SummaryUsing a matched insurant–general practitioner panel data set, we estimate the effect of a general health‐screening program on individuals' health status and health‐care cost. To account for selection into treatment, we use regional variation in the intensity of exposure to supply‐determined screening recommendations as an instrumental variable. We find that screening participation increases inpatient and outpatient health‐care costs up to 2 years after treatment substantially. In the medium run, we find cost savings in the outpatient sector, whereas in the long run, no statistically significant effects of screening on either health‐care cost component can be discerned. In sum, screening participation increases health‐care cost. Given that we do not find any statistically significant effect of screening participation on insurants' health status (at any point in time), we do not recommend a general health‐screening program. However, given that we find some evidence for cost‐saving potential for the sub‐sample of younger insurants, we suggest more targeted screening programs. Copyright © 2014 John Wiley & Sons, Ltd.