Health Insurance in Austria

In Austria, the legal health insurance covers almost the entire population (99.9 percent). This system provides comprehensive protection for insured individuals and their dependents in case of illness.

Currently in Austria, the following insurance companies operate, which cannot be chosen but are organized based on occupations, and thus the insurance is allocated to the specific person to be insured:

• Austrian Health Insurance Fund, ÖGK – Austrian Health Insurance Fund
• Insurance Institution for Public Employees, Railways and Mining BVAEB – Insurance Institute for Public Servants, Railway Workers and Miners
• Social Insurance Institution for the Self-Employed, SVS – Social Insurance Institute for Independent Entrepreneurs

Healthcare

Healthcare must be sufficient and appropriate in accordance with legal regulations, but must not exceed the necessary extent. Legal entitlement to services – regardless of the level of health insurance contribution – includes the use of in-kind benefits from contracted physicians, in the insurers’ own institutions or contracted institutions (hospitals) for medically necessary services in each case. Every insured and eligible person enjoys the same rights.

The provision of services largely occurs without additional costs for the insured. However, for some insurance institutions, such as the Social Insurance Institution for Self-Employed Individuals (Sozialversicherungsanstalt der Selbständigen, SVS), as well as the Insurance Institution for Public Service Employees, Railway Workers, and Miners (Versicherungsanstalt öffentlich Bediensteter, Eisenbahnen und Bergbau, BVAEB), a co-payment (Selbstbehalt) may occur when seeking medical assistance.

Professional Affiliation

The Austrian social insurance system is organized on a professional basis. This means that belonging to a specific insurance company fundamentally depends on the activity performed.

Since January 1, 2020 (the reform of the social security structure), the following changes have come into effect:

Employees previously insured at regional health insurance funds are now insured with the Austrian Health Insurance Fund (Österreichische Gesundheitskasse, ÖGK). Retirees who were previously insured at regional health insurance funds, as well as those who were insured with one of the previous five operational health insurance funds, are also insured with the ÖGK.

Insured at the Insurance Institution for Public Service Workers, Railway Workers, and Miners (Versicherungsanstalt öffentlich Bediensteter, Eisenbahnen und Bergbau BVAEB) are both persons insured at the former insurance institute for railway workers and miners, and public employees previously insured by the public service insurance provider whose service relationship began after December 31, 1998, as well as contract employees whose service relationship began after December 31, 2000 (if they do not belong to a provincial-level health fund), and those previously insured at the Vienna Public Transport Company’s operational health insurance fund and their eligible dependents.

Merchants and freelancers previously insured with the Commercial Social Insurance Institute (Sozialversicherungsanstalt der gewerblichen Wirtschaft, SVA) are now insured with the new Independent Entrepreneurs’ Social Insurance Institute (Sozialversicherungsanstalt der Selbständigen, SVS). Agricultural and forestry self-employed individuals previously insured with the Agricultural and Forestry Social Insurance Institute (Sozialversicherungsanstalt der Bauern, SVB) are also insured with the SVS.

Legal health insurance also protects the dependents of the insured – without additional insurance contributions, or with preferential contributions (supplementary contributions). Persons who are not covered by legal health insurance can apply for self-insurance.

What Does Health Insurance Provide?

The services of legal health insurance include, among others:

• Screening and preventive examinations for youth and adults to detect diseases early
• Medical care (medical assistance, medical aids, medications, hospital treatment, and home care if necessary)
• Dental treatment and dental prosthetics
• Sick pay during sick leave in case of incapacity to work, rehabilitation support for reduced work capacity, and reintegration assistance after a long illness
• In-kind and monetary benefits in case of maternity