“The health system is financed by a mix of general tax revenues and compulsory social health insurance (SHI) contributions. Income-related SHI contributions accounted for about 60% of publicly financed health expenditures, while the remaining 40% come from general taxation, including value-added tax (VAT), income tax and tobacco tax, which are collected at federal level. SHI has nearly universal coverage (99.9%). There is no competition between SHI funds as the insured are assigned by type or place of employment.”

Source: Bachner F, Bobek J, Habimana K, Ladurner J, Lepuschütz L, Ostermann H, Rainer L, Schmidt A E, Zuba M, Quentin W, Winkelmann J. Austria: Health system review. Health Systems in Transition, 2018; 20(3): 1 – 256.

“SHI contributions are based on income and not on health risks. Contribution rates are determined by law and can only be changed by the Austrian Parliament. The contribution rate amounted to 7.65% of employment-based income or income (also called the contribution base) for the majority of the contributing population in 2017. The contribution rate is nearly equally shared between employers and employees: 50.6% (contribution rate of 3.87% of income) are paid by the employee and 49.4% (contribution rate of 3.78% of income) by the employer. Lower contribution rates apply to civil servants (7.635%) and pensioners (5.1%). SHI contributions for certain population groups (e.g. the unemployed) are financed from general tax revenues.

“SHI funds collect contributions independently. Employers pay SHI contributions, including both the employers’ and the employees’ share, to one of the 18 SHI funds. The federal state pays the employer contribution for pensioners (through pension insurance) and for the unemployed (HVB, 2016b).

“SHI contributions are capped. In 2018, contributions increased proportionally up to a base salary or wage threshold of €5,130 per month for employees (plus annual bonus payments of €10,260). This means that the maximum SHI contribution was €392.44 per month (Allgemeines Sozialversicherungsgesetz, 1955). For self-employed and farmers the maximum income threshold on which to pay contributions was set at €5,985, and the maximum SHI contribution was €457.86 per month (HVB, 2017g). However, it must be mentioned that the annual maximum amount of SHI contributions are equal for employees and self employed/farmers due to the 13th month or 14th month bonus payments for employees.”

Source: Bachner F, Bobek J, Habimana K, Ladurner J, Lepuschütz L, Ostermann H, Rainer L, Schmidt A E, Zuba M, Quentin W, Winkelmann J. Austria: Health system review. Health Systems in Transition, 2018; 20(3): 1 – 256.

“In Austria SHI [Social Health Insurance] covered 8.82 million persons (including non-residents) or 99.9% of the population in 2016. About 76% of the insured population (6.66 million persons) paid wage-based contributions while about 24% were co-insured dependants such as children (until the age of 18, extendable under certain conditions until the age of 27), spouses and partners (HVB, 2017b). In 2010, coverage was extended to several non-standard employment relationships such as marginal part-time workers, quasi-freelancers, the newly self-employed, and temporary agency workers (see Table 2.2).

“Membership in an SHI fund is determined by law according to place of occupation, type of occupation or occupational status (unemployed, pensioners, etc.). Thus, there is no regulated competition between SHI funds.

“Insurance coverage is mandatory under various laws that apply to different groups in the population covered by different types of health insurance funds. The General Social Insurance Act (Allgemeines Sozialversicherungsgesetz, 1955, ASVG) regulates the nine regional health insurance funds that insure 76% of the population. There are five company health insurance funds (Betriebskrankenkassen) for the employees of five larger companies that are also regulated by the ASVG (see Table 3.4). In addition, there are specialist insurance laws (the Federal Act on Social Insurance for Persons engaged in Trade and Commerce (GSVG), Act on Social Insurance for Farmers (BSVG) and the Civil Servants’ Health and Accident Insurance Act (B-KUVG), Act on Social Insurance for the Self-Employed in Commerce, Trade and Industry (FSVG)) that regulate health insurance and respective health institutions for specific groups of the populations (self-employed, farmers and civil servants) (HVB, 2017f) (see Table 3.4).”

Source: Bachner F, Bobek J, Habimana K, Ladurner J, Lepuschütz L, Ostermann H, Rainer L, Schmidt A E, Zuba M, Quentin W, Winkelmann J. Austria: Health system review. Health Systems in Transition, 2018; 20(3): 1 – 256.

“SHI funds finance the largest share of health expenditure (45 % in 2018). Direct government spending – mostly contributions by the states for inpatient care – also constitutes a large share (30 %). In 2020, a major reform merged the existing SHI funds into five funds: the nine regional SHI funds now form a single fund – Österreichische Gesundheitskasse (ÖGK) – which covers about 82 % of the insured population, while self-employed workers, farmers, civil servants and railway workers remain insured by two specialist SHI funds. All SHI funds cover broadly the same benefits, and several steps have been taken since 2017 to harmonise benefits further, but differences remain among the insured population of the ÖGK and between funds for specific professions (see Section 5.2).”

“Health expenditure from public sources accounted for 75 % of the total in 2019 – a share that has been stable over the past decade – but it remains below the EU average of 80 %. The share of out-of-pocket (OOP) payments has also been stable since 2010, and accounted for 18 % of total health spending in 2019, which is above the EU average (15 %). OOP spending is mostly on outpatient medical care, medicines, long-term care and dental care (see Section 5.2).

“In 2020, additional public spending was allocated to the health and long-term care sectors to cover COVID-19 related expenses, including EUR 60 million for SHI funds.”

“In 2014, public spending accounted for 77.9% of total spending on health, while OOP [Out Of Pocket] payments and VHI [Voluntary Health Insurance] accounted for 16.1 and 4.6% respectively (WHO, 2016).”

Source: Thomas Czypionka and Clemens Sigl. “Austria.” In Voluntary health insurance in Europe: Country experience [Internet]. Sagan A, Thomson S, editors. Copenhagen (Denmark): European Observatory on Health Systems and Policies; 2016. Observatory Studies Series, No. 42.

Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and sixteen other nations.

Page last updated Nov. 11, 2022 by Doug McVay, Editor.