When it comes to Austria’s health system, a few things always surprise foreigners. For example, unlike some other countries, like the United States, Brazil, or India, residents in Austria are obliged to have public health insurance.

Enrolment is generally automatic and linked to employment. A vast majority of workers are insured by ÖGK through their employer. Still, many, such as self-employed people, will have their insurance with SVS or BVAEB, in the case of public servants.  

Insurance is also guaranteed to co-insured persons, such as spouses and dependents, pensioners, students, disabled people, and those receiving unemployment benefits.

“People are surprised about the amount of different health insurance providers, all of which are part of the public system”, says Miglena Hofer, senior legal counsel at Austria For Beginners. 

The Local spoke to her and Severina Ditzov, also a senior legal counsel with the company focusing on easing the integration process of expats and their families, to understand a few of the things that can be most surprising about the health care system for those coming into Austria. 

Different insurers, different systems

Austrian health care is universal, and contributions are mandatory – with few exceptions. However, one thing that will surprise many people is that your insurance fund can differ depending on your occupation.

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For example, most people in the country are insured by the Österreichische Gesundheitskasse (ÖGK), with about 7.4 million insured people in Austria (some 82 per cent of the population). 

However, civil or public servants, miners, and persons employed with the federal railways are insured by BVAEB. According to the company, more than 1.1 million people in Austria are insured with it. 

Additionally, the self-employed, freelancers and farmers will be insured by SVS. 

There is also the General Accident Insurance Fund (AUVA) for accident insurance and the pension fund Pension Insurance Fund (PVA), to which all residents contribute. 

“People are, of course, surprised to find out that each provider offers different coverage”, highlights Miglena. This means that not every doctor will work with all ÖGK, SVS, and BVAEB, for example. Therefore, it’s essential to check whether the doctors you are going to work with your insurer.

Even more, the insurers might cover different things or pay in different ways. “Some of the public insurances, like SVS and BVA, have self participation. The fund will cover 90 per cent of the treatment, and the rest will be paid by the patient”, Severina explains.

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This can be particularly surprising for people changing insurers, for example, those who went from being formally employed by a company with ÖGK to being a self-employed person insured with SVS.

On top of that, people can have private insurance

Austria works with a two-tier system, so besides the mandatory public insurance, residents can also have their own private policies. 

So, additionally, from the public contribution to the state funds, they can pay private companies to provide health care policies too. Doctors can also choose to work with public or only private patients – or both.

“Public doctors may also have private practices, and they are not obligated to have them in two different places”, says Severina.

“It is very common that the doctor works as a public doctor on Mondays and Wednesdays and private doctor on Tuesday and Friday, or private before noon and the public after 12pm, for example”. 

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A receptionist would need to tell the patient beforehand if the examination will be private or not, and the information should also be available online, but sometimes they forget to inform, or the person doesn’t correctly check and gets thoroughly surprised when receiving a bill at the end of the consultation.

There is also a difference between Wahlarzt and a Privatarzt. “While both are private doctors, you only get partially reimbursed by the public insurance if you go to a Wahlarzt”, Miglena clarifies. 

A different style of medicine

The style of the consultations can also be shocking to foreigners. 

“Austrian doctors, especially those working with public insurance, are not very empathic or chatty”, Miglena says. “During your appointment, you hardly speak to the doctor as they jump from one room to another”, she adds.  

It is not rare for consultations to last just a few minutes, a drastic change for people from South America, for example, where doctors sometimes spend 30 to 60 minutes talking to patients. 

Another substantial difference is that Austrian medicine is very much focused on prevention and natural remedies, with many doctors prescribing teas and exercise to patients used to getting prescriptions for anxiety and sleeping pills in the United States, for example. 

Pollyanna, a Brazilian who has been living in Vienna for four years, tells how she had difficulties finding a prescription to take the medicine she was used to and that helped her sleep: “The doctor didn’t even want me to take melatonin, let alone my usual prescription medicine”.

Her husband, who is an American, went through a similar situation and felt the difference between doctors in the United States and in Austria.

This style of medicine, one that focuses on prevention and self-recovery, makes it common for people with the flu to be sent home with the recommendation to rest and also creates one of the most unusual things for many expats in Austria: the fact that the public healthcare system will cover a weeks-long stay at a spa.

The expert advice

If any of these quirks, especially the quick consultations with long waiting times, bothers you, you might want to invest in additional private insurance, according to the expert lawyers.

“Sadly, one gets treated way better if they have private insurance”, Miglena says. “Suddenly, every doctor speaks English and is friendly to you, looks you in the eyes, and doesn’t mind answering your questions in detail”. 

“With public insurance, one has to wait for approximately four to eight weeks for examination with a specialist; private insurance can get you faster appointments,” Severina adds.

If you are looking for a doctor – private or not- Austria’s DocFinder.at is a good tool with filters to help you find a doctor based on your insurer or which languages they speak.