There are three areas of social insurance in Austria, health, accident, and pension insurance. Anyone who is covered by the state insurance system will be covered by at least one of these branches. The job you are employed in determines the amount you pay in contributions and the level of social insurance available to you. Basic health and dental treatment, specialist consultations, stays in public hospitals and medication are covered for all employees. Family dependants are automatically covered through the insurance of the employed family member.
All employers must register their employees with the district health insurance fund known as the Gebietskrankenkasse within 7 days of starting work. Employees and employers pay equal sums into the healthcare fund. Dependant family members are covered by the contributions paid by employed family members. If you are self-employed, you need to get additional insurance to cover members of your family. Children who are studying at a university are covered through their parents insurance until their 28th birthday or until they complete their studies, if this is sooner. All other groups must register themselves with their local Gebietskrankenkasse, situated in all towns and cities. The state pays for the care of vulnerable groups like the disabled.
All Austrians entitled to use the state healthcare system are issued with an e-card from the Gebietskrankenkasse. This has replaced the former paper-based system of health insurance vouchers, which were called Krankenschein.
The e-card system has allowed the Austrian Social Security system to monitor all health claims electronically. The card has revolutionised the state healthcare system by removing the bureaucratic barriers that existed before. Today, the e-card acts as the patients proof of a claim with the doctor or dentist and can be used as a Citizen ID card because it contains an electronic signature and a person’s personal data including their date of birth and social security number.
When you visit the doctor, you need to present your e-card. Patients can only consult doctors who have contracts with the social insurance fund and this should be checked when you make an appointment as some doctors treat privately insured clients only. You can recognise physicians who accept state payments usually by a sign saying Kassenarzt or Alle Kassen displayed in their surgery. In case you are treated by anyone other than a Kassenarzt, you will have to pay the fees yourself.
Waiting times to see doctors vary and it is recommended that you make an appointment in advance. If you need urgent help, you may go to the doctors surgery on speculation, but be prepared for a long wait.
Under Austrian law, public and private hospitals have to treat patients in an emergency no matter what their insurance status is. However, once your condition is stabilised they will want proof of your insurance status. Emergency treatment is provided at the emergency room of all hospitals and is known as the Notaufnahme.
Austria has a network of state-maintained public and privately owned hospitals. Most people use the General Hospital, which deals with a wide variety of disease and injury. All state run hospitals are open to all insured patients, including private. Patients are admitted to hospital either through the emergency department or through a referral by their doctor. Once a patient is admitted treatment is controlled by one of the hospital doctors.
The quality of hospital rooms varies according to the quality of a person’s health insurance scheme. Privately insured patients will get a single or double room. State insured patients may have to share with two or three other people. In some hospitals, some of the nursing is done by qualified nuns.
Austria has an excellent state funded (but by no means free) immunisation programme. There is a mass vaccination programme for tick-borne encephalitis, which is a major risk in forested areas from spring to autumn. The injection provides protection for up to three years.
Old age pensioners are also entitled to immunise against influenza and pneumonia and children receive a high standard of immunisation care.
Vaccinations are conducted at a doctors surgery, they are not compulsory and citizens may have to pay a fee.
Hospital fees are expensive and are paid for either by the individual or their insurance company. Even in the case of an emergency, treatment is free to stabilise the condition, but as soon as the patient is admitted into hospital, fees will be incurred and patients can decide against inpatient stays if they so wish.
The Gebietskrankenkasse pays the most of the prescription costs directly, but there is a small additional fee for each drug, which the patient has to pay. This is known as the Zuzahlungspflicht, and it is currently 4.45 euros. Patients who use a private health care scheme must pay for their medication and then send their receipts to their insurer for reimbursement.
Dispensing chemists known as an Apotheke sell medicines in Austria. Drugstores called Drogerie, only sell toiletries, herbal remedies and a range of self-administered tablets like vitamins.
A prescription is known as a Rezept and can only be given by a doctor or specialist consultant. Austrian law is very strict about the prescription of medicines and many medicines that are available over-the-counter in other countries, must be prescribed by a doctor, this even includes some painkillers. It is very difficult to find in well-known international brands and chemists are often likely to encourage buyers of over-the-counter medicines to use an herbal alternative.