DRUCKEN

Medical help on vacation


Austria

If insured persons fall ill in an Austrian province outside the remit of the WGKK, they can consult a doctor under contract (outpatient clinic, facility under contract) at the Regional Health Fund responsible at their location on presentation of their e-card.
Attention! It is absolutely necessary to tell the doctor that the insured person is on vacation, as in this case the quarter rule is not in effect.

If the illness involves inability to work (sick leave), the insured person has to consult a doctor under contract with the respective Regional Health Fund and also inform his or her employer.

Abroad

When travelling to an EU/EEA member state, insured persons require the “European Health Insurance Card” (EHIC), which can be found on the back of the e-card. It serves as proof of entitlement for persons entitled in Austria while they temporarily stay in an EU/EEA member state, Switzerland, or a state covered by a bilateral agreement. Only for the Republic of Turkey a treatment certificate (form A/TR 3) is required.

If insured persons do not have a valid EHIC or if it was lost and therefore cancelled, the WGKK issues a provisional replacement certificate for the European Health Insurance Card (PRC) on application in any district office or customer centre.

On presentation of the valid EHIC or PRC, all benefits in kind such as treatment by doctors or in hospitals can be received that become medically necessary while temporarily staying abroad in another EU/EEA member state or Switzerland, taking into account the type of benefit and the expected duration of the stay. It is required, however, that the treatment facility used is a partner under contract with the health insurance system of the state in which the insured person stays.

Attention! When travelling to a EU/EEA member state or Switzerland in order to undergo certain treatment, the costs will only be borne by the WGKK if it has given prior approval; in this case EHIC or PRC must not be used.

Info

Validity of the European Health Insurance Card or the provisional replacement certificate (PRC) for the EHIC:
Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Macedonia, Montenegro, Malta, Netherlands, Norway, Poland, Portugal, Romania, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, United Kingdom.

Note on Bosnia-Herzegovina, Serbia and Montenegro: the EHIC and the PRC have replaced form A/BIH 3 from 1 July 2015. Directly presenting the EHIC/PRC to the provider of the benefit is not possible in Bosnia-Herzegovina subject to national law. The EHIC/PRC has to be presented to the locally responsible Bosnian and Herzegovinian health insurance institution. The customer then receives a national certificate of entitlement that has to be handed over to the Bosnian and Herzegovinian provider. In urgent cases (e.g. admission to a hospital), however, the EHIC/PRC is often accepted as proof of entitlement.

Note on Denmark:
in Denmark insured persons who are not citizens of a EU/EEA member state, must not use the EHIC and the provisional replacement certificate for health insurance purposes.

Note on Switzerland: Switzerland has been included in the social security system of the European Community by means of a special agreement between the European Community and its member states on the one hand, and the Swiss Confederation on the other. When staying in Switzerland, it must be noted that for non EU citizens the EHIC and PRC must not be used.

Note on Cyprus: when staying in Cyprus, the use of the EHIC and the PRC is restricted to the Greek part of Cyprus.

There are bilateral agreements with:

Bosnia-Herzegovnia EKVK/ PEB Citizenship irrelevant
Macedonia EKVK/ PEB Citizenship irrelevant
Montenegro EKVK/ PEB Citizenship irrelevant
Serbia EKVK/ PEB Citizenship irrelevant
Turkey A/TR 3 Citizenship irrelevant

Attention! In Turkey the EHIC and the PRC are not valid!

For Turkey the following is valid:

Under certain circumstances, a bilateral treatment certificate can generally be issued by the employer for employees and their entitled dependants. Otherwise, the WGKK issues treatment certificates for its insured persons in all district offices/customer centres. The treatment certificate should not be applied for more than two weeks before the start of the vacation.

The treatment certificate (health voucher) can, if required, be exchanged for a treatment certificate valid at the place of vacation at the relevant foreign health insurance institution.

In case of accidents or acute illnesses, hospitals and similar facilities often also accept the treatment certificate directly.

Benefits in kind are not provided under the Austrian legal stipulations, but exclusively according to the benefit guidelines and stipulations of the host country.

If this procedure is not possible (certificate is not accepted, emergency etc.), insured persons are asked to request an invoice that is as detailed as including type, scope and date of treatment. The settled invoice can late be submitted to the WGKK for (partial) reimbursement of the costs - see below.

If an insured person falls ill in a country not listed above (e.g. U.S.A., Thailand), the costs of any treatment required (treatment by doctors, at a hospital etc.) have in any case to be paid in full by the insured person.

On their return, however, insured persons can apply for reimbursement at the WGKK, on presentation of the detailed, settled invoices. The WGKK can only reimburse 80 percent of those costs that would have arisen if the same treatment had taken place in Austria (there is a special legal stipulation for the case of employers posting employees abroad).

If hospital care is received, though, the insured person is entitled to a care allowance of EUR 251,37 (2019) per day. This fixed daily rate is ten percent lower for dependants. If the costs are lower than the fixed daily rate, only the actual costs are reimbursed.

Attention! To ensure the remaining costs, often very high, do not have to be paid in full by the insured person, it is advisable to consider taking out private health insurance well before taking a trip abroad. Many travel businesses and the private insurers have a broad range of offers. Many credit-card companies already include insurance cover that also sometimes covers the costs of transport back to Austria if required.

Statutory insurance cover does not extend to transports back home from the place of vacation.

More information on the European Union, European Economic Area, Switzerland and the contractual states:
Telephone: +43 1 601 22-2820