Austrian Health System

Krankenkasse

Austria has a national health-insurance system known as the Krankenkasse (KK), which is part of a comprehensive Social Security system (Sozialversicherung) that also includes accident insurance, workmen’s compensation, and a pension plan. There is a national umbrella organization, with several smaller funds based on geography or occupation. Those insured by the KK should know the name of their fund (Kasse) as the benefits and entitlements are different with each fund. Most people in Vienna are insured by the Vienna Health Insurance Agency (Wiener Gebietskrankenkasse or WGKK).

Participation in the KK is compulsory for everyone working in Austria with a "regular" employment contract, those working in certain professions, and those with a trade license (Gewerbeschein). The premium for coverage is a set percentage of a person’s salary (with half to be paid by the employee and half by the employer). Employees of the United Nations and other international organizations can choose between the KK and private health insurance.

Anyone, regardless of citizenship, who is a permanent resident of Austria and is not insured under a program of the Austrian Social Security system (i.e., through employment) can still join the Austrian health insurance plan. If you’re interested, you should apply at the Health Insurance Agency (Gebietskrankenkasse) in the province (Bundesland) where you live (in Vienna, contact the WGKK). If your are self-employed, unemployed, or in school, this is called self-insurance (Selbstversicherung). The premium may be increased if and when Austrian Social Security contributions are increased, though it may also be reduced in cases of individual hardship, upon application. For more information, ask your employer or the WGKK.

The e-card

Once you have joined the KK you will receive an e-card for each insured family member (babies and children have their own cards). The e-card serves as the patient’s proof of claim with the physician (or dentist) and replaces all forms of the traditional health insurance vouchers (Krankenscheine), which were phased out in 2005.

You must produce your e-card at a doctor or hospital visit so that the services can be recorded and the doctor paid accordingly by the Krankenkasse. Patients must show their e-cards whenever visiting their doctor. When reading a card, the doctor checks via a secure data network — the so called health information network — if a person is insured and which health insurance institution will pay for the medical treatment. This data is not stored on the card, but is requested online from the e-card system. The e-card can be used for general doctors (praktische Arzt), specialists (Facharzt), or at the dentist (Zahnarzt). The e-card states your social security number (Sozialversicherungsnummer) which is important to remember or keep a note of as it is often needed on forms. The format of the social security number is XXXXddmmyy, where XXXX is a four digit number and ddmmyy is the insured person’s date of birth.
 
On the reverse of the e-card is the European Health Insurance Card (EHIC). The EHIC replaces the international health insurance voucher (form E111) for the claim of medical treatment during temporary visits (e.g. holiday) in member states of the European Union, the European Economic Area, and Switzerland.

If your doctor feels it is necessary to refer you to a specialist (or you need to see more than one specialist within a three-month period) or to send you for further tests, he/she will issue a referral voucher (Überweisungsschein) which must be presented for treatment within two weeks of its issuance by your doctor. All laboratory tests and prescriptions have to go through a physician.

When you visit a doctor during regular consultation hours (Ordination), you may have to wait a long time, even for a short visit. To make the most of your appointment, get to the point quickly and have all your questions written down. The KK pays doctors very little per patient so their income is based on the number of patients they see.

Krankenkasse Benefits
In addition to doctor’s visits, the KK offers extensive benefits – the most important of which are the following:

 Annual physical examination
 Hospital treatment
 Maternity leave
 Medical or therapeutic devices
 Medication
 Payment during sick leave
 Treatment in other countries

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Private Medical Insurance

Many Austrians have private insurance (Nebenversicherung, Zusatzversicherung) along with the KK to cover additional benefits or costs such as special care (Sonderklasse) in a hospital, or to see a private doctor who doesn’t have a contract with the KK. There are numerous Austrian insurance firms that provide such coverage at various levels, either as part of a group insurance plan organised by your employer (as with the KK, half the premium is paid by the employer, half by the employee) or as a self-insurance plan.

Making a Doctor Appointment

The Austrian medical system is unlike other countries where one visits a single General Practitioner for the full spectrum of ailments and checks. Depending on what you need to see a doctor about, you go directly to a specialist doctor or to a general practitioner (praktischer Arzt) if it is for something for which there is no specialist. Women see a gynaecologist for regular checks and during pregnancy; once the baby is born he/she is taken to a paediatrician for checks and when ill. There are also specialist for orthopaedics, eyes, internal medicine, urology, and many more, which can be quite daunting when you open up the yellow pages (Gelbe Seiten) to look up a doctor.

A good starting place is the doctors search tool on the Ärtzekammer Für Wien - Praxisplan website which allows you to search by a number of criteria to find a suitable doctor. For gynaecologists pick “Frauenheilkunde und Geburtshilfe” in the Fachgebiet (specialist area) field or “Kinder und Jugendheilkunde” for a paediatrician. You can also ask around the Vienna Babies Club for a recommendation. We have a limited list of our members’ gynaecologists and pediatricians. Members may also use the e-mail Notices service to ask for recommendations.
 
The words "alle Kassen" indicate that they accept all Austrian Kassen (the alternative being that they may accept patients of a particular KK only) and "keine Kassen" means they only consult on a private patient basis. Doctors who are under contract to the KK may still see patients privately, which usually means shorter waits and longer consultations for the patient. When you call for an appointment, you should specify that you want to be seen as a private patient.

If you need to make an appointment, look for the word "Voranm" an abbreviation of Voranmeldung, in the doctor’s telephone-book listing. Most doctors also list their regular consultation hours (Ordination or Ord) when they see patients on a first–come-first-served basis. Many now have telephone recordings switched on after office hours that state consultation times.

If you’re covered by the KK, but wish to consult a doctor who is not under contract to the KK, it’s still possible to have your lab work, X-rays, etc. done through the KK by having your general practitioner (prakitscher Arzt) with the KK affiliation rewrite the prescriptions. It is also possible for patients with only Krankenkasse insurance to visit a private doctor and apply to the KK with proof of payment of their bill (Honorarnote) for which the KK may partially reimburse you, depending on the services the doctor provided. Consult your private doctor for details.

After Hours

If you need to see a doctor after hours and in a non-emergency situation, the first point of call is your own doctor, pediatrician, etc. Most Krankenkasse doctors will only see patients during office hours (Ordinationszeiten). Private doctors often give patients their mobile number so they can be contacted outside their normal office hours. If the office is closed and you want to see a doctor, you should either drive to a hospital or visit one of the Ambulanzen. An Ambulanz is a clinic within a hospital for outpatients and non-patients, many of which are open 24h. If you’re not sure which hospital to go to, the AKH is the best bet.

If you do not want to or cannot drive yourself, you can call for a Krankentransport ambulance which a staffed by highly qualified paramedic. The difference to the 144 Rettung number is that no paramedic is sent out with the ambulance – 144 should only be called in real emergencies. There are three organisations which you can call for transport to hospital. These are Rotes Kreuz, Samaritaner Bund, and Johanniter/Malteser. Which one you call is up to you. The location of their central ambulance stations are listed, so it may be advisable to call the one closest to you, if time is of the essence.

For a comprehensive list of phone numbers useful in emergencies, visit our Emergency Numbers page.

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