7 min - BioSense Team - 2026-06-24
- level:essential
- bilan sanguin
- prévention
- 40 ans
- examens
From age 40, certain blood tests become statistically more relevant. But there is no universal annual blood panel: a useful check-up depends on your profile, your history and your risk factors. This article reviews the tests to discuss with your doctor, those that genuinely deserve a place given your situation, and what France's national health insurance reimburses.
You book an appointment with your GP for your annual check-up. You leave with a prescription, you get your blood drawn, you collect the results. But you're not quite sure what was ordered, or why some tests are included and others aren't. You also wonder whether you should have "more" tests, like the ones you see everywhere online.
Here's how to think about a useful annual blood panel from age 40: what makes up the classic core, what's worth adding based on your profile, and what the French health insurance system actually reimburses.
How often should you have a blood test after 40?
An important first point: in France there is no official recommendation imposing a universal "annual blood panel" on the entire adult population. France's High Authority for Health (HAS) instead recommends targeted tests based on your age, your personal and family history, your risk factors (smoking, diet, sedentary lifestyle, excess weight) and any symptoms. A systematic annual blood panel is neither mandatory nor always necessary.
That said, from age 40, taking stock once a year or every two years with your GP is a common and reasonable practice, particularly when cardiovascular or metabolic risk factors are present. The frequency depends on your situation: a healthy adult with no medical history can space them out more than someone on a chronic treatment or with a strong family history.
Good to know: France's health insurance offers a free check-up, the Prevention Health Examination (EPS), every five years from age 16, available to any general-scheme insured person on simple request to their local fund (CPAM). It takes place in a Health Examination Centre, lasts about two to three hours, and includes a personalised biological work-up based on your profile. Still far too little known.
Key point — There is no mandatory universal blood panel in France after 40. The useful tests depend on your profile. In parallel, the health insurance offers a free Prevention Health Examination every five years, still too little known.
The routine tests frequently indicated after 40
Six families of tests form the core of a common annual panel after 40. All are reimbursed by the health insurance on medical prescription.
1. The lipid panel: total cholesterol, LDL, HDL, triglycerides
The cornerstone of cardiovascular prevention. LDL cholesterol (the "bad" one) is the main marker of atherogenic risk; HDL (the "good" one) is protective; triglycerides reflect dietary and carbohydrate balance. European cardiology guidelines define different LDL targets depending on overall cardiovascular risk — hence the importance of a contextualised reading.
2. Fasting blood glucose
The reference marker for screening diabetes and prediabetes. A fasting level above 1.10 g/L on two occasions suggests prediabetes, above 1.26 g/L diabetes. Depending on your context, your doctor may add an HbA1c, which gives a view over two to three months.
3. The complete blood count (CBC)
A routine test measuring red cells, white cells and platelets. It detects anaemia, infection, inflammation, or rarer abnormalities. Often paired with an erythrocyte sedimentation rate or CRP measurement when there's a clinical pointer.
4. Kidney function: creatinine and estimated GFR
Blood creatinine is used to estimate the glomerular filtration rate (GFR), which reflects how well your kidneys are working. Particularly useful with high blood pressure, diabetes, or if you regularly take certain medications (anti-inflammatories, antihypertensives).
5. Liver function: ALT, AST (and GGT depending on context)
The transaminases ALT and AST reflect liver function. They can be elevated in non-alcoholic fatty liver disease, excessive alcohol consumption, or adverse effects of certain medications.
6. TSH (thyroid)
The first-line marker for exploring thyroid function, particularly useful when symptoms are present (fatigue, weight gain or loss, feeling cold, palpitations) or in women over 50. Not always necessary in the absence of symptoms — to discuss with your doctor.
Key point — Lipid panel, fasting glucose, CBC, kidney function, liver function, TSH depending on context: these six families of tests make up the core of an annual panel after 40. All are reimbursed on prescription.
The tests to discuss based on your personal profile
Beyond the core, some tests are worth adding depending on your situation. These are rarely "tests to order systematically," but rather add-ons to discuss with your doctor.
Iron status: ferritin and transferrin saturation
Particularly relevant in menstruating women, vegetarians or vegans, endurance athletes, or in cases of persistent fatigue. Ferritin reflects your iron stores; transferrin saturation assesses the availability of circulating iron.
Vitamins: D and B12
For vitamin D, a caveat: since 2014, reimbursement of the 25-OH vitamin D assay has been restricted by the health insurance to six specific indications (suspected osteomalacia, follow-up after bariatric surgery, repeated falls in older people, kidney transplant follow-up, prescription of certain medications, advanced chronic kidney disease). Outside these indications, testing is possible but at your own expense (around €11–15).
Vitamin B12 is worth measuring in cases of persistent fatigue, neurological symptoms, a strict vegan diet, after 60, or with prolonged use of certain medications (metformin, proton pump inhibitors).
HbA1c
Glycated haemoglobin reflects average blood glucose over two to three months. Particularly indicated with excess weight, a family history of diabetes, borderline fasting glucose, or high blood pressure. It detects prediabetes earlier than a one-off glucose reading.
Targeted markers depending on context
Other tests may be indicated in specific situations: PSA in men after 50 within an individual, discussed prostate cancer screening; uric acid for joint pain or a history of gout; CRP when inflammation is suspected; calcium for bone disorders. None are prescribed without a clinical reason.
Key point — Ferritin, vitamins D and B12, HbA1c, PSA, uric acid, CRP: these additional tests are prescribed based on your profile and risk factors, never as systematic routine. The conversation with your doctor is essential.
What isn't reimbursed… and why that isn't necessarily a problem
A point that often comes up in our exchanges with users: the confusion between "reimbursed by health insurance" and "clinically useful."
Vitamin D testing is the emblematic case. Since the UNCAM decision of 2014 (confirmed in 2021), this test is only reimbursed in specific indications. The reason? An explosion of prescriptions (multiplied by ten between 2005 and 2012, for an annual cost of €144 million), without the clinical benefit of systematic testing being demonstrated. The HAS and the Academy of Medicine agree on one point: measuring vitamin D is of no use in a healthy person with no risk factor, and supplementation can be prescribed without prior testing.
In other words, the absence of reimbursement here reflects a clinical-relevance decision, not blind cost-cutting. The same applies to other tests sometimes offered on paid check-up platforms: "more tests" doesn't mean "a better panel." A targeted, well-interpreted panel is more useful than an exhaustive one read out of context.
The BioSense method
A blood test is only valuable in context. BioSense cross-references your results with your health questionnaire — age, sex, history, current treatments, lifestyle, reason for the prescription, any symptoms — and with official guidelines (HAS, ANSM, Santé Publique France, French and international learned societies). Your results are also tracked over time, which makes it possible to spot a drift before it becomes a problem.
*ChatGPT answers you. BioSense knows you.* *BioSense, your prevention companion.* BioSense does not provide a diagnosis and does not replace your doctor. It is a prevention companion that helps you understand, ask the right questions and act day to day.
Preparing for your medical appointment: three useful questions
Before your next consultation, here are three questions to prepare to guide the prescription:
- Given my history, my age and my risk factors, which blood tests are genuinely useful this year?
- How often should I repeat these tests?
- Am I eligible for the free Prevention Health Examination from the health insurance, and would it be useful in my case?
This preparation saves time during the consultation and steers the conversation toward what really matters for you.
Import your blood test into BioSense and receive a plain-language explanation of each of your biomarkers, contextualised to your profile, with tracking over time. Your data is hosted in France on infrastructure certified for hosting health data (HDS).
[→ Import my report](/en/onboarding/upload)
Sources and methodology
- French Health Insurance (Ameli) — Prevention Health Examination: everything about this free health check.
- French Social Security Code — Articles L321-1 to L321-3 and R321-2 to R321-6 (free health examination).
- High Authority for Health (HAS) — Clinical usefulness of vitamin D testing (assessment report, 2013).
- UNCAM (National Union of Health Insurance Funds) — Decision of 14 August 2014 amending the list of covered procedures (vitamin D).
- UNCAM — Decision of 25 November 2021 confirming the reimbursement restrictions for vitamin D testing.
- HAS — Care pathway guide: Type 2 diabetes in adults.
- HAS — Appropriate use of laboratory tests (fact-sheet collection).
- European Society of Cardiology and European Atherosclerosis Society (ESC/EAS) — 2019 Guidelines for the management of dyslipidaemias (European Heart Journal, 2019), with a targeted 2025 update.
- HAS and the French Society of Endocrinology (SFE) — Subclinical hypothyroidism in adults (2007) and HAS — Management of hypothyroidism in adults (2022).
*BioSense methodology: our content draws on official French guidelines (HAS, ANSM, Santé Publique France, INSERM, Assurance Maladie, Anses), European guidelines (ESC, EASD, NICE) and international ones (WHO, ADA, AHA, NIH), as well as specialised learned societies (SFE, SFBC, GRIO). It is reviewed with an educational approach before publication.*
Going further
- Health check-up: what France's social security actually reimburses
- Blood test reference ranges: why "within range" isn't enough
- Persistent fatigue after 40: which biomarkers to explore first
*This article is for informational purposes only and is neither medical advice nor a diagnosis. For any questions about your health, consult your doctor.*