there is a concrete suspicion of disease, the health insurance fund still covers many examinations. Ask your health insurance fund before you sign.

What may a doctor charge for a self-pay service?

He must bill according to the German Scale of Fees for Physicians; the 2.3-fold rate is customary, up to 3.5-fold only for particular effort. Flat-rate fees are not allowed. You are entitled to cost information in advance and an invoice.

Do I have a right to a second opinion?

Yes, for certain planned procedures specified by the Federal Joint Committee, the health insurance fund pays for an independent second opinion. It may not come from the doctor who is supposed to perform the procedure herself. Beyond that, you can obtain another opinion at any time.

How do I check a doctor’s qualifications?

Via the doctor search of the responsible state medical association. It lists specialist and additional designations such as nutritional medicine or sports medicine. Terms such as longevity medicine or regenerative medicine are not recognized designations.

Do I have to decide on an IGeL service immediately?

No. No one may pressure you into an individual health service or put you under time pressure. Without a written contract before treatment, you do not have to pay for such a service, according to the IGeL-Monitor.

Related

Sources

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Information only, not medical advice and not a usage or dosage recommendation. Prescription-only and unapproved substances belong in the hands of a physician. Last updated: 2026-09-30.