Health Insurance in Austria

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

Currently, the following insurance companies operate in Austria, which are not chosen but assigned based on occupations, thus determining the insurer for the insured individual:

• Österreichische Gesundheitskasse, ÖGK – Austrian Health Insurance Fund
• Versicherungsanstalt öffentlich Bediensteter, Eisenbahnen und Bergbau BVAEB – Insurance Institution for Public Employees, Railways, and Mining
• Sozialversicherungsanstalt der Selbständigen, SVS – Social Insurance Institution for the Self-Employed

Healthcare Services

Healthcare services must be adequate and appropriate according to statutory requirements, but not exceed what is necessary. Legal entitlement to services – regardless of the amount of the health insurance contribution – includes access to in-kind benefits from contracted doctors, the insurers’ own facilities, or contracted institutions (hospitals) for medically necessary services in the given case. All insured persons and eligible dependents enjoy the same rights.

Services are largely provided without additional costs for the insured. However, some insurers, such as the Social Insurance Institution for the Self-Employed (Sozialversicherungsanstalt der Selbständigen, SVS) and the Insurance Institution for Public Employees, Railways, and Mining (Versicherungsanstalt öffentlich Bediensteter, Eisenbahnen und Bergbau, BVAEB), may require a co-payment (Selbstbehalt) when accessing medical assistance.

Occupational Affiliation

The Austrian social insurance system is organized based on occupation. This means that affiliation with a particular insurance company depends fundamentally on the work performed.

Since January 1, 2020 (following the social insurance structure reform), the following changes have been implemented:

Employees previously insured with the regional health insurance funds are now covered by the Austrian Health Insurance Fund (Österreichische Gesundheitskasse, ÖGK). Retirees previously covered by the regional health insurance funds, as well as those who were insured with any of the former five company health insurance funds, are also insured under the ÖGK.

The Insurance Institution for Public Employees, Railways, and Mining (Versicherungsanstalt öffentlich Bediensteter, Eisenbahnen und Bergbau, BVAEB) covers individuals who were previously insured with the former insurance institution for railway and mining workers, as well as public sector employees previously insured with the public insurance provider whose service began after December 31, 1998, and contract employees whose service started after December 31, 2000 (unless affiliated with a provincial health fund), along with those formerly insured by the company health insurance fund of the Vienna Transport Company and their eligible dependents.

Traders and self-employed professionals previously insured with the Social Insurance Institution of Commercial Economy (Sozialversicherungsanstalt der gewerblichen Wirtschaft, SVA) are now insured with the new Social Insurance Institution for the Self-Employed (Sozialversicherungsanstalt der Selbständigen, SVS). Farmers and foresters previously insured with the Agricultural and Forestry Social Insurance Institution (Sozialversicherungsanstalt der Bauern, SVB) are also covered under the SVS.

The statutory health insurance also covers the insured’s dependents – either without an additional insurance contribution or with a discounted contribution (supplementary contribution). Those who do not fall under the scope of statutory health insurance may apply for voluntary insurance.

What Does Health Insurance Cover?

The benefits of statutory health insurance include, among others:

• Screening and preventive examinations for young people and adults to detect illnesses early
• Medical care (medical assistance, medical aids, medications, hospital care, or home nursing when necessary)
• Dental treatment and dentures
• Sick leave payments during periods of incapacity for work, as well as rehabilitation benefits and reintegration support after a long illness
• In-kind and cash benefits in case of maternity