Social welfare & health system

Excellent healthcare provided by medical professionals and institutes providing state-of-the-art medical services along with a dense network of public and private hospitals ensure that the health care system in Austria is one of the best in the world.

The social security and welfare system in Austria

Austria’s social services such as minimum benefits as well as social insurance and pension benefits contribute to a very high level of social security for the country’s inhabitants.
Together with France, Belgium, Denmark, Finland, Germany, Italy and Sweden, Austria ranks among the eight countries investing more than one quarter of their gross domestic product in social expenditures. This is clearly higher than the OECD average of 20.1 percent.

The social insurance system in Austria is characterised by a mix of central and decentralised components. The social insurance system is dominated by legally mandated social insurance benefits as well as universal services for the entire population, regardless of any proven neediness. Part of the healthcare system, public housing, a large proportion of social services, childcare facilities and minimum income are regional competencies i.e. in the hands of the federal states, municipalities and cities.

Austria features a particularly well-developed system of cooperation among the large economic interest groups of employers and employees and with the government. The Austrian social partnership makes a significant contribution to economic growth and social peace in Austria thanks to its ability to achieve a consensus, the reconciliation of interests and a coordinated approach.

According to EU-SILC 2016 (European Union Statistics on Income and Living Conditions), 45 percent of households would be at the risk of poverty. Retirement and social welfare benefits succeed in reducing this share to 14 percent. This demonstrates the strong role played by social welfare benefits in preventing poverty.

The Austrian social insurance system

The Austrian social insurance system represents a mandatory insurance scheme. Contributions are paid by the employers on behalf of all employees and if applicable on behalf of their relatives as well (source link: wko.at). Self-employed people with a trade license, new self-employed persons and contractors must pay their social security contributions themselves. The statutory contributions of employed persons (workers and freelancers) are automatically deducted by the employers and paid to the tax office. Employers are also responsible for registering their employees with the social insurance system.
The amount of contributions to be paid i.e. the so-called contribution rates varies depending upon which group of employees an individual is assigned, for example wage earners, salary earners, apprentices, marginally employed workers etc.
 

The Austrian social insurance system consists of several different pillars:

  • Health insurance (Krankenversicherung), which also encompasses maternity leave. Health insurance benefits include assuming the costs of medical treatment, hospitalisation, medical check-ups, childcare allowances, sickness benefits etc.

  • Under certain conditions, family members are insured free of charge.

  • Work accident insurance (Unfallversicherung), providing coverage in case of occupational accidents and diseases and their consequences e.g. invalidity and disablement.

  • Pension insurance (Pensionsversicherung), e.g. retirement benefits.

  • Unemployment insurance (Arbeitslosenversicherung) encompassing benefits in case of unemployment such as unemployment benefits and emergency assistance.
    Every salaried employee automatically pays into unemployment insurance. If you lose your job, Public Employment Service Austria (AMS) pays for your social insurance until you find new employment.

Health insurance

Few countries in the European Union spend as much on health care as Austria, which invests more than a 10th of its GDP as of 2018, according to the Ministry of Social Affairs. Thanks to compulsory insurance (Pflichtversicherung) about 99.9% of the population is insured.

This means there are no increased rates or exclusions for pre-existing conditions, or lifetime caps on coverage. With 500 practicing physicians per 100,000 inhabitants, you are guaranteed access to medical help anywhere, anytime. Comprehensive coverage includes high-quality treatment for everything from the common cold to heart surgery, plus free yearly checkups for adults (if you are not insured), and amazing support for mothers to be. Generally, you have two options: public insurance alone, or public plus supplemental private insurance. With public insurance alone, you contribute small co-payments for treatment from a wide selection of doctors and public hospitals. With supplemental private insurance, you have the option of consulting private doctors, with potentially higher fees in specific cases being covered fully or in part depending on your insurance. In many cases, the amount of your co-pay and your type of insurance are determined by your employer. However, anyone can purchase private ­insurance, even if the employer doesn’t offer it. Those interested in the legal ins and outs of Austrian social insurance can study the respective social insurance acts (Sozialversicherungsgesetz).

You must get insured, but how? With few exceptions, every­one must get health insurance. This requirement and the rate of contributions are independent of nationality, place of residence in Austria or individual medical risk factors. However, you are not free to choose your public

insurer, as this is determined by your occupation. The costs and benefits are similar for the individual insurance schemes, but the steps you follow to become ­insured are different.

Those employed in Austria, as well as public servants, are automatically insured through their employers. Those earning less than €475.86 as of 2021 (Geringfügig) are not directly insured but can take out self-insurance or receive coverage from another job if they do not already have coverage. You can insure your spouse, registered partner, and children through co-insurance.

There are several health insurance providers encompassed within the Association of Austrian Social Security Institutions. The specific health insurance provider responsible for a given individual depends on the person’s place of residence and the professional activity of the insured person.

Compulsory health insurance (Krankenversicherung) covers a wide range of treatments, from primary and hospital care, to specialized and emergency care, X-rays, maternity services, psychotherapy, prescription medicines and rehabilitation.  There are three public insurers in Austria. 

 

Under certain conditions, family members are insured free of charge.

Health insurance

There are several health insurance providers encompassed within the Association of Austrian Social Security Institutions. The specific health insurance provider responsible for a given individual depends on the person’s place of residence and the professional activity of the insured person.

Benefits

In addition to covering the costs of medical treatment, hospitalisation, medical check-ups, childcare allowances, sickness benefits and payments during maternity leave, the Austrian health insurance system also assumes costs for dental care, rehabilitation, home nursing, therapeutic aids, examinations within the context of the mother-child pass and nursing.

Prerequisites

The underlying prerequisite for taking advantage of health insurance benefits and what the health care system in Austria has to offer is presenting the e-card, which every insured person, and, if applicable, her or his relatives, receives from the medical insurance provider within fourteen days after registration with the health insurance provider. The back of the e-card also serves as the European Social Security Card, enabling the insured person to make use of medical services provided in other member states of the European Union.

  • Employed persons or self-employed individuals, amongst others, are entitled to medical insurance.

Employees and Public Servants

As an employee, your insurance institution is the Austrian Health Insurance Fund (Österreichische Gesundheitskasse, ÖGK). Civil servants, such as politicians, university staff, teachers, as well as farmers and workers in the railway and mining industries are insured via BVAEB. 

  • So what do you have to do? Nothing — it is the employer’s responsibility to register you, with coverage beginning on the day you start to work.
  • How much do you pay? The employee pays from 1.5% to 3.9% of his or her income,

depending on the insurer, which is matched by the employer.

 

Business Owners and freelancers

As a self-employed person, you are insured with the Social Insurance Institution for the Self-Employed (Sozialversicherungsanstalt der Selbstständigen, or SVS). These differ slightly in how they make benefits available and in how much they ask the insured person to contribute in fees or co-payments, but overall, they are similar. One difference is that the SVS often requires patients to pay up to 20% of doctors’ bills (Selbstbehalt). This can eventually be reduced to either 10% or 5% as long as you meet predefined health goals, set by you and your doctor. Here, it is important to make a distinction between business owners or partners and freelancers. 

  • So what do you have to do? In short, if you need an Austrian business license (Gewerbeberechtigung) to practice your trade, or if you are a liable partner in an OG, KG, or a GmbH (various forms of businesses in Austria), you are obliged to get insurance. You are automatically signed up for insurance once you register your business. Freelancers not operating with a business license need to register as soon as their annual income exceeds €5,370 monthly gross, or pay retroactively. If the freelancer’s earnings are below the Geringfügig limit, their self-insurance rates are as they are for all Geringfügig workers. 
  • How much do you pay? In total 7.65%, however 3.87% of earnings is paid by the freelancer and 3.78% by the employer, with a minimum payment of €475.86 per quarter, regardless of your income. Any income exceeding €5,370 monthly is not subject to an SV-Beitrag (insurance contribution). However, any amount you earn above €77,770 annually as of 2021 does not increase your contribution. When your total income exceeds the Höchstbeitragsgrundlage, or €77,770, the difference between this and the highest annual income is the value the insurance is based on.

If you are both employed and self-employed, the income from all your economic activity is added up, calculating your contribution basis. Your insurance depends on your highest source of income; if your salary is higher than what you earn as a self-employed person, you are covered by the ÖGK — and vice versa.

 

Self-Insurance

If you are a student or earn less than €475.86 (Geringfügig) a month as of 2021, you can opt in to self-insurance (Selbstversicherung). If, however, you are a retired expat, it is obligatory. Those receiving social or welfare benefits are automatically insured (see Social security, p 194). The usual monthly contribution is €454.86, but it is considerably reduced for students and others with limited financial resources. Self-insurance coverage is mostly comparable to public insurance, with some notable exceptions, such as sick leave and maternity benefits

 

Sickness Benefits

If your doctor verifies that your illness prevents you from being able to work, you will receive sickness benefits. For workers and employees, the ÖGK pays 50 percent of your gross income beginning on your fourth sick day, while the SVS holds off for 43 days before paying out a daily allowance of €31.55 for a maximum of 20 weeks. In either case, you need to visit your doctor to renew your sick leave note every two weeks. If you are self-employed and unable to work for a period (for example, due to an accident), but have someone who is able to run your business while you recover, you can apply for the Betriebshilfe program.

 

Family support

You are entitled to a paid maternity or paternity leave as well as child benefits (Kindergeld).

Exemptions from fees

Austrian residents who earn less than €1,000.48 per person or €1,578.36 per partnership per month can apply for exemption from paying prescription fees and the daily allowance for inpatient care. This relates to those employed as well as self-employed.

E-CARD Prerequisites: E-Card

The underlying prerequisite for taking advantage of health insurance benefits and what the health care system in Austria has to offer is presenting the e-card, which every insured person, and, if applicable, her or his relatives, receives since 2005 from the medical insurance provider within fourteen days after registration with the health insurance provider. It’s a smart chip card you’ll need to bring to all medical consultations. It serves as proof of your insurance status and provides medical professionals access to your Electronic Health Record (ELGA). It’s recommended to carry your e-card at all times, as it unlocks your universal access to the public system of hospitals, doctors, and treatment centers across the country, including Austria’s world-renowned health spas (Kuren). With the e-card, doctors and pharmacists can see what medications you take, helping them prevent adverse effects from incompatible medications. It also allows your doctor to upload prescriptions electronically, so you get recurring drug prescriptions hassle-free from your local pharmacy. While your data is protected, you can still choose to opt out of the ELGA system. You can access the ELGA portal any time to monitor your personal data. Another electronic ID all Austrian residents are recommended to get is the Mobile Phone Signature and Citizen Card (Handysignatur und Bürgerkarte). With this, you

can easily log into essential online services, such as filing your taxes or submitting bills

from private doctors to public insurers for partial reimbursement.

The back of the e-card also serves as the European Social Security Card, enabling the insured person to make use of medical services provided in other member states of the European Union.  

  • Employed persons or self-employed individuals, amongst others, are entitled to medical insurance.

→ Marginally employed workers are provided with medical insurance upon request.

  • Entitlement to unemployment insurance or emergency assistance or
  • Receiving retirement benefits
  • Receiving maternity pay or a childcare allowance.

As long as you are traveling in an EU/EEA member state and the doctor or clinic has a contract with your insurance provider, you simply show your e-card to get treatment. For many other countries, you need to bring an international treatment certificate. In some cases, such as Switzerland, the European Health Insurance Card (EKVK) on the back of your ecard is accepted. If you fall ill in a country outside of the EU/EEA, you pay for all costs, but can later apply for a small reimbursement, as long as you keep the invoice.

 

Co-insurance of relatives

In addition to the compulsorily insured people, the social health insurance system also protects their relatives. Whether insured via ÖGK, BVAEB, SVS or self-insurance, you are able to co-insure your dependents so they receive the same benefits as you, as long as they are also Austrian residents. An additional contribution may have to be paid in certain cases.

Relatives are considered to be the following family members whose place of residence is in Austria:

  • Spouse or registered partner
  • Children born in wedlock, legitimised and adopted children
  • Illegitimate children of a female insured person and, under certain conditions, illegitimate children of a male insured person
  • Stepchildren and grandchildren who live with the insured person in the same household
  • Foster children taken care of by the insured person at no cost, or if foster care is based on official permission
  • Under certain conditions, the life partner and relatives running the household
  • Specified related persons or persons related by marriage and life partners entitled to a care allowance (starting at Level 3) who, under certain conditions, are nursed by the insured person.

Co-insurance based on additional payments

In contrast to co-insured children, grandchildren and certain relatives, people related by marriage and life partners entitled to a care allowance (starting at Level 3) who are cared for by the insured person, the spouses, life partners and relatives running the household have to pay an additional social insurance contribution for the duration of the co-insurance.

This amounts to 3.4 percent of income (including bonus payments) or retirement benefits i.e. the specified contribution base of the insured person.

 

What's covered?

Austrian doctors are taught a holistic approach to treatment and will gladly recommend alternative treatments, such as traditional Chinese medicine, homeopathic medicine or treatment at a health resort (Kur). But what is covered by your insurance?

FACTS ABOUT AUSTRIAN HEALTH CARE

  • 2,558,049 Annual inpatient stays in Austria’s hospitals
  • 6 AVERAGE number of doctor‘s visits per person, annually
  • 26 AVERAGE prescriptions filled per person, annually
  • OVER 65,000 HOSPITAL BEDS, Austria has the fourth largest number among OECD countries
  • 84 years average life expectancy for women
  • 79 years average life expectancy for men
  • 99.9% of the population has health insurance
  • 79% of Austrians over the age of 14 consider themselves in good health
  • 10.4% of GDP spent on health care, one of the EU’s highest
  • 16% spent by the average person out-of-pocket; the rest is covered

 

Outpatient care

GENERAL PRACTITIONER (HAUSARZT)

GPs contracted with the public health insurers will provide you with primary care, including yearly health checkups, immunizations, blood work, and medical prescriptions (Rezept), as well as referrals (Überweisung) for specialized treatment, consultations with specialists and examinations such as allergy or radiology tests. You are free to choose a private GP for longer consultations for a fee. To find a doctor contracted with public insurers, look for Alle Kassen or Kassenarzt (see Health Infrastructure, p 190).

SPECIALISTS

Services offered by specialists are covered, but it is recommended to have a referral from your GP when making an appointment. The number of appointments you can have is not limited, but you may only see one specialist per specialty area every three months, and you may need a new referral for subsequent visits. Many people choose to see private specialists for more in-depth consultations, the costs of which are partially reimbursed by public insurance on a case-by-case basis.

BASIC DENTAL CARE

Public insurance covers necessary dental expenses such as white fillings, though this does not include regular cleaning. It also covers emergency treatments for pain and endodontic treatment, such as root canals or tooth removal. In these cases, anesthesia is included. Since July 2015, fixed orthodontic treatment for anyone under 18 years is covered, as long as it falls within the required treatment index.

EMERGENCY CARE

No emergencies will be turned away at an emergency room (Notfallaufnahme), but even-tually you will need to provide proof of coverage. When transported by ambulance in a case of emergency, all costs are covered by your insurer. However, if the receiving doctor finds that you were transported for a non-emergency, you will have to bear the steep cost of the ambulance service, starting at around €800, depending on the distance from the hospital.

MEDICATION, HEALTH AIDS AND THERAPEUTIC APPLIANCES

As long as you have a prescription (Rezept) and your drug is on a list of subsidized medications, a nominal fee of €6.50 is charged, unless you meet certain requirements to waive the fee. Over-the-counter drugs, supplements, and alternative medication are not subsidized. If prescribed by a doctor, up to €498 of health aids such as orthopedic shoes or visual aids, might be covered per year, with the insured person paying a 10% deductible.

CONTRACEPTION, FAMILY PLANNING, PREGNANCY AND BIRTH

All medical procedures related to childbirth, including planned or emergency C-sections, are covered by public insurance (see Pregnancy, p 195). However, public insurance does not cover the costs of contraceptives. Abortions are not reimbursed unless there is a medical reason, and costs range between €350 and €800, with potential additional costs, depending on the method of abortion used.

VACCINES

Austria offers free standard immunizations for children up to 15 years, which can be obtained through most pediatricians and general practitioners, or via your local district authority (Bezirkshauptmannschaft). Many vaccinations are mandatory for children and follow a strict schedule.

 

Inpatient Care

HOSPITAL STAYS

If you stay at a public hospital, your insurance pays for accommodation, food, care, medical examinations and treatment. The patient pays a modest daily contribution for this service. To stay at private hospitals, you must pay the bill yourself, although you might receive partial reimbursement. Medical transport services in the event of accidents, emergencies or an inability to get to the hospital yourself due to a medical condition, are usually covered, or at least partly reimbursed.

REHABILITATION AND PHYSICAL THERAPY

To be eligible for rehabilitation, a doctor must certify that a patient is a suitable candidate and establish a projected timeframe for recovery. Purely medical rehabilitation, defined as deriving from substance abuse, burnout, physical injury or surgery, is covered by public insurance for up to six weeks, apart from a daily fee between €8.90 and €21.63.

Experimental or non-essential medical therapies are not subsidized.

TREATMENT AT A HEALTH SPA

As a preventive measure (or in order to manage mild ailments), most insurers will help you foot the bill for a stay at a health spa (Kur), as long as certain medical requirements are met. Many people make use of a Kur to manage chronic stress, physical ailments, or a combination of both. If your application is granted, your stay is covered for up to three weeks, apart from a daily fee between €8.90 and €21.63.

END OF LIFE

There are 322 hospices and palliative care facilities in Austria. Many of these services are offered to patients at hospitals or to patients transferred to another facility. These can also be provided at home: There are roughly five dozen mobile palliative teams established across the country. These medical professionals help assure elderly and terminally ill patients will remain comfortable in their final days.

MENTAL HEALTH AND ADDICTION

Public insurance offers a range of mental health services free of charge through contract partners and at specialized facilities for drug rehabilitation, trauma, and ­eating disorders. Many hospitals also offer psychotherapeutic treatment free of charge. However, be aware that waiting times can be long.

If you consult a freelance psychotherapist, you are entitled to a partial reimbursement, as long as your chosen psychotherapist is covered by insurance and certain conditions are met. Most importantly, a mental disorder must be authenticated, and a medical examination must take place, at latest prior to your second therapy session. You can expect a minimum reimbursement of €28 to €65 per session, depending on your insurer — but the amount can be as high as 80% of the full cost. Fifty-minute session fees will vary from €70 to €200.

 

If you can’t afford therapy, you can contact the Social Psychiatric Clinic in your district and place your name on a waiting list. The complete cost will be covered by insurance but the wait time might be up to four months, and you do not have a choice of therapist.

Alternatively, you can call therapists and ask if they have an available insurance-covered space (Kassenplatz).

 

Supplemental Care

ALTERNATIVE MEDICINE

Although around 80% of Austrians avail themselves of at least one form of complementary or alternative medicine each year, most of it is not covered by public insurance. But some exceptions are made for homeopathy and pain alleviation measures, such as acupuncture, in the public health system. Medicinal cannabis is technically legal, but the law does not permit its sale in traditional dispensaries, and the costs are not subsidized.

LIFESTYLE MEDICINE

Preventive activities such as consulting a nutritionist, taking a specialized gym class, practicing mindfulness, yoga, or meditation, are, in most cases, not subsidized by your  insurer. However, if insured through SVS, you can apply for a €100 voucher once a year (SVS Hunderter) to help carry the costs of such activities, as long as you choose from a predefined list of partners.

PRIVATE INSURANCE

Patients with private insurance have access to additional health care providers and can access additional amenities and treatments. If you do not want to share a hospital room with other patients, or you plan to regularly consult private doctors, it makes sense to invest in supplemental, i.e. private insurance (Zusatzversicherung or Privatversicherung). Private insurance offers obvious perks, but there are some downsides. While public insurance does not discriminate, a private insurer will level charges depending on your age, medical history, and other risk factors. Monthly rates might range between €35 and €500, depending on your age when you first apply. Once you turn 64, you will not be able to get private insurance. Some patients also complain that once doctors know you are privately insured, they will overcharge for their services, for which you have to pay up front.

Accident insurance

Workers, employees, and students from kindergarten through university automatically have accident insurance (Unfallversicherung) through The Austrian Workers’ Compensation Board (Allgemeine Unfallversicherungsanstalt, or AUVA). Self-employed are covered through the SVS. For workers and employees, this only covers accidents that take place at work or on your way there, as well as any occupational illness you might suffer from. For students, any injuries with causal relation to education are covered. For university students, their citizenship and residence status determine coverage, as not all pupils have accident insurance. To receive increased support, you can apply for supplementary insurance, also through the AUVA.

 

Needs-based minimum benefits

Those who receive the needs-based minimum benefits (Bedarfsorientierte Mindestsicherung), which are monthly benefit payments for long-term unemployed people and those in need, also get an e-card and full access to health care free of charge.

 

Marginally employed workers are provided with medical insurance upon request.

Work accident insurance

There are several work accident insurers encompassed within the Association of Austrian Social Security Institutions

  • General Accident Insurance Institution (Allgemeine Unfallversicherungsanstalt) (AUVA)
  • Social Insurance Institution for the Self-Employed (Sozialversicherungsanstalt der Selbstständigen (SVS)
  • Austrian Insurance Institution for Public Sector Employees (Versicherungsanstalt öffentlich Bediensteter (BVA)
  • Austrian Insurance Institution for the Railways and Mining Industry (Versicherungsanstalt für Eisenbahnen und Bergbau (VAEB)

Benefits

Work accident insurance benefits are provided in cases of occupational accidents and diseases or the death of an employed person. These services include curative treatments, rehabilitation as well as compensation and services in case of death such as the payment of a survivor’s pension.

Pension insurance

A certain amount of your social insurance contribution goes toward your pension, managed by the Austrian Pension Insurance Fund (PVA). For people who do not plan to retire in Austria, it’s important to note that that pension will be paid out to you no matter where you are, and does not need to be cashed out upon leaving the country. To acquire the pension, you need to apply for it from your Austrian insurance agency, preferably before leaving the country. Once you reach retirement age, you may have your pension paid to you, or you can transfer it to another fund in the country you are moving to.

At present, the retirement age in Austria is 60 for women and 65 for men. According to Austrian law, EU and EEA citizens as well as Swiss nationals are entitled to retirement benefits, provided they were employed in Austria for a period of more than one year and were covered by pension insurance. If insurance contributions were paid for less than one year, this amount will be included in calculating the pensions the employees receive in other countries.


There are two main types of retirement pensions: standard old-age pension and early retirement pension. You are entitled to the former if you have reached the required age and have made regular required payments for at least 15 years. Men can, however, claim early retirement pension at 62 if they have worked and made insurance payments for 45 years. As a result, their pensions might decrease by 4.2% to 15% a year. Lastly, you can claim your pension insurance directly in Austria, even if some of your insurance period was spent in other EU or EEA Member States.

Further information: www.pensionsversicherung.at

 

Unemployment insurance

Unemployment insurance services such as unemployment benefits and emergency assistance are coordinated by the Public Employment Service Austria (Arbeitsmarktservice - AMS).

If an individual wants to claim entitlement to unemployment benefits from the EU/EEA area or Switzerland while searching for a job in Austria, the public employment service of the person’s country of origin is the right contact partner. The form U2 which includes the deadline for registering with the regional AMS office in Austria, the maximum duration of unemployment benefits and other information must be filled out by the person and confirmed.
After successful registration with the responsible regional office of the AMS in Austria, the public employment service of the person’s country of origin will be immediately informed about the registration of the applicant as a job seeker, which in turn can make the corresponding payments. If no job is found in Austria within the period of time stipulated on the form U2, benefits can only be granted in the case of an immediate and timely return of the person to her or his country of origin.

It is absolutely essential to take information provided by the country of origin into account.

Download info brochure

Concise information about living and working in Austria and the services of ABA - Work in Austria can be found in our info brochure for skilled workers.