Private Health Insurance: Coverage, Cost & Calculator [2024]

Last Update: 8. August 2023

Author: Sebastian Arthofer, MSc BSc

Are you looking for a private health insurance in Austria and want to get simple and easy to understand information?

At the same time you would like to have the possibility to calculate the costs independently online in order to compare prices transparently?

You have come to the right place!

private health insurance

In this article we answer the 9 most frequently asked questions about private health insurance and at the same time you have the opportunity to compare the premium online specialized.

Before we start though, let’s get an overview with the 7 most important points about private health insurance in Austria.

Let’s go.

P.S.: No time to read? Just use our explainer video (in German).

7 most important infos to start with (+2x bonus)

From over 1,500 consultations, we have summarized the 7 most important info on private health insurance in Austria for you:

This is the best way to proceed

👉 Compare private health insurance online. Get an overview of price and coverage.

👉 The private health insurance can become extremely complex without an overview of the market. Book yourself a free, no-obligation consultation and be advised by our specialists with the experience of several thousand insurance comparisons. Consultations are free of charge and can be held in English.

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Table of contenct

Before we go into detail about all the components of private health insurance, let’s clarify how private insurance works?

Here we go.

What is private health insurance and how does it work?

Let’s get an overview of what private health insurance is, how it works and how it can be distinguished from the statutory health insurance.

The principle of supplementary / voluntary insurance

Private health insurance versus statutory health insurance

Private health insurance (PKV) in Austria is a form of health insurance that is taken out voluntarily in addition to statutory health insurance (GKV), and where the insured have their costs for private services, such as elective doctors or private hospital covered.

As a rule, the insured pays monthly premiums to a private health insurance company, which in return covers the costs of medical treatment and services for them.

Coverage comparison GKV vs. PKV

Private health insurance in Austria generally offers a higher range of benefits than public health insurance and can also be tailored to the individual needs of the insured.

Public doctors vs. Private doctors

Wahlarzt EntwicklungThere are two types of doctors in Austria: panel doctors and elective doctors.

  • Public doctos are physicians who have contracts with the ÖGK, the SVS or BVAEB  and are thus authorized to offer services within the framework of the statutory health insurance.

Treatment by a panel doctor is covered by the health insurance, provided it is medically necessary(!).

In contrast… 

  • Private doctors are physicians who do not have a contract with the health insurance fund and thus do not work within the framework of the public health insurance. Treatment by an elective doctor must be paid for by the patient, even if it is medically necessary. Those costs will be covered by a private health insurance.

To cover these costs, one takes out private health insurance. Elective physicians generally have a higher reimbursement rate than public health insurance physicians, but also often offer a higher level of comfort and more individualized care.

General admission in hospital vs. private hospital

Privatklinik Geburt Einbettzimmer 

In Austria, there are different types of hospitals that offer different services and prices.

  • A public hospital where you are admitted to the general admission (usually 4-8 bed rooms) is a hospital that offers services at set prices that are covered by the statutory health insurance.

  • However a public hospital offers a seperate war called “Sonderklasse” (2 bed rooms) for those who are insured by the private health insurance.

  • A private hospital, on the other hand, is a hospital that offers its services privately and has not agreed upon fixed fees for the treatments.

The prices for treatments in a private hospital are therefore individually negotiable and usually higher than in a hospital of the general fee category. However, private hospitals or even the “Sonderklasse” usually also offer a higher level of comfort (1 or 2 bed room) and more individualized care than hospitals of the general fee class.


The statutory health insurance only covers the general admission class whereas the private health insurance covers the private hospital or the special class.


Finally, you will now find a short explanatory video, which summarizes all the relevant points. (in German)

Video abspielen

Finally, the question remains who offers private health insurance in Austria.

The 7 providers of private health insurance in Austria

In Austria, there are several private health insurance companies that offer private health insurance.

List of private health insurance providers

The largest and best known providers of private health insurance in Austria include.

Is it actually worth comparing?

The different providers offer different coverages and prices, so it makes sense to get different quotes and compare them carefully before deciding on a particular private health insurance.

Market shares of private health insurance providers

To get a feel for the size of each insurance company here, below you will find the market shares of private health insurance in Austria.

The market shares of private health insurance are as follows:

  • Uniqa around 44%
  • 18% for Merkur and Wiener Städtische.
  • Generali around 14%,
  • followed by  Allianz with roughly 4%
  • and the rest (Muki, Donau etc.) with around 2%.
  • Wahlarztversicherung

    Du erhältst ein Haushaltsbudget im Kalenderjahr und kannst dir deine Kosten beim Wahlarzt bzw. Privatarzt rückerstatten lassen. Nebenleistungen, wie Physiotherapie, Massagen und Heilbehelfe werden zusätzlich rückerstattet.

  • Sonderklasseversicherung

    Die private Krankenversicherung übernimmt deine Kosten im Privatspital oder auf der Sonderklassestation. Die Tarife unterscheiden sich, ob du nach Unfall oder nach Krankheit versichert bist.

  • Zusatzleistungen

    Leistungen wie eine Babyoption, Einbettzimmer oder ein Reisetarif können typischerweise nur in der Kombination mit einer Wahlarztversicherung oder Sonderklasseversicherung abgeschlossen werden und sind somit Zusatzpakete.

What does private insurance cover?

Leistung Privatversicherung Österreich

In essence, private insurance in Austria takes care of 4 specific benefits. The benefits of private health insurance are as follows:

  • #1: Full coverage of private doctor expenses
  • #2: Additional coverage of private physiotherapy as well as psychotherapy and other services.
  • #3: Full coverage of the costs of the stay in the “Sonderklasse” and the private hospital
  • #4: Covering the costs of accompanying the parents when the children are admitted to the hospital

#1 Full coverage of elective medical expenses

Full coverage of elective medical expenses means that an insurance company covers 100% of the costs of treatment by an private doctor chosen by the insured (as opposed to a panel doctor suggested by the public health insurance company).

#2 Additional coverage of physiotherapy and other services

In addition to 100% coverage of elective physician services, private health insurance typically covers the following additional services:

  • Alternative medicine methods (e.g.: homeopathy, acupuncture).
  • Ayurvedic medicine, classical homeopathy, Kneipp medicine, Mayr
  • therapy, osteopathy, ozone therapy and traditional Chinese medicine (TCM)
  • Mother-child-pass examinations
  • Fees are also paid for outpatient surgeries and for special examinations
  • examinations (MRI, CT, imaging diagnostics, isotopes, pathology)
  • treatment by registered psychologists or psychotherapists

These services are fully or partially covered depending on the plan.

Diese Leistungen sind abhängig vom Tarif vollständig oder teilweise übernommen.

#3: Full coverage of the costs of the stay in the special class and private hospital

In addition to the elective doctor insurance module, private health insurance can also include special class insurance or private hospital insurance. In this case, 100% of the costs are covered. The following benefits are covered:

  • Single or double room (depending on the tariff)
  • Direct billing with contract hospitals
  • Hospital transportation costs

#4: Payment of accompanying costs for parents when children are admitted to hospital

If your child is admitted to hospital and you wish to be with your child in a single or double room, costs are generally covered.

Provided your child has special class insurance, this policy will also cover your additional costs for hospitalization.

For whom is private health insurance worthwhile?

Lohnt sich eine private Krankenversicherung

Is private health insurance worthwhile?

The question of whether private health insurance is worthwhile is often hotly debated.

If the benefits of the statutory health insurance are sufficient for you, then the conclusion of a private health insurance is probably less sensible.

Private health insurance can offer benefits in certain cases, such as access to elective doctors and shorter waiting times for certain treatments and operations in private hospitals.

These benefits are only covered by private health insurance.

But is it worth it for me individually?

In the next section, we show you per age group what considerations many of our customers had when taking out private insurance.

We will address the following age groups:

  • 1) Young parents and infants (0 – 3 years)
  • 2) Young sporty adults (20 – 30 years)
  • 3) Junge sportliche Erwachsene (20 – 30 Jahre)
  • 4) Working adults (30 – 40 years)

1) Young parents and infants (0 – 3 years)

Meanwhile, almost all young parents insure their newborns. This is mainly due to the fact that there are almost no public doctors left in the metropolitan areas.

lohnt sich eine private krankenversicherung für babys

→ 5 mother-child pass examinations in the first year of life.

In addition, regular Mother-Child Passport examinations at an elective pediatrician are relatively expensive over time.

In the first year alone, you’ll have to take your newborn to the doctor 5 times. This alone accounts for costs of over €500.

→ Increased visits to the doctor with entry into kindergarten

Who does not know it?

Once the fall season starts, the little ones are sick much more often. And when they enter kindergarten, this becomes even more intense.

In kindergarten, your child is regularly exposed to new bacteria and if you don’t have a trusted doctor with available appointments, the regular visits can become “torture.”

Also, don’t overlook the increased costs associated with regular visits to an elective doctor.

→ No crowded waiting rooms = no risk of infection.

Have you ever had to wait in a crowded waiting room for your appointment?

Now imagine this situation with your newborn or toddler.

With overcrowded waiting rooms, on the one hand, the further risk of infection is higher, and on the other hand, the unnecessary time has to be bridged.

Private health insurance allows you to use elective physicians free of charge, where there is typically no waiting time in the office.

This reduces the risk of infection for your child and also saves valuable life time.

2) Children and teenager between the ages of 4-18

As your child gets older, visits to the doctor are more likely to change.

In the past it was the regular mother-child check-ups, but at a young age, due to the increased risk of leisure time, a visit to the hospital or due to growth, a visit to the doctor is quickly possible.

Is private health insurance worthwhile for young people?

lohnt sich eine private krankenversicherung für Jugendliche

→ Leisure risks increase (clubs, excursions, etc.)

An important component at a young age is social integration.

Thus, many children join sports clubs or similar and can develop well socially there.

But increased leisure activities also increase the risks of injury.

Quickly once

  • you fall off your bike,
  • hurt yourself playing soccer, or
  • sprains your finger playing volleyball.

In many of these situations, parents and teenagers alike do not want to wait forever at the doctor’s office and have a trusted doctor at their side even for more complicated fractures.

Also the stay in the hospital should take place in peace and security and not in the 4 or 8 bed room, where the neighbor snores the latest Justin Bieber song.

And also your company in the hospital should not cause any further costs.

Many of these points are thereby uncomplicatedly covered by private health insurance

→ Quick appointments with the doctor & psychological care for teenagers

Similar to babies, teenagers don’t want to have to sit out their time at the doctor’s office, and with increased school stress and puberty, there are other new challenges that may require psychological support.

But the choice of doctors and getting second opinions should not be underestimated at this age.

sollte in diesem Alter nicht unterschätzt werden.

Young athletic adults (20-30 years)

Once the first money has been earned, life is certainly easier after training or studies.

However, if injuries happen again and again at a young age – due to sports – one quickly comes into contact with the system of statutory health insurance.

And many young – motivated professionals – don’t want to wait weeks to recover from their latest accident.

lohnt sich eine private krankenversicherung für junge Erwachsene

→ Take out young, save on premiums

If your parents have not yet made health provisions for you at a young age, many young sporty adults between the ages of 20 and 30 are looking into private health insurance.

The first money is earned, but to spend this completely for the insurance, does not float many.

One point should always be kept in mind: the earlier one takes out private health insurance, the more favorable the premium.

Even over a lifetime.

But how is that possible?

Quite simply.

Your young contract will only be adjusted for inflation over the years.

A new contract always includes the age risk and thus the premium increases quickly exponentially – i.e. more than inflation – especially for people over 45.

Prämienvergleich private krankenversicherung jung vs. alt

→Time savings: Better to enjoy free time than to sit in the waiting room.

Especially in your younger years, leisure time is probably more important to you than sitting safely for hours in an office waiting for the free appointment with the doctor.

But also the regular checkups at the ENT doctor or at the ophthalmologist should be done without long waiting times in the office.

And also in the professional context, many young professionals are interested in quickly becoming active again in the job for which they have put up with years of training or even study.

Working adults (30-40 years)

For many people who are between 30 and 40 years old, private health insurance is a good way to protect their health.

Those who have income from their jobs can take advantage of the benefits of private health insurance.

One of the biggest advantages of private health insurance is that it offers a certain amount of flexibility. For example, you can decide which treatment methods you want to use and also which services you can afford.

In addition, private health insurance often offers more benefits than other types of insurance. This means that in the event of an illness, one receives more support and recovers more quickly.

→ Fast appointments for fast recovery

Private health insurance in Austria is a great way to get appointments quickly and easily.

Many doctors often admit privately insured patients directly into the treatment room, which can significantly reduce waiting times.

Many doctors are also more flexible than those with public health insurance when it comes to scheduling appointments. As a rule, you do not have to wait long for a doctor’s appointment.

And flexible office hours are especially important for working people, so that they can have the appropriate examinations after work or at the weekend.

And finally, it must be said that the quicker the appointment with the doctor, the quicker the recovery typically is.

→ Stress management in everyday life

Many adults complain about persistent everyday stress at work.

And especially with the increased digitalization and the accompanying fast-paced everyday life, psychological problems can also arise again and again due to stress.

Here, private health insurance can help to use private psychological care or coaching and consciously address the fears or problems.

And possibly also once the assumed massage helps to escape from everyday life and enjoy a few quiet minutes.

→ Continuity: a trusted doctor (diagnosis & surgery).

arzt des vertrauens

Possibly you have already had the situation. You are riding with your loved ones and suddenly you crash your bike.

The hand hurts, but you continue riding.

The next day, the hand swells more and more and it becomes clear to you: you need to see a doctor.

Your friends already have experience with a special accident orthopedist whom you consult.

The doctor convinces you with her professional competence and comes to the conclusion that your hand is unfortunately broken. And it is also relatively complicated.

She suggests that you have the operation done in a private hospital.

Your doctor is always by your side and the operation goes without complications.

After a few weeks your hand is completely healed.

And it is these steps, having the trusted doctor with you throughout the process, that many customers find particularly important.

Private Krankenversicherung Kosten

2 concrete examples for you

What does private health insurance cost?

To start with: private health insurance in Austria costs on average about 30€ per month for children and about 45€ to 100€ for adults.

Tariffs significantly above 100€ can be useful for the following situation:

  1. Planned delivery in private clinic or existing pregnancy.
  2. Previous illnesses in the family (increased risk of illness)
  3. Free financial means for investment in health

However, here too there are major differences between insurance companies.

Now that we have a rough understanding of what private health insurance costs, the question arises as to what specifically influences the premium.

What factors influence the premium for private health insurance?

Decisive for the amount of the premium in private health insurance are 3 important parameters:

  • age
  • the scope of benefits
  • the state of health

Das Alter

Prämienvergleich private krankenversicherung jung vs. alt

⇒ The younger, the cheaper.

The earlier you join a private health insurance policy, the cheaper the premium will be.

An existing health insurance contract is adjusted annually only with inflation per year. There are no other adjustments.

A newly concluded contract includes the age risk. Especially contracts with a conclusion after 45 years increase, per year exponentially.

The scope of benefits

private krankenversicherung kosten leistungsvergleich

⇒The more benefits, the more expensive the premium.

For the elective doctor tariff (BASIS), the higher the “elective doctor budget”, the more expensive the tariff.

If you extend your elective doctor solution with the special class after accident with the option of illness, the premium in the package (COMFORT) increases only minimally. By combining an elective doctor’s tariff with private hospital insurance, you can save up to 30% in premiums. This is the so-called combination discount.

Probably the biggest difference in the premium is when an elective doctor tariff with the special class after accident and illness is concluded (PREMIUM). This is the largest solution in Austria.

If you want to know more about the difference between the individual benefits in private health insurance, I recommend our explanatory video: the 3 packages of private health insurance.

Age

Basis 💡

Comfort 🔮

Premium 💎

Kind

30 - 53 €

32 - 48 €

44 - 62 €

20

51 - 86 €

51 - 99 €

109 - 154 €

30

61 - 96 €

60 - 120 €

135 - 190 €

40

65 - 98 €

76 - 137 €

159 - 224 €

Would you like to save up to 30% on premiums (for the same benefits) with our specialized comparison?

As you can see, the premium range between insurances can differ greatly. That’s why we always recommend an insurance comparison.

AND, sometimes it all comes down to the finer points.

If you are still undecided about which concept and which insurance fits your needs exactly, we can help you in a free and non-binding online consultation.

Our experts have more than 2,000 consultations under their belt and will be happy to discuss your individual situation with you. They are all trained exclusively for private health insurance and do not deal with any other topics.

The state of health

⇒ The sicker, the more expensive.

If you’re looking to purchase private health insurance, your current and past health status also plays a role.

The premiums you see when you make an offer or prepare an application are assuming you are in the best of health.

Only with the preparation of the application you will also be sent health questions.

You should fill these in to the best of your knowledge. And depending on your pre-existing conditions, the premium may then increase accordingly.

Therefore, the conclusion of a private health insurance at a young age is also highly recommended due to the state of health.

How do I save premium on private health insurance?

3 applicable strategies to save premium

private krankenversicherung prämie sparen

Now you must be wondering what strategies you can use to save premium?

That’s easily answered:

  • Choose a realistic elective doctor budget between €1,300 and €1,400 in a calendar year.
  • Take advantage of the combination discount of up to 30%.
  • Choose a tariff with a deductible if the special class after illness is important to you.

→ Choose a realistic budget for elective medical expenses between € 1,300 and € 1,400 in a calendar year.

Experience shows that our customers at krankenversichern.at need between €1,300 and €1,400 in elective physician cost budget.

This includes services of elective physicians (general practitioners as well as specialists), private MRIs, CTs and other ancillary services such as physiotherapy or psychotherapy.

This value is the average of all customers, and the amount does not change drastically with age. It is the composition of the costs that changes.

So when you are young you might use a sports doctor, but when you are older it is the orthopedist and physiotherapy.

With over 1,200 customers, this corresponds to very reliable figures.

→ Use the combination discount of up to 30

As mentioned above, one strategy is to combine an elective doctor insurance with a special class insurance (COMFORT).

This has 3 main advantages:

  1. The premium is reduced, and the total premium remains almost the same
    Basic ⇒ 55€
    Comfort ⇒ 60 €
    (Comparison: 30 years, ÖGK, Vienna).
  2. Benefits greatly expanded: the scope of benefits expands massively due to the special class after accident
  3. Provision with upgrade without renewed health check: The option for illness allows you to upgrade to Premium without a renewed health check

→ Choose a tariff with deductible if the special class after illness is important to you

Finally, if you are interested in the full coverage (PREMIUM), you should definitely agree on a deductible.

Why?

There are many providers where the deductible is waived, for example, in the following situations:

  • after an accident
  • during childbirth
  • in the case of serious illnesses, such as
    • malignant neoplasms
    • brain tumors
    • operations of the carotid and aortic arteries
    • bypass and many others.

By agreeing on a deductible, you can save up to 50% premium.

Would you like to save up to 30% on premiums (for the same benefits) with our specialized comparison?

Gesetzliche versus private Krankenversicherung

What is the difference?

What is the difference between statutory and private health insurance?

Statutory health insurance is the mandatory hospital and doctor’s care in Austria.

Every employee and self-employed person is compulsorily insured by law.

Private health insurance is taken out in addition to statutory health insurance.

Therefore, it is often referred to as supplementary insurance.

Here are the differences

Gesetzliche Krankenversicherung

Private Krankenversicherung

Pflichtversicherung

Freiwillig Zusatzversicherung

Kostenübernahme allgemeine Gebührenklasse im Krankenhaus

Kostenübernahme Sonderklasse oder Privatspital im Krankenhaus

4 -8 Bettzimmer

2 Bett Zimmer

Kostenübernahme beim Kassenarzt

Kostenübernahme beim Privatarzt/Wahlarzt

~ 8.000 Kassenärzte

~ 10.000 Wahlärzte

Lange Wartezeiten bei Behandlung und Operationen

Kurze Wartezeiten bei Behandlung und Operationen

Private Krankenversicherung Gründe

Reasons for private health insurance

Why have private health insurance at all?

“Are you supplementary insured or not!” – a saying you often hear when you are already sitting in a doctor’s crowded waiting room after many hours.

When it is finally your turn to describe your symptoms to the doctor, you realize that you have a maximum of 5 minutes because he is massively pressed for time, since there are many other patients sitting outside who need his help.

If you end up in the hospital because of an accident or because of an illness, then you are annoyed by the other room neighbors who are snoring the latest Justin Bieber hit at night.

If you say, no this nerve-wracking feeling both at the doctor and in the hospital is not for you, then you should think about taking out private health insurance.

The following reasons play an important role:

Krankenzusatzversicherung-vorteile

Ihre Vorteile

What are the advantages and disadvantages of private health insurance?

What are your advantages with a private health insurance

What are your disadvantages with private health insurance

Additional benefits of private health insurance

private-krankenversicherung-faqs

FAQ

Private health insurance is a voluntary supplementary insurance to the statutory health insurance in Austria. It allows you to be reimbursed for the costs of treatment by an elective doctor and covers treatment in a private hospital or special class in a hospital.

The statutory health insurance is a compulsory insurance and covers the costs of panel doctors and the general fee class in the hospital. Private health insurance is taken out voluntarily and covers the costs of elective doctors and the private hospital.

The private health insurance has 3 components. The elective doctor insurance, the special class insurance and additional services (single room, baby option or travel tariff) of the private health insurance.

This depends mainly on how often you go to the elective doctor per year or how often you would like to go. As a rule, two to three visits to an elective doctor per year are sufficient. You can also significantly shorten waiting times for appointments or surgeries compared to the statutory health insurance physicians.

In principle, the amount of the premium depends on age and state of health. For a healthy 30-year-old person, however, you can expect to pay around €55 to €85 for a sensible insurance policy with the ideal range of benefits.

Privately insured persons have private health insurance in addition to statutory health insurance and can be fully reimbursed for the costs of elective physicians and use a private hospital.

The best private health insurance is currently an elective medical insurance with special class after accident and option for illness from Generali Krankenversicherung.

You choose your desired private health insurance from one of the 7 providers in Austria and apply for it with an insurance broker. Afterwards, your application goes through a risk assessment and if accepted positively, you will receive your policy.

No. With an insurance broker, you pay exactly the same price as with the insurance company directly and get independent advice on top of that. The commission is paid by the insurance company to the broker.

No. Only health questions must be answered. Performed during the underwriting process.

During the underwriting process, you may be contacted by a doctor from the insurance company and asked about certain of their health questions.

Yes, you can start receiving benefits as soon as you are covered by your elective plan. Depending on the insurance company, may be one point more or less in the policy in hand. Exceptions are here, however, special waiting periods (eg pregnancy treatments), which must be observed.

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