How healthcare works in Austria for foreign residents

Austria's healthcare system is built on social health insurance. Almost everyone who works in Austria is insured automatically, and that insurance pays doctors, hospitals and medicines directly. For Americans used to networks, deductibles and explanations of benefits, the Austrian system is simpler in some ways and confusing in others: there are two kinds of doctors, a chip card that replaces most paperwork, and small fixed charges in place of copays. This guide explains how it works, based on the Austrian Health Insurance Fund (ÖGK), the federal portal oesterreich.gv.at and the Ministry of the Interior's migration portal.

Who is insured

The migration portal explains that compulsory health insurance covers:

• almost everyone in paid employment;
• most self-employed people;
• people receiving unemployment benefits;
• pensioners;
• the dependants of all these groups.

Anyone can also take out voluntary cover. For most American employees, insurance starts with the job: the employer registers you, contributions come out of your pay, and you become a member of a public health insurance fund. For most private sector employees, that fund is the ÖGK.

### Dependants

Insured people and their dependants are entitled to benefits. The migration portal lists spouses, registered partners and, under certain conditions, life companions, along with children up to 18, up to 21 if not employed, and up to 26 if studying. Children are covered free of charge, and so are spouses and partners in families with children. Special rules apply to childless spouses, whose inclusion carries a charge.

### If you are not employed

Retirees, people living on savings and others outside the compulsory system can apply for ÖGK self-insurance. In 2026 the monthly contribution is €565.25. It covers benefits in kind, not cash benefits, and spouses and children can be co-insured.

### Insurance and your residence permit

Health cover is also an immigration requirement. The migration portal lists health insurance that covers all risks and is valid in Austria among the general requirements for settlement permits. If you are employed, your compulsory insurance satisfies this. If you are applying as a retiree or as a self-supporting person, you need to show cover yourself, which is where ÖGK self-insurance or a suitable private policy comes in. Because self-insurance can involve a waiting period before benefits start, check the timing against your application before relying on it.

The e-card

Your proof of insurance is the e-card, a chip card issued to everyone insured and to their dependants. The federal portal explains that it also gives access to the e-card system and ELGA, the electronic health record. The front shows your name, your social insurance number, the e-card service line (050 124 3311) and the 1450 health hotline.

New or replaced e-cards issued since January 1, 2020 carry a photo for anyone aged 14 or over. Most people do not have to do anything, because the photo is taken from existing government registers, such as an Austrian passport or ID. As a US citizen, you probably have no Austrian photo on file, so you may be asked to bring a photo to a registration office. The portal recommends doing this three to four months before your card expires.

There is an annual service fee of €25 for 2026, collected through your employer and due on November 15 of the previous year. People in social need can apply for an exemption.

Two kinds of doctors

### Contracted doctors

Many doctors have a contract with the ÖGK (Vertragsärzte). The ÖGK explains that they bill the fund directly, so if you are insured with the ÖGK and show your e-card, you pay nothing extra for most treatments. These include doctors in their own practices, group practices, primary care units, contracted hospital outpatient departments and the ÖGK's own health facilities. In some cases you need a referral as well. The ÖGK website has a search to find contracted doctors near you.

The advice from the ÖGK is short: always bring your e-card.

### Private doctors

Doctors without a contract (Wahlärzte) set their own fees. You are treated as a private patient and pay the bill first. You can then ask the ÖGK for a refund, either directly or through the doctor.

The ÖGK generally reimburses 80 percent of what it would have paid a contracted doctor for the same service, never more than you actually paid. It notes plainly that you rarely receive 80 percent of your bill, because private doctors usually charge more than the fund's rates.

Since July 1, 2024, private doctors who treat at least 300 patients a year must submit refund claims for their patients through the WAHonline system. You still pay the bill first, but you only need to tell the doctor which bank account should receive the refund. If you submit a claim yourself, the ÖGK needs:

• the paid invoice with treatment details, dates, duration and diagnosis;
• your personal data, including your social insurance number;
• the doctor's stamp;
• proof of payment.

You can also file through the Meine ÖGK app. The ÖGK will not reimburse if you saw a private doctor and a contracted doctor of the same specialty in the same calendar quarter, and if you see several private doctors of the same specialty in a quarter, it reimburses only the first invoice submitted.

Medicines

Doctors issue prescriptions, and pharmacies dispense them. The migration portal gives the 2026 prescription charge as €7.55 per item. People whose income is below a set minimum can apply for an exemption.

Hospitals

Hospital treatment is covered, but the migration portal notes that patients pay a daily contribution for each day spent in hospital. Some services are paid by patients themselves, such as private hospitals, orthodontic treatment and dental bridges, with part of the cost refunded by the health insurance fund.

Sick leave

If you cannot work because of illness that is not your own fault, your employer normally keeps paying your salary for up to 12 weeks, according to the migration portal. After that, the health insurance fund pays sickness benefit until your incapacity ends, though it is lower than your salary. Long-term care needs are covered separately through a care allowance with seven levels.

When you need help fast

• 1450: the health hotline for advice when you are unwell and do not know where to go.
• 144: ambulance.
• 141: doctors' on-call service outside office hours.
• 112: the European emergency number.

Practical steps for newcomers

1. Confirm your employer has registered you with social insurance; you will receive your social insurance number.
2. Watch for your e-card in the mail; arrange a photo if asked.
3. Find a contracted family doctor near you through the ÖGK search.
4. Save 1450 in your phone.
5. Keep paid invoices from private doctors and submit them, or check the doctor uses WAHonline.

Common questions

Do I pay to see a doctor in Austria? Not for most treatments with a doctor who has a contract with the ÖGK, as long as you show your e-card. Private doctors bill you first.

How much does the ÖGK refund for a private doctor? Generally 80 percent of what it would pay a contracted doctor for the same service, never more than you paid.

What does a prescription cost in Austria? The prescription charge is €7.55 per item in 2026, with exemptions for low incomes.

What number do I call if I feel sick at night? Call 1450 for health advice, 141 for the on-call doctor, or 144 for an ambulance in an emergency.