Healthcare In Austria: Free Or Fee-Based System?

Austria's healthcare system is considered one of the best in Europe, providing universal coverage and high-quality care. It is a two-tiered system, with publicly funded healthcare covering 99% of the population, and a private option available for those who want it. Healthcare is free for pensioners, spouses of workers, those on unemployment benefits, and people unable to work for other reasons. For everyone else, a small contribution is deducted from their salary for public healthcare.

Austria's two-tier healthcare system

The first tier of Austria's healthcare system covers 99% of the population, 75% of which is funded by public taxes. This tier includes universal medical coverage for residents of Austria and those from other EU countries. All insured persons are issued an e-card, which is presented when visiting a doctor to receive medical services without advanced payment. The e-card also allows for the digitisation of health claims and can be used for electronic signatures.

The second tier is supplementary private health insurance, which offers additional benefits such as shorter waiting times, access to exclusive physicians, private rooms, and more flexible visiting hours. In 2010, it was estimated that 130,000 individuals chose to pay for private healthcare.

The public healthcare system in Austria is comprehensive, covering virtually all health care needs, regardless of age or background. It includes cover for hospitalisation, outpatient care, rehabilitation services, maternity services, and prescription services. Basic healthcare in Austria is free and includes treatment in public hospitals, medication, basic dental care, and some specialist consultations.

Private health insurance in Austria is generally used to complement the public health services. It provides access to additional services, such as dental care, alternative medicines, and wellness programmes that may not be available under the public system. Private insurance also offers more flexibility, allowing individuals to choose their physicians and providing access to smaller wards in state and private hospitals.

Austria's healthcare system is funded by government spending and social health insurance, with employees contributing 3.87% of their net income. While medical insurance is only mandatory for selected groups, others can voluntarily sign up for public or private insurance.

Public vs private healthcare

Austria has a two-tier healthcare system, with a public health service and a large network of private healthcare providers. The public system is funded by the government and social health insurance, with employees contributing 3.87% of their net income. Medical insurance is mandatory for residents earning an income in Austria, but others can sign up voluntarily.

Public Healthcare

The public healthcare system in Austria is inclusive and comprehensive, covering virtually all health issues and medication requirements. It is available to Austrian citizens and EU/EEA citizens. It is also accessible to students from EU/EEA countries or Switzerland with national health insurance in their home country, who can use the European Health Insurance Card. Self-insured students pay around €50 per month.

Public healthcare covers four areas: illness, maternity, precautionary, and therapeutic aid. It includes doctor visits, mandatory vaccinations, hospital and emergency care, and dental check-ups. However, there may be small co-payments for some health services, such as prescription medications and hospitalisation.

Enrollment in the public healthcare system is generally automatic and linked to employment. It also covers spouses and dependents, pensioners, students, the disabled, and those receiving unemployment benefits. The cost of public insurance is based on income, not individual medical history or risk factors.

Private Healthcare

Private healthcare in Austria offers additional benefits, such as shorter waiting times, access to exclusive physicians, private hospital rooms, and more flexible visiting hours. It is a good option for those who want faster access to specialised treatments or require chronic or serious illness care. Private insurance also covers travel and dental care, gym memberships, and a range of physicals and check-ups.

The average cost of private health insurance in Austria is approximately €220 per month, varying based on age and plan features. Private insurance is a lifelong contractual relationship, and insurance companies cannot impose restrictions or terminate coverage without the individual's permission.

Who can access healthcare in Austria?

Austria's healthcare system is inclusive and accessible to all. Healthcare is considered a fundamental right in the country, and Austria's public healthcare system covers 99% of the population.

Public Healthcare

Public healthcare in Austria is available to:

• All Austrian citizens
• EU/EEA citizens
• Students from EU/EEA countries or Switzerland with national health insurance in their home country (using the European Health Insurance Card)
• Foreigners with a valid residence permit, including foreign workers, international students, and foreign pensioners
• Asylum seekers, refugees, and those without legal residence
• Spouses and underage dependents of employed individuals ("co-insured" persons)
• Self-employed workers (although they are not automatically enrolled)

Private Healthcare

Private healthcare is available to anyone who wishes to purchase it as a supplement to their public insurance or as an alternative if they are not covered by public insurance.

How is Austrian healthcare funded?

Austria's healthcare system is funded by a mix of compulsory social health insurance (SHI) contributions and general tax revenues. Income-related SHI contributions make up about 60% of publicly financed health expenditures, while the remaining 40% comes from general taxation.

The SHI funds are managed by the Main Association of Austrian Social Security Institutions (HVB), which pools the contributions and allocates them to SHI funds for payment of healthcare providers.

The federal government is responsible for the legislative framework, including the regulation of SHI. The federal aspect of the system is handled by the Federal Ministry of Labor and Social Affairs, which develops the framework for the services offered and manages the sickness insurance fund (Krankenkasse) that funds the healthcare system.

The states (Länder) also contribute to the health budget and regulate hospital care within their jurisdictions. They are primarily responsible for the organisation and financing of inpatient and outpatient care in hospitals.

While the public sector offers almost universal medical coverage, many residents choose to take out private health insurance to access better care more quickly.

The quality of Austrian healthcare

Austria's healthcare system is considered to be of excellent quality. In a 2015 ranking by the World Health Organization (WHO), it was placed 9th in the world. The Legatum Prosperity Index of 2023 ranked Austria 22nd in the world for healthcare, with a score of 80.2/100. The same year, the Euro Health Consumer Index placed Austria 12th in Europe, noting that the country's lack of public abortions impacted its ranking.

Austria's healthcare system is also highly accessible. The country has a relatively high density of hospitals and physicians. In 2011, there were 4.7 physicians per 1000 people, which is slightly above the European average. In 2021, Austria had the second-highest density of doctors in the EU, with 5.4 doctors per 1000 residents.

The Austrian healthcare system is also decentralised, with each of the nine states and the federal government having specific legal limitations and roles. The federal aspect, the Federal Ministry of Labor and Social Affairs, is responsible for developing the framework for the services offered and handling the sickness insurance fund, which funds the healthcare system. The states manage hospitals and emergency care in their areas.

The Austrian healthcare system is considered inclusive, covering virtually all health issues and medication requirements. It also protects the spouses and children of those covered by the worker's medical insurance.

However, there are some drawbacks to the Austrian healthcare system. Firstly, there are long waiting times for public health insurance patients, especially for elective surgery. Additionally, hospital rooms can be shared by up to eight or nine patients. Moreover, while prescription costs are relatively low for medicine on the "positive list", they can be expensive for other medications.

Frequently asked questions