Before you start

Meldezettel
Employment registered by your employer with the ÖGK, or self-employed registration with the SVS
Austrian social insurance number, which is issued on that registration

Step-by-step

1
Let your employer register you — but check that they did
Employers must register you with the social insurance carrier before you start work. That registration generates your Sozialversicherungsnummer and triggers the e-card. If you have no e-card three weeks in, chase payroll rather than the ÖGK.
Via employerWho: Your employerBefore your first working day
2
Wait for the e-card and note the annual service fee
The card arrives by post. A service fee is charged once a year for the following year and collected through payroll in November — €25 for 2026. It is indexed annually and is not levied on co-insured dependants.
Via employerWho: You€25 for 2026, charged in November 2025
3
Register a Hausarzt with a Kassenvertrag
Find a GP who has a contract with the ÖGK — the ÖGK's own search filters for it. With a contracted doctor you show the e-card and pay nothing. This one choice determines most of your future medical costs in Austria.
OnlineWho: YouMonth 1
4
Understand what a Wahlarzt costs before you book one
A Wahlarzt has no ÖGK contract. You pay the full invoice up front and submit it for reimbursement, and you get back 80% of what the ÖGK would have paid a contracted doctor — not 80% of your bill. For a specialist charging well above the tariff, the refund can be a small fraction of what you spent.
In personWho: You
5
Add co-insured family members
Spouses and children can be co-insured without additional premium in defined circumstances, but it must be applied for — it is not automatic on a marriage certificate arriving in the post. Do it early, because retroactive cover is limited.
OnlineWho: You
6
Self-employed: register with the SVS and budget for the co-payment
The self-employed insure with the SVS, not the ÖGK, and pay a 20% co-payment on most treatment — halved to 10% for those who take part in the SVS health-goals programme. Contributions in the first years are assessed provisionally and then recalculated backwards once real profits are known.
OnlineWho: You

Documents you’ll need

e-card
Meldezettel
Social insurance number
Employment contract or SVS registration
European Health Insurance Card for travel within the EU, printed on the reverse of the e-card

Things most newcomers don’t know

Wahlarzt reimbursement is 80% of the official tariff, not 80% of what you paid.

This is the most expensive misunderstanding in Austrian healthcare. A Wahlarzt sets their own price; the ÖGK refunds 80% of what it would have paid a contracted doctor for that same service. If the private fee is three times the tariff, your refund covers roughly a quarter of the bill. Vienna has a high density of Wahlärzte, especially in dermatology, gynaecology and psychotherapy, and appointment waits with contracted doctors push people toward them without anyone explaining the arithmetic.

Source: ÖGK

Which insurer you belong to is decided by how you work, not by choice.

Employees go to the ÖGK, the self-employed to the SVS, public servants and railway staff to the BVAEB. You cannot shop between them. The practical consequence is that going freelance moves you to a fund with a 20% co-payment on treatment that employees never encounter — reducible to 10% by taking part in the SVS health-goals programme, which is worth doing in year one rather than year five.

Source: SVS; ÖGK

The e-card is now also your identity token for public services.

Beyond healthcare, the card carries your social insurance number and works with ID Austria for a growing set of online administration, including FinanzOnline. Losing it is more disruptive than losing a health card elsewhere in Europe, and the block-and-replace process takes time. The European Health Insurance Card printed on the reverse also covers you across the EU without any separate application.

Source: ÖGK; oesterreich.gv.at

International-organisation staff are outside the Austrian system, including the parts they might want.

UN, IAEA, OPEC and OSCE staff in Vienna are covered by their organisation's own scheme rather than the ÖGK, hold no e-card, and build no Austrian pension entitlement. That is generally fine while employed and awkward afterwards: a family that stays in Vienna after the contract ends has to enter the Austrian system from scratch, and the years of contributions that a comparable Austrian employee would have accumulated simply are not there.

Source: community-reported; BMEIA

Common mistakes to avoid

Booking a Wahlarzt without understanding that the refund is a percentage of the tariff, not of the bill.
Not checking that your employer actually filed the social insurance registration.
Assuming a spouse is co-insured automatically rather than on application.
Going freelance without budgeting for the SVS co-payment and the retroactive contribution recalculation.
Letting cover lapse in a gap between jobs instead of applying for voluntary self-insurance.

Some of this may be out of date. Spotted something inaccurate? Help us keep it right for the next newcomer.