Health insurance in Austria

from Wikipedia, the free encyclopedia

The health insurance in Austria shall reimburse the insured the cost (fully or partially) for the treatment in diseases in maternity and often by accident . It is part of the health and social security systems .

Financial flows in the Austrian healthcare system
      Bonuses → Private insurance   Special services    
                             
                        Catalog services ( after DRG )      
        Contributions → Health insurance (
compulsory insurance) 		         
                         
        Taxes FA →                        
          → BM (Fin) countries → BGA          
       
                Art. 15a BV-G   ↓ budget   ←      
Country Fund (
LGF) 		   
                →   →          
             ↓    
population   Deductibles   Fund KA ←                  
     
 AN , AG (←) → ←   fee   ←    
        Private KA                
    some deductibles *   ← PRIKRAF ←      
     
              Expense coverage        
or. (←) → Outpatient clinic ←        
                   
    some deductibles *           Flat rate
+  individual services 		       
  (←) → (practicing)
doctor 		←        
          Exp. f. Drugs
+  of pharmacy services 		 
    Prescription fee **                          
patient (←) → pharmacy ←        
                   
    ↑                        
        reimbursement        

(Fin) Ministry of Finance distributes the budget for the Ministry of Health ;
* flows directly to KV carriers;
** flows via pharmacy to health insurance providers;
(←) partly direct reimbursement or exemption for mandatory verse.
Reds: Government Sector,
Yellows: Private Sector

Diagram according to Ziniel (2005)

Types of insurance

There are two types of health insurance in Austria:

  • Compulsory insurance or statutory health insurance (guarantees the necessary medical treatment)
  • private additional insurance (additional services, such as single room)

Compulsory insurance

Statutory health insurance expenditure (2012)
breakdown in billions of euros in %
Medical help 4,568 30.1
Institutional care 4,446 29.3
Administrative burden 0.430 2.8
drug 3.005 19.8
Remedies 0.240 1.6
Other expenses 2,500 16.5
Total expenses 15,189 100.0
Sources: Social insurance, Austrian Chamber of Pharmacists

In Austria, health insurance is compulsory for people with a legal income or their families. Every employed person is also insured if the income exceeds the marginal earnings threshold (2018: € 438.05 per month). Compulsory health insurance is prescribed by the General Social Insurance Act (ASVG) and in other special laws, B-KUVG, GSVG, BSVG, NVG. Certain relatives such as spouses and children are also insured against an additional contribution (Sections 123, 51d ASVG). In addition, the unemployed and pensioners are subject to statutory health insurance. The responsible health insurances are responsible for the carrier . Around 100,000 people are not insured.

You cannot choose the health insurance provider itself, it depends on the respective employer and its location. So there are

  • Health care for the civil servants of the municipality of Baden
  • Medical care for the officials of the state capital Linz
  • Sick care for Upper Austrian community officials
  • Health care for Upper Austrian state officials
  • Upper Austrian teacher, health and accident welfare
  • Health care institution for civil servants of the Steyr magistrate
  • Medical care for the officials of the city of Wels
  • Health care institution for civil servants in the provincial capital of Graz
  • Sick care institution of the city officials of Villach
  • Sick care institution of the municipal officials of the state capital Salzburg
  • Health and accident care of the Tyrolean state teachers
  • Health and accident care of the Tyrolean state officials
  • Health and accident care of the Tyrolean municipal officials
  • Health care facility of the officials of the municipality of Hallein

The obligation to contribute to the statutory health insurance for employed persons applies to employees and employers. The employer is obliged to register the employee with the responsible health insurance institution before starting work and to regularly pay the statutory contribution rates. The employer is liable for the social security contributions; he is entitled to deduct the employee's share of the social security contributions from the employee's salary.

The self-employed and self-insured have to bear the full contribution themselves.

Private supplementary insurance

In addition to compulsory insurance, every person living in Austria with a registered primary residence is free to take out various private supplementary insurance policies with an insurance company of their choice .

In addition to the special class insurance , which guarantees more comfort in the event of a hospital stay, such as a two-bed room with shower, toilet, TV and telephone, many insurers now also offer policies that cover additional costs for visits to the dentist or costs for cures and alternative healing methods .

Cross-border commuters who live in Austria but have their job in Switzerland, Germany or Liechtenstein are exempt from statutory compulsory insurance in Austria. According to the social security agreements, these cross-border commuters are subject to compulsory health insurance in the country in which they are employed. However, you can insure yourself with the GK in Austria.

Web links

Wiktionary: Health insurance  - explanations of meanings, origins of words, synonyms, translations

Individual evidence

  1. ↑ Reproduced in: Ch. Herber; J. Weidenholzer (Ed.): Assessment approach of the implementation of the health reform 2005 . Linz 2007, p. 133 (PDF, ooegkk.at, accessed on July 20, 2014) - there “Ziniel (2005)” without further details.
  2. ↑ Austrian Chamber of Pharmacists: Pharmacy in Figures 2014 , Chapter 6.1 Health Insurance Expenditures , table of expenditure on p. 41 ( pdf , 2.1 MB, apotheker.or.at).
  3. ↑ Benefits of the statutory health insurance , help.gv.at
  4. ↑ System of compulsory insurance (ASVG, GSVG, FSVG, BSVG) , help.gv.at
  5. ↑ 100,000 Austrians have no insurance , Kurier, September 11, 2013
  6. ^ Health insurance , Employment Service Austria, accessed on April 4, 2015
  7. ↑ Uninsured people, In the waiting room of the poor , zeit.de, March 29, 2012
  8. ↑ Self-insurance in health insurance , help.gv.at.