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Health insurance in Austria

Peculiarities of health insurance in Austria for foreigners - how to get health insurance, legislation, how to choose, how much does health insurance cost in Vienna.
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Author : Evgeny Pilnikov,
Luxury Immobilen CEO
10 min
PUBLISHED 04.11.2021
We have prepared a special article which contains information about the health insurance system in Austria, how a foreign citizen can obtain medical insurance, what services it covers and what is its cost.
Obtaining quality medical care and finding affordable medical services are important issues for people when moving abroad. In this regard, Austria is one of the most comfortable countries to reside in for expats not only in Europe, but also around the world. The Austrian healthcare system is characterized by accessibility, a high level of medical care and high-quality hospitals, as well as the professionalism of doctors.

There is no shortage of medical specialists in the country as there are 51 doctors for every 10,000 citizens (this is almost twice as many as in the USA). The healthcare system in Austria covers almost 100% of the population and almost all local citizens and residents have health insurance.

Health insurance system in Austria

The health insurance system in Austria is among the TOP 10 best in the world; the World Health Organization (WHO) has assigned the country 9th place in the world ranking of health insurance. In Austria, medical care for the population is provided at a regional level and 99% of the country's residents have health insurance. The regional authorities – Gebietskrankenkassen (GKK) - are responsible for organizing this work.

Healthcare is one of the main priorities for the government of Austria. For example, in 2019, more than 10% of GDP was spent on this industry. The healthcare system is funded through the social insurance system and these issues are regulated by the Federal Law on General Social Insurance (Allgemeines Sozialversicherungsgesetz, ASVG) of 1955. The law includes 3 areas: medical, pension and accident insurance.
Health insurance in Austria, as in most EU countries, is obligatory for all residents. This requirement applies to the following groups of people:

  • Employees
  • Self-employed and freelancers
  • Unemployed citizens receiving benefits
  • Pensioners
  • Dependent persons of the categories listed above
The system of public health insurance in Austria is well developed, but if you wish, you can also insure yourself with a private insurance company. The Ministry of Social Affairs, Health, Care, and Consumer Protection provides residents of Austria access to public health insurance and the right to medical care. At the same time, residents of Austria are required to regularly transfer part of their salary as part of their insurance payments.
NOTE: A person's income level affects the amount of the insurance payment, while the age and health status of a person do not affect the amount of payments. People with low and zero incomes receive medical care for free.

Who can access the healthcare system of Austria and how

Access to healthcare in Austria is available to all people who are in the territory of the state, including residents and tourists. It is recommended to purchase travel insurance in advance when visiting Austria as a tourist or whether on a business visit for a short period. Otherwise, when contacting a medical institution, you will have to pay for all received services at full cost.

The conditions of medical care for residents of Austria are universal, regardless of their age and income level. Residents are all individuals who legally reside in the country for 6 months or more. They are entitled to free medical care under the state social insurance system.

The state health insurance system for expats in Austria

In order to obtain medical insurance, it is enough to be officially employed as an expat in Austria as monthly insurance payments will be transferred automatically.

In Austria, as in other EU countries, the employer is responsible for registering their employees with the Social Insurance Authorities (Sozialversicherungsträger). The employer is also obliged to withhold part of the employee's salary and transfer this money to the state. A resident cannot choose an insurance company that will serve them, because it depends on the employer. But the employee has the right to choose an addition to the standard policy, for example, the inclusion of physiotherapy in the package. However, a separate fee is charged for additional options, as a rule.

After registration in the social insurance system, each resident receives their own individual number. Since 2005, all expats have been issued with electronic plastic cards (e-cards), which provide access to free medical care for the period of residence in Austria. The cost of the card is EUR 11.95 (USD 14) and the amount is charged annually as a service fee.
To receive an electronic card, you do not need to submit an application as the medical insurance company will send the card to your home address after registration. Data on the patient's medical records and prescribed medications will be contained in this card. It is necessary to provide an e-card every time you visit the hospital.
NOTE:Non-working expat spouses and children are automatically connected to the insurance of a working resident. In addition, non-working pensioners and their spouses living in Austria are entitled to receive state health insurance
Self-employed, freelancers and business owners can also get state health insurance. There is a special body for social insurance of these employment categories in Austria: Sozialversicherungsanstalt der Selbständigen (SVS).

But healthcare will not be completely free: these individuals need to pay 20% of the cost of treatment. The above categories of persons have the opportunity to choose between mandatory and full private health insurance. It is necessary to choose the appropriate type depending on the professional and family situation. For example, the amount of the contribution for compulsory medical insurance for self-employed individuals directly depends on their income. If monthly earnings exceed EUR 4,688 (USD 5,422), then the medical contribution without sickness benefit will be approximately EUR 774 (USD 895) per month plus an additional insurance fee. Thanks to the additional fee, monthly expenses range from EUR 430 to EUR 480 (from USD 497 to USD 555). This also includes medical benefits, for example, in the amount of EUR 2,500 (USD 2,891). Based on all of the above, it is recommended to carefully consider each of the options and choose the most suitable one for you.
Students can take out joint insurance through the health insurance of both their parents or just one of them. This is usually possible before the age of 27. However, in this case it will be necessary to receive a family allowance or confirmation of the continuation of studies. To do this, students must present proof of academic performance for 8 hours a week or score 16 ECTS points for the academic year.

Students who come to study in Austria from non-EU countries are not provided with state medical insurance. To obtain a student visa, they will first have to purchase a policy from one of the private insurance companies, which is valid for the entire period of their stay in Austria. A fairly common option in such cases is self-insurance at the Austrian Health Insurance Fund (ÖGK), the cost of which constitutes EUR 63.44 (USD 73) per month, taking into account the student discount. The main nuance to keep in mind is that the income should be no more than EUR 10,000 (USD 11,567) per year. Additional insurance depends on the amount of benefits offered by the relevant insurer and some packages are available for as little as EUR 5 (USD 5.78) per month.
NOTE! A student can contact the health insurance fund in order to learn about the requirements for self-insurance in ÖGK. Moreover, it is possible to choose insurance for limited employment as an alternative option, but the income should not exceed EUR 475.86 (USD 550.43) per month in this case. The monthly cost of medical insurance for limited employment will constitute EUR 67.18 (USD 77.71).

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European Health Insurance Card (EHIC)

European Health Insurance Card (EHIC) is available to all citizens of EU countries, including Austria. Citizens of non-EU countries can also receive this card if they legally reside in the territory of a European state and are registered in its social insurance system.

The following data is stored in EHIC:

  • Date of birth of the cardholder.
  • First and last name of the cardholder.
  • The first 10 digits of the health insurance number as a personal identification number.
  • Medical insurance company identification number.
  • Card identification number.
  • Card validity period.
  • A field for the signature of the cardholder with the EU emblem.
The EHIC card holder is entitled to state medical care in any of the 27 EU countries under the same conditions as the local population. For example, a French citizen who comes to Austria can receive the same medical care as a native Austrian, and vice versa.

But it should be remembered that the list of services or medicines provided to EHIC cardholders for free or at a reduced price may vary in different countries. Moreover, holders of the European Health Insurance Card who are not EU citizens cannot use it on the territory of Denmark, Iceland, Norway, Switzerland and Liechtenstein.

In some countries a free service is available for EHIC owners. In other states, the patient must first pay for their medical services, and only will then receive compensation from the social insurance authority.

You can apply for or renew an EHIC in most European countries online. In Austria, the EHIC is issued together with an electronic health insurance card, which is located on the back of the e-card.

The cost of public health insurance in Austria

A monthly contribution of 18.12% is automatically transferred from the salary of a resident participating in the state health insurance programme to the government. In addition, the employer is obliged to deduct 21.32% of the same amount to the social insurance fund. The monthly fee is not charged to pensioners, the disabled and the unemployed, who will not receive income and health care itself, in fact, is free for them.
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What is covered by public health insurance in Austria

Medical insurance in Austria includes coverage of all expenses related to examinations and treatment in public medical institutions as well as the purchase of prescription drugs.

In cases when the state insurance does not cover certain medical services that you are going to receive, you must pay their full cost yourself. Prices for medical services in Austria are quite high, therefore, you can choose a suitable package from private insurers which will make your treatment much cheaper.
Hospital visits
The availability of health insurance provides free hospital visits in Austria, but some institutions provide separate fees. For example, if you go to a doctor who does not accept federal health insurance, you may be required to make an advance payment for an examination or treatment. In the event of such situations, in most cases the insurance company will reimburse you up to 80% of the cost of the services rendered after the claim has been put through. Doctors working within the state system usually show signs with the inscription Kassenarzt, which means "doctor under contract", or alle Kassen, which means "all insurers". In addition, there may be cases when the fee for staying at Vienna Health Association hospitals (Wiener Gesundheitsverbund) is about EUR 12 (USD 13.87) per day. At the same time, the insurance covers 100% of the costs of hospitalization. It should be noted that when visiting out-patient patients who are observed by doctors working under contract, anywhere from 10% to 20% of the total cost of treatment can be withheld from the visitor.
Emergency medical care
If you need emergency treatment, you can contact the nearest medical center. The state medical insurance will fully cover the cost of the services provided to you.
Prescriptions and medications
Medicines prescribed by a doctor in Austria can also be obtained through medical insurance. But a mandatory small fee applies to each prescription at EUR 6.30 (USD 7.28).
Vaccination
Children under 15 years of age are vaccinated free of charge in Austria. The conditions of a vaccination and its cost for patients over 15 years of age, as well as for those who want to get vaccination before traveling abroad, need to be clarified with their insurer.
Pregnancy management
Medical insurance covers examinations of pregnant women, childbirth itself and maternity care.
Psychiatric care
In Austria, psychiatric treatment in general is also covered by insurance, but in some areas, such as psychotherapy, only a certain part of the cost of services is reimbursed.
Dental services
These services are also included in the state insurance, but the specifics of their coverage should be clarified with your insurance company. Free services usually include professional cleaning and filling of teeth. Prosthetics and surgical operations can only be covered by private insurance.
Ophthalmological care
The specific conditions of coverage depend on the policy of your insurance company.
Protection of sexual health
This type of service, including all necessary tests and examinations are covered by medical insurance. This area of medicine in Austria is mainly dealt with by general practitioners (a therapist or school information campaigns).
Complementary and alternative medicine
At the moment this type of medical care is currently gaining popularity in Austria. If your doctor practices alternative methods of treatment, then, most likely, insurance will cover these services.
Treatment in the EU countries
The holder of an Austrian electronic card can count on the coverage of treatment in other EU countries by state insurance, since the EHIC is located on the back of the card.
IMPORTANT! In case of emergency situations for urgent doctor calls, it is necessary to call 144 for the ambulance or 141 for the emergency room (Rettungsdienst). There is also a single emergency number in Austria – 112.

Private health insurance in Austria

In addition to compulsory state health insurance, residents in Austria can apply for a private health insurance policy as well. The quality of services in the 2 sectors is practically the same, but there may be a difference in the availability of a choice of certain services and the level of comfort.

The availability of private insurance, for example, opens up access to a wider range of clinics and medical specialists. The waiting time for admission will also be reduced. Owners of a private health insurance policy will receive a separate or double room during hospitalization and will not be placed in the same room with other patients. The insurance can also cover the purchase of certain types of medicines, optical devices (glasses, contact lenses), dental operations and so on. Depending on the federal district, insurance may cover the purchase of therapeutic devices. For example, the cost of buying an electric wheelchair within EUR 498 (USD 575) can be covered by regional funds in Vienna and Tyrol. Some insurance funds of Lower and Upper Austria and Salzburg can cover expenses up to EUR 3,320 (USD 3,836).
Insurance companies, both public and private, are managed by the Austrian Financial Market Authority. There are many insurers operating in the Austrian market and the most popular are the international companies such as Globality Health, Cigna Global and Allianz Care. The services of such companies include a wide range of plans that are suitable for different cases where the age and health status of the client affect the cost of the policy.
For example, the more medically challenged a person is, the more expensive their medical insurance will cost. The price of insurance for elderly and seriously ill people can reach EUR 500 (USD 576) per month and above. The monthly cost of health insurance for children and adolescents under 18 years old in most cases is only EUR 30 (USD 34).

The procedure for reimbursement of medical services costs is carried out in accordance with the policy of a particular insurance company. In most cases, hospitals and polyclinics bill the insurer directly, while the insured person does not pay anything, however other schemes can also be used as well. For example, the patient themselves transfers money to the hospital or doctor for the services received, after which they will receive compensation from the insurer based on the presented checks and documents on the appointment of examinations, procedures and medications, etc.
NOTE: Students from non-EU countries often use the services of private companies, because of lack of access to the state insurance system. Students who live in Austria and have independently taken out health insurance must make contributions to the amount of about EUR 50 (USD 57) for national health insurance every month.

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SUMMARY

  • Health insurance in Austria is mandatory for all residents - the indigenous population and expats.
  • Residents of Austria have access to both public and private health insurance.
  • To participate in the state health insurance programme, it is enough for an expat to officially find a job in Austria. The necessary contributions will be automatically transferred from each salary to the government. Insurance will be provided not only to the resident themself, but also to their family: spouse and children under the age of majority.
  • Foreign freelancers can register in the state health insurance programme in a special body - Sozialversicherungsanstalt der Selbständigen (SVS).
  • Electronic medical cards (e-card) can be obtained when registering in the state social insurance system. This card must be presented at each visit to the hospital or medical facility.
  • The European Health Insurance Card (EHIC) is placed on the reverse side of the e-card and entitles you to receive medical care under insurance on the territory of all EU states.
  • The age and health status of an expat affects the cost of a private health insurance policy. The monthly payment for private health insurance for children under 18 years of age can be EUR 30 (USD 34) and for elderly people with chronic diseases – EUR 500 (USD 576) or more.
  • Obtaining medical care in Austria is possible without insurance. But in such a situation, you will have to pay the full cost of medical services, which are quite expensive in the state.
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Evgeny Pilnikov.
Expert.
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