Healthcare Reimbursement in Austria: Who Reimburses What Depending on Your Situation

As France and Austria are members of the European Union, their social security schemes are coordinated by Regulation (EC) 883/2004: a worker falls under the legislation of a single country, in principle that of their place of work, and their insurance periods add up. The carte Vitale does not work at an Austrian doctor: proof of rights is the Austrian e-card for a local insured person, the EHIC for a temporary stay, or a portable form (A1, S1) for a lasting stay. The two countries have no common border: cross-border worker status has no practical scope between them.

Five cases stand out: the employee on a local contract, the seconded employee, the self-employed person, the retiree and the person without activity, to which are added the student, the family, the CFE member, the first-euro policyholder and the tourist. The notions of reimbursement basis and out-of-pocket cost help you compare covers. How the care network works is described in the guide to the Austrian healthcare system.

The employee on a local contract is declared by their employer to social insurance and receives care from the ÖGK. A consultation with a contracted doctor is fully covered on presentation of the e-card. They pay a €7.55 contribution per prescribed item and a daily hospital contribution (€10.18 to €23.50 depending on the Land, 28 days at most per calendar year). Sickness allowances reach 50% of the last salary, then 60% from the 43rd day (CLEISS). See the glossary entry on the local contract.

The seconded employee sent by a French employer stays attached to French social security for up to 24 months, with form A1. They can request the EHIC to access local practitioners directly, or advance the costs and claim reimbursement from their French fund with form S3125. If the family lives in Austria, it can register for local care with an S1. Sick leave is declared to the French fund within 48 hours and daily allowances come from France (CLEISS). See seconded or expat and the glossary entry on the seconded employee.

The self-employed person working in Austria falls under the SVS (the social insurance institution for the self-employed), whose contributions are presented in the page on working in Austria. A French self-employed person who works only temporarily in Austria can, under conditions, remain in the French scheme with an A1 certificate.

The retiree drawing a French pension requests form S1 from their pension fund before departure, then hands it to the ÖGK: they then receive care under Austrian legislation, at the expense of France. Each family member has their own S1. They keep their carte Vitale and retain full rights in France during a stay (ameli). If the tax resident is established outside France, a health contribution of 3.2% on the basic pension and 4.2% on the supplementary pension is levied on their French pensions (CLEISS). See the guide to form S1: how it works and the page on retiring in Austria.

The student on a temporary stay (Erasmus type) uses the EHIC, which remains valid for up to two years, is ordered at least 15 days before departure and covers medically necessary care; it covers neither planned care nor permanent residents (CLEISS). For a lasting move without a derived right, student Selbstversicherung costs €78.84 a month in 2026. See student insurance abroad.

The spouse and children are covered as dependants of the insured person: the spouse, the partner in a registered partnership and, under conditions, the dependent cohabitant, as well as children until they come of age, and until 27 for studies (CLEISS). See expat family insurance.

The person without activity and without a derived right takes out a Selbstversicherung with the ÖGK: €565.25 a month in 2026, with a possible reduction depending on resources. Benefits start in principle after six months, or immediately with 26 weeks of insurance in the last 12 months; cash allowances are excluded (oesterreich.gv.at).

The CFE member contributes to a voluntary social protection body for French nationals abroad. Assurance Maladie (the French national health insurance) specifies that an expat can keep French cover through the CFE, then contributing to both systems. The CFE is therefore added to the compulsory Austrian scheme of an employee or a self-employed person; it serves as support for stays in France and for the return. No waiting period applies if enrolment takes place before departure or within three months of moving abroad; beyond that, the waiting period is three months before age 45 and six months after. There is no medical questionnaire, and a child must be conceived after enrolment for maternity cover (CFE). See the guide to CFE reimbursements.

First-euro international health insurance reimburses actual costs within its ceilings, after any excess, waiting periods and exclusions. It opens access to practitioners without a contract and to private hospitals, with direct billing depending on the contract, and may include repatriation.

The tourist presents their EHIC to the doctors and hospitals of social insurance; with a Wahlarzt or in a private hospital without a contract, they advance the costs as a private patient. Travel insurance that covers hospitalisation, repatriation and mountain rescue usefully complements the EHIC. See long-stay travel insurance.

An expat who returns asks their health insurance fund to reopen their rights with form S1106 (Assurance Maladie). Without activity on arrival, they show three months of stable residence in France; with an employment contract, affiliation takes place with no waiting period. According to the CFE, CFE members benefit from a resumption with no waiting period, under the body’s conditions. See the guide to reducing the waiting period and the page on returning to France.

• Consultation: free with a contracted doctor using the e-card. With a Wahlarzt, the ÖGK reimburses 80% of the tariff it would have paid to a contracted doctor, within the limit of actual costs, on a paid invoice submitted within 3.5 years: the amount received is often below 80% of the invoice. Actual costs for a first-euro contract.
• Hospital stay: the ÖGK within its network, with a daily contribution of €10.18 to €23.50 depending on the Land; French scheme for the seconded employee; EHIC for a temporary stay in a contracted facility; international contract with direct billing.
• Medicines: €7.55 per prescribed item in 2026 for an ÖGK insured person; reimbursement according to the contract for an international contract; the EHIC gives entitlement to the same conditions as local insured persons.
• Dental: with a Wahlzahnarzt, the ÖGK reimburses 80% of the contracted tariff. Removable dentures are subsidised on the basis of the contracted tariff, with a share borne by the insured person of 20 to 30% of the tariff since May 2026; crowns, bridges and implants are in principle a private service, except for a particular medical indication (ÖGK).
• Optical: the ÖGK pays a contribution on prescription, calculated on a contracted tariff, with a minimum share borne by the insured person; amounts are checked with the ÖGK, and international contracts set a ceiling per period.
• Maternity: the examinations of the parent-child pass (Eltern-Kind-Pass) are free with contracted doctors: five gynaecological consultations, two blood tests and three ultrasounds during pregnancy, then ten examinations of the child. An uninsured woman resident can obtain a cover voucher from the fund of her home area. Maternity allowance corresponds to 100% of the average net salary of the last three months (CLEISS). The CFE requires conception after enrolment, and international contracts generally apply a waiting period to maternity.

The reimbursement guide and the expat health insurance page give benchmarks; Expavy helps you weigh these options against your situation.