Compulsory health insurance
Compulsory health insurance applies to
- almost all those in paid employment (see also section on kinds of employment)
- most self-employed persons
- persons claiming unemployment benefits
- dependants of all these groups
Anyone can seek voluntary cover for health and pension insurance.
Patients themselves must pay for a few services (e.g. treatment by private doctors, in private hospitals, orthodontic treatments, dental bridges, etc.). However, part of the costs will be reimbursed by their health insurance fund (Krankenkasse).
In the event of hospitalisation, a certain sum is payable by the patient for each day spent in hospital.
Insurance of dependants
In Austria, both insured persons and their dependants are entitled to benefits. These are:
- spouses, registered partners and – under certain circumstances – life companions
- children up to age of 18
- children up to age of 21 if not in employment
- children up to age of 26 if following a course of study
Children can be included in the insurance free of charge. This also applies to spouses, registered partners and life companions in families with children.
Special provisions apply to childless spouses; inclusion in the insurance is subject to a charge.
The insured and his/her dependants are entitled to receive medical care from a general practitioner, specialist or dentist who has a contract with the health insurance fund. A list of such doctors is available from the health insurance fund.
Medicines are prescribed by the practitioner and dispensed at pharmacies. One has to pay a prescription charge of € 5.85 (2017) per item. One can claim exemption if one’s income falls below a certain minimum amount.
There is an annual charge of € 11.35 for the E-card (social insurance card) (exceptions apply).
If an employee is unable to work owing to an illness that is not the result of his/her own negligence, the employer will normally continue to pay his/her wages/salary for up to twelve weeks.
After that, sickness benefit will be paid by the health insurance fund until the incapacity for work has been certified as ended. Sickness benefit does not correspond to the amount of the wage/salary.
Persons requiring long-term care as a result of illness or disability are eligible for a care allowance. Applications for care allowance must be made to the relevant health insurance fund. Depending on the need for care, a distinction is drawn between seven different levels of care.