Health insurance , also known as health insurance in Austria , refers to the health insurance provider . Health insurance companies fully or partially cover the costs of therapies in the event of illness , maternity , and often after an accident and are part of the respective health system and the respective social insurance .
The health insurance companies as corporations under public law and as part of the health and social insurance system in Germany are to be distinguished from the health insurance companies as private companies. Special forms are the Postbeamtenkrankenkasse and the "Krankenversicherung der Bundesbahnbeamten" (KVB) as well as the Bayerische Beamtenkrankenkasse (private health insurer).
Health insurance companies are legal entities under private or public law that do not pursue a profit-making purpose, mainly operate social health insurance and are recognized by the Federal Department of Home Affairs.
The health insurance companies are legally regulated in the Federal Health Insurance Act (KVG) ( Health Insurance Act ).
The health insurance companies have to organize themselves as an association, foundation, cooperative or stock corporation with a non-economic purpose.
Institutionally, the health insurances (in the compulsory health insurance ) are supervised by the Federal Office of Public Health (BAG).
Main and secondary tasks
The health insurance companies mainly operate social health insurance (compulsory insurance). However, the health insurance companies are free to offer additional insurance (e.g. preferential treatment, higher hospital comfort, dental services, complementary medical services) in addition to social health insurance. They can also operate other types of insurance (e.g. death benefits and disability benefits) to a certain extent. Finally, health insurances with a certain minimum number of insured persons are also allowed to carry out reinsurance.
In particular, a health insurance company must implement social health insurance according to the principle of reciprocity and guarantee equal treatment of the insured. She may only use the funds of the social health insurance for their purposes. It must have an organization and management that ensure compliance with the statutory provisions. It must be able to meet its financial obligations at all times. It has to carry out an individual daily allowance insurance in accordance with the Health Insurance Act and has its registered office in Switzerland. Finally, it must also offer social health insurance to persons subject to compulsory insurance who live in a member state of the European Community, in Iceland or in Norway, unless the Federal Council exempts it from this obligation.
A total of 52 health insurers (approved health insurers for the premium year 2018 according to the list of approved health insurers from the Federal Office of Public Health) are currently approved in Switzerland, but some of them only operate regionally. See the list of approved health insurers in Switzerland .
In Austria, the health insurance providers are the responsible health insurance companies. The contribution rate is currently for Dependent 7.5% (including additional contribution and supplementary contribution) and is divided between employee and employer (for employees: DN: 3.65% DG: 3.75%; in workers: DN: 3.95% DG: 3.55%; for agricultural workers: DN: 3.8% DG: 3.7%). The contribution rate for public employees is 7.8% (DN: 4.2% pensioners 4.75% DG: 3.6%). The contribution rate for the self-employed is 9.1%, for farmers 7.5%. Pensioners pay 4.95%. The maximum contribution basis is € 3840 per month, € 53,760 per year (including two special payments; as of 2007).
The individual carriers are:
- Österreichische Gesundheitskasse : All non-self-employed persons and pensioners who are not insured in one of the other health insurance companies. It emerged from the merger of the new regional health insurance funds and the company health insurance funds in Kapfenberg, voestalpine Bahnsysteme, Mondi and Zeltweg.
Insurance company for public employees, railways and mining (BVAEB) : The following groups of people are insured with it:
- Persons who are employed under public law,
- Persons who, through election or posting, exercise a state function (politicians),
- Federal contract employees whose employment relationship was established after December 31, 1998.
- Contract employees of the federal states, municipal associations and municipalities whose employment relationship was established after December 31, 2000,
- University employees according to the Universities Act 2002,
- Persons who receive a retirement or pension benefit or a pension after such an employment relationship or such a function (pensioners),
- the employees of the public railways (ÖBB, private railways, etc.),
- those employed by the company's own operations and auxiliary facilities (e.g. Bodensee-Schifffahrt of the ÖBB),
- Employees of sleeping and dining car companies,
- Employees of the insurance company for railways and mining,
- certain pension recipients, recipients of an ASVG pension, if this is paid by the VA and recipients of an ongoing cash benefit from one of the pension institutions named in § 479 ASVG,
- Pension recipients of a pension from the employee pension insurance if the VA was or would have been responsible for the health insurance in the last employment before the pension entitlement,
- as well as recipients of a rest (pension benefit) from the pension office of the ÖBB, miners' or equivalent companies,
- the employees of Wiener Linien (formerly the company health insurance fund Wiener Verkehrsbetriebe),
- all apprentices and
- all free employees.
- Social insurance institution for the self-employed : responsible for the self-employed and freelancers, as well as pension recipients according to the GSVG and those who are self-employed in agriculture and forestry in Germany and their full-time relatives as well as for pensioners according to the BSVG.
- The various health care institutions .
All health insurance companies are grouped together in the main association of Austrian social insurance agencies. The federal states of Upper Austria, Tyrol and the municipalities of Vienna, Salzburg, Graz, Innsbruck, Bregenz, Villach, Wels, Steyr, Baden, Hallein maintain their own institutions for their employees (civil servants / contract employees), the health care institutions (KFA). These do not belong to the main association.
The last five company health insurance funds in Austria were dissolved at the beginning of 2020 and transferred to the Austrian Health Insurance Fund or the Insurance Company for Public Employees, Railways and Mining (BVAEB) .
In Belgium, too, membership in one of the health insurance companies is compulsory. The following health insurances can be chosen freely:
- Christian health insurance
- Liberal health insurance
- Free health insurance
- Neutral health insurance
- Socialist health insurance
The health insurers also offer voluntary and additional insurance.
In addition, the Aid Fund for Health and Disability Insurance (HKIV), a public institution, fulfills the same function as the health insurance companies in the context of compulsory insurance. Persons belonging to the statutory staff of the NBGE can also choose the Health Care Fund of the National Society of Belgian Railways (NGBE).
- Central association of statutory health insurance on gkv-spitzenverband.de
- Federal Office of Public Health on bag.admin.ch
- Swiss Association of Health Insurers on santesuisse.ch