Health Care in Upper Austria

 

General information

Regardless of whether you are self-employed or an employee, if you work in Austria you will automatically receive social insurance coverage (compulsory insurance).

As a result you are:

  • Medically insured
  • Insured against accidents
  • Insured for your retirement pension

From the first day of employment, you will have complete insurance coverage.

 

Consulting a physician

e-card
Should you (or your immediate family - spouse, children who are insured with you) wish to consult a physician, you will need an e-card. When the e-card is presented at an appointment with a physician, the cost will be covered by your insurance.  As a person with insurance coverage from a locally authorized health insurer (Gebietskrankenkasse), you are not subject to any costs for medical treatment aside from the yearly service fee of €10. Persons insured by other health insurance funds, such as those for the self-employed, are obliged to pay a percentage of the costs for various services. As an insured person, you will receive the e-card automatically by mail.

Gebietskrankenkassen OÖ (GKK) >>


 

 Forgotten your e-card?

Should you fail to produce an e-card when visiting a physician, the doctor is entitled to request a deposit, in order to ensure that the card is presented at a later date. Additionally, a deposit will be needed if you are not a regular patient at the respective practice. Once you have presented the e-card, the deposit will be returned.


 

Entitlement to services

Should you so require, you are entitled to use the services of one physician from each of the specialist groups (general practitioners, gynaecologists, opticians, dental surgeons, etc.) per quarter. You may receive as many treatments and consultations from this physician as medically required. However, you may only change from one physician to another within the same specialist group under exceptional circumstances. For example, this means that in the period between January and March (1st quarter) you may not visit two different opticians. Should your physician be absent, there will be a stand-in, who you may contact.


 

 Free choice of physician

As a patient you are basically free to choose your physician. Physicians that have a contract with your health insurance fund (e.g. the Upper Austrian Gebietskrankenkasse) are entitled to treat you and then clear the treatment fee with your insurer directly. This means that as a patient you do not have to pay the physician anything. 
In order to avoid excessive surgery waiting times, it is necessary to arrange an appointment in advance. Please keep this appointment and come on time. However, in the case of an emergency another patient will be given priority. Should you find youself unable to keep the appointment, please do not forget to cancel.


 

Private physician

You also have the option of going to a private physician, but this means that you will have to bear the costs. Once you are given an invoice of treatment costs, you may only receive partial compensation from your health insurer (for example by the Gebietskrankenkasse). Therefore, it is essential that you understand how much the treatment will cost before you receive it.


 
European insurance card (e-card) – stays in other countries

The reverse side of the e-card constitutes an official European Health Insurance Card. This is used when treatment by a physician is required during temporary stays in other countries and is valid in EU member states, EEC countries and Switzerland. For Bosnia-Herzegovina, Macedonia, Serbia, Montenegro and Turkey you should obtain a foreign treatment certificate from your employer or health insurance fund in advance.



All other countries

Basically, an insured person enjoys insurance coverage. However, cost compensation in line with Austrian directives and rates is only granted following the treatment in the other country and a related application for repayment after the patient’s return to Austria.  This means that a patient must pre-finance any treatment in a foreign country.

As a rule, every insured person who has uninterrupted insurance coverage for at least a year receives the European Health Insurance Card (reverse side of the e-card is completed in full). All other persons (reverse side of the European Health Insurance Card is filled with ***) can apply for a provisional replacement certificate from their employer or health insurance fund. They will then receive the same services.  



Physicians with foreign language skills

The Upper Austrian Medical Association provides information regarding the location of physicians who speak foreign languages >> (site is only available in German).



Medication, prescriptions

When your physician prescribes medication, he/she will write you a prescription. When you present a prescription at a pharmacy (completely filled out), you will receive the necessary medicine. You do not have to pay for the full cost of the medication (which can be very high), but merely the € 5.15 prescription fee, which is paid directly to the pharmacist.



Prescription fee exemptions

Should your monthly net income not exceed the following sum, you may apply to the health care insurance fund for a prescription fee exemption:

  • € 872.31 for single persons
  • € 1,307.89 for married couples

Detailed Information >> (site is available in German only)

Sign of pharmacies in (Upper-) Austria

This sign indicates the presence of a pharmacy.  It can be found on the exterior of the pharmacy building.

You can find the addresses of the pharmacies that are open at night, on weekends or on public holidays in a current edition of a local daily newspaper. You can also find a list of pharmacies here >>. If you go to a pharmacy at night, on the weekend or during a public holiday, you must pay an additional fee of  € 1.30 (during the daytime) or € 3.80 (at night, from 8 pm to 8 am).

Stay in a hospital

When you are admitted to a hospital please take along your green social insurance card/e-card, as well as a letter of referral should you have one. Your health insurance covers almost all of the costs of your hospital stay, with the exception of a small fee.


 Outpatient treatment

There are various specialist departments in hospitals (e.g. accident; ear, nose and throat and dental outpatients departments) that will allow you to return home once treatment has been completed. However, following your treatment in a hospital you may have to attend an outpatients department. Your physician may also send you to the outpatients department of a hospital for further examinations. The outpatients departments of admitting hospitals are also open on weekends and on public holidays. Please have your e-card ready for admission.


 Notification of sickness for employed persons

If you are unwell and unable to work, you must inform your employer and then see a physician. A retroactive notification for more than one working day is only possible in exceptional cases and therefore you should always consult a physician immediately! You will then receive a certificate stating that you are unable to work as a result of illness. The obligatory notification of illness is sent directly to the health insurance fund.

Once you are better, the health insurer will require notification of your recovery. The physician treating you is responsible for providing it. However, you can also give notice that you are in good health (for example in case of the Gebietskrankenkasse, you can provide this notification online via the Internet using the “Gesundmeldung” form  >> (notification of medical discharge).