Health Insurance and Doctors in Austria: A Guide for Poles (2026)

This guide is for you if you live and work in Austria or are just moving there – and want to know how Austrian health insurance works, which doctor to visit, how much you will pay at the pharmacy and in the hospital, and what happens to your insurance with NFZ. At the end, you will also find a short section for those who come to Austria for just a few days or weeks.

Last verification: October 21, 2026. Informational material – not legal or medical advice. Amounts refer to the year 2026 and change every year; confirm them with your health insurance fund or on the official website before making a decision.

In Brief

Who is Insured and in Which Fund

Austria is based on the principle of Pflichtversicherung, or mandatory insurance: if you meet the legal conditions, the law automatically includes you in the community of insured individuals, and you do not need to apply for anything. In the largest fund, ÖGK (Österreichische Gesundheitskasse), mandatory insurance includes, among others, employees, apprentices (Lehrlinge), retirees from the ASVG system, individuals receiving unemployment benefits, and child care allowances (ÖGK 2026). After starting work, confirm with your employer that you have been registered and wait for your e-card.

In addition to ÖGK, there are other insurance institutions with separate rules:

ÖGK – fund for most employees and their families; has branches (Kundenservice) throughout Austria.

SVS (Sozialversicherung der Selbständigen) – insurance for self-employed individuals (including Gewerbetreibende, Neue Selbständige) and farmers. An important difference: SVS charges a 20% co-payment for treatment by a doctor and dentist; after meeting the health goals of the “Selbständig Gesund” program, you can apply to reduce it to 10% (SVS).

BVAEB (Versicherungsanstalt öffentlich Bediensteter, Eisenbahnen und Bergbau) – fund for public sector employees, railways, and mining. It has its own rules regarding prescriptions and co-payments, which it refers to, among others, oesterreich.gv.at.

All amounts and rules in this guide refer to ÖGK unless otherwise indicated. If you belong to SVS or BVAEB, check the details with your institution.

e-card – Your Card to the System

After registering for insurance, you receive an e-card. The card does not contain medical data – only personal information (first name, last name, insurance number, date of birth), and cards issued since 2020 have a photo. On the back of the e-card, the European Health Insurance Card (EKUZ, in German EKVK) is printed, provided you have the required insurance periods (ÖGK 2026).

A yearly service fee (Service-Entgelt) is charged for the e-card – always on November 15 for the following year. For 2026, it is 25.00 euros, and for 2027, 26.85 euros. Some individuals are exempt from this fee, e.g., those employed in a minor capacity (geringfügig Beschäftigte); according to ÖGK, from 2027, retirees will also pay the fee (ÖGK 2026). If you lose your card, report it to the e-card hotline at 050 124 33 11 or order a new one through the “Meine ÖGK” portal.

Kassenarzt, Wahlarzt, or Privatarzt

In Austria, you generally have free choice of doctor. However, it is crucial whether the doctor has a contract with your fund – this determines how much you will pay.

The bars only indicate the direction of costs, not specific amounts. Sources: gesundheit.gv.at – Kassen-, Wahl- oder Privatarzt, gesundheit.gv.at – Kosten und Selbstbehalte.

How Much You Really Get Back from Wahlarzt

The reimbursement is 80% of the cash rate for the same service – the fund deducts 20% for higher administrative costs. Since Wahlärzte usually charge more than the cash rate, in practice, you typically recover significantly less than 80% of the bill. For some limited services, the reimbursement is even lower (gesundheit.gv.at).

Be cautious of two traps described by the gesundheit.gv.at portal: the fund may not reimburse the costs of a visit to a Wahlarzt if you have already visited a Kassenarzt of the same specialty in the same quarter, nor for a visit to another Wahlarzt of the same specialty in that quarter.

From January 1, 2026, Wahlarzte must generally use the e-card system, so you also show the card to them. Exception: doctors who see fewer than 300 patients per year (ÖGK 2026).

1. Pay and Get a Detailed Bill

   The bill (Honorarnote) must include your name, insurance number, address, date of issue, description of the services performed with dates, and proof of payment.

2. Submit the Bill to the Fund

   In ÖGK, the most convenient way is online through Meine ÖGK (portal or app) with ID Austria. You can also submit the bill in paper form at the branch.

3. Provide Bank Account for Transfer

   The reimbursement comes via bank transfer – include your account details and address (gesundheit.gv.at).

Family Doctor and Referral to a Specialist

The first contact is usually a Hausarzt, or general practitioner (Allgemeinmedizin), or a primary care unit (Primärversorgungseinheit). Unlike in Poland, you can visit many specialists with a contract with the fund without a referral, just with your e-card. Most often, within a quarter, you can visit one general practitioner and one doctor of a specific specialty without a referral; exact rules depend on the fund (gesundheit.gv.at – Überweisung).

A referral (Zuweisung) is almost always required for examinations such as X-rays, tomography, laboratory tests, or physiotherapy. Referrals are valid for three months from the date of issue. If the service requires the fund's approval, the referral must be submitted to them within a month (gesundheit.gv.at).

Prescriptions and Rezeptgebühr 2026

For each medication issued on a cash prescription, you pay at the pharmacy Rezeptgebühr – from January 1, 2026, 7.55 euros. There is an annual limit: when the total fees in a given year reach 2% of your annual net income, you are automatically exempt for the rest of the year, without application. Before the limit takes effect, however, each non-exempt individual pays at least 41 fees of 7.55 euros each. Fees for co-insured family members count towards your limit. You can check your fee account (Heilmittelkostenkonto) online with ID Austria (oesterreich.gv.at).

Low-income individuals can apply for a full exemption from the Rezeptgebühr (and the e-card fee). The income thresholds for 2026 are provided by ÖGK in their brochure, e.g., 1504.65 euros per month for a single person with documented additional costs for a chronic illness (ÖGK 2026).

Prescriptions from Wahlarzte: Wahlarzte without a special agreement with ÖGK (Rezepturrechtsvertrag) issue only paper prescriptions. According to ÖGK, such prescriptions for medications available without the fund's approval can be filled at any Austrian pharmacy – the pharmacist checks your entitlements via the e-card. Medications requiring the fund's approval must first be presented to the ÖGK medical service (ÖGK 2026).

Dentist – What the Fund Covers

With a dentist under contract with ÖGK (Vertragszahnarzt) or in ÖGK dental clinics (Zahngesundheitszentren) with your e-card, you will receive free services including: X-ray examination, fillings in front teeth, root canal treatment, extractions, surgical procedures, and tartar removal. Children and adolescents from 10 to 18 years old receive free hygiene services (ÖGK 2026).

Source for all rows: ÖGK, Leistungen und Services 2026.

Hospital and Kostenbeitrag

When hospital treatment is necessary, the fund covers costs in the general class of a public hospital (e.g., state hospitals, religious hospitals) or a private hospital with a contract. You pay a daily Kostenbeitrag, which is set by the hospital's governing body (e.g., federal state); you pay for a co-insured family member. The fee applies for a maximum of 28 days in a calendar year, regardless of the number of hospitals. Exempt from this fee are, among others, minors and women in childbirth, for stays up to 10 days (ÖGK 2026).

The amount varies between federal states. The gesundheit.gv.at portal in its January 2024 update reported a range of about 12–16 euros per day and noted that amounts are indexed every year – check the current rate for 2026 on the hospital's website. You pay the full amount for Sonderklasse (private class) – the fund does not reimburse this (gesundheit.gv.at).

Emergency Cases – Which Number

At 1450, specially trained registered nurses answer – they will help assess whether a pharmacy, on-call doctor, or hospital is needed (ÖGK 2026). We do not have official information on whether the hotline supports calls in Polish – be prepared to converse in German.

Mental Health and Psychotherapy

ÖGK offers psychotherapy and clinical-psychological treatment as material benefits (Sachleistung, billed directly to the fund) – but under certain conditions: it must be a disorder of a disease nature (simply “counseling for problems” does not qualify), a medical examination must occur before the second session, and therapy longer than 10 units requires the fund's approval (ÖGK 2026).

If you go to a privately practicing therapist, you pay out of pocket, and ÖGK provides a subsidy (Kostenzuschuss) – in 2026, for example, 33.70 euros for a 60-minute individual session and 19.30 euros for a 30-minute session. This is usually a small part of the fee. You cannot simultaneously use fund therapy and the subsidy (ÖGK 2026). Inquire about available spots in fund therapy at your ÖGK branch.

Family: Mitversicherung

Family members can be co-insured (mitversichert) with you – usually free of charge. General conditions: they usually reside in Austria (exception: children studying abroad) and do not have their own statutory insurance. You submit the form “Prüfung der Anspruchsberechtigung für Angehörige” to ÖGK (ÖGK 2026).

What Happens with NFZ When Moving to Austria

In the EU, you pay health insurance contributions only in one country. The country is determined by your situation; if you work in several countries, the decision is made by ZUS (farmers – KRUS) (NFZ – work in the EU).

1. You are employed by an Austrian employer

   You become insured in Austria. The right to treatment at the expense of NFZ expires 30 days after the cessation of your Polish insurance title, e.g., termination of the employment contract – along with the rights of family members registered by you (NFZ – residence in another country). Your Polish EKUZ will no longer apply.

2. You are delegated by a Polish company

   When delegated for up to 24 months with an A1 certificate from ZUS, you remain in NFZ. When delegated for 12 months or longer, you can receive an S1 document from NFZ and register it in the country of residence (NFZ).

3. You live in Austria, and your insurance is in Poland

   For example, you work remotely for a Polish company or are a Polish retiree. Then you apply to NFZ for S1, register it with the Austrian fund, and receive treatment under Austrian rules, retaining full rights to treatment in Poland. S1 becomes invalid when you start working in Austria (NFZ).

4. Report Changes

   NFZ requires you to report changes, e.g., country of residence, taking up work in another EU country, or receiving a pension there. Using documents without entitlements may result in the reimbursement of treatment costs (NFZ).

Cross-border workers (living in Poland, working in Austria, and returning home at least once a week) also use the S1 document, in the opposite direction: it is issued by the country where you work and registered with NFZ. Confirm the details of the procedure for Austria with ÖGK and the provincial NFZ branch – see “What is Uncertain”.

Short Stay in Austria with Polish EKUZ

If you are insured with NFZ and come for a vacation or a short visit, take your EKUZ and an ID card or passport. Go to a public healthcare facility (in Austria: a doctor with a contract with the fund or a public hospital) and show your documents (NFZ). EKUZ covers medically necessary services under the rules of the host country – including local fees, such as Rezeptgebühr. EKUZ will not work with Wahlarzt or Privatarzt as it does with Kassenarzt.

How to Find a Doctor Who Speaks Polish

• Medical chamber search engines. Österreichische Ärztekammer refers to doctor search engines maintained by the medical chambers of federal states (Vienna, Lower Austria, Salzburg, etc.). Check if your federal state's search engine allows filtering by known languages, and whether the doctor has a contract with your fund (“alle Kassen”, “ÖGK”) or is a Wahlarzt.
• Ask the fund. The ÖGK branch or hotline can point you to Kassenarzt doctors in your area.
• Polish Embassy in Vienna. The Consular and Polish Diaspora Department (gov.pl/web/austria) publishes lists of law firms that speak Polish. At the time of verification, we did not find a list of doctors there – ask the consulate directly.
• Always confirm by phone whether the doctor actually speaks Polish and what their status is (Kassenarzt, Wahlarzt, private) before scheduling an appointment.

Common Mistakes

• Assuming that Wahlarzt will reimburse 80% of the bill – reimbursement is based on the cash rate, so it is usually lower.
• Visiting a Wahlarzt and a Kassenarzt of the same specialty in the same quarter – the fund may not reimburse costs.
• Starting a prosthesis or orthodontic appliance without prior approval from ÖGK.
• Not registering a spouse for Mitversicherung or being surprised by the 3.4% co-payment.
• Continuing to use Polish EKUZ after starting work in Austria.
• Calling 144 for matters that can be handled by 141 or 1450 – and vice versa: delaying 144 in life-threatening situations.

Frequently Asked Questions

Do I need to register myself with the health fund?

No, if you work on a regular contract – insurance arises by law, without your application. Self-employed individuals are insured with SVS.

Do I need a referral to see a specialist?

For many specialists with a contract with the fund, no – just the e-card is sufficient. A referral is almost always required for imaging tests, laboratory work, and physiotherapy.

How much does a prescription medication cost in 2026?

7.55 euros for a cash prescription, unless you are exempt. After reaching 2% of annual net income, fees disappear for the rest of the year.

Will my child be insured?

Yes, children can be co-insured with you for free – you need to submit a form to ÖGK.

Will I retain the right to treatment in Poland?

It depends on where you are insured. Working in Austria generally means losing your insurance with NFZ. Having S1 from NFZ allows you to retain full rights to treatment in Poland.

Fact-Check Summary

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