EXPLAINED: What is a Wahlartzt in Austria?
Going to a Wahlarzt, or an 'elective doctor', comes with a higher price but can also provide benefits. What are the differences between a public and elective doctor and how can you get costs refunded if you choose a Wahlarzt in Austria?
In Austria, there are many different healthcare options available, as doctors can choose to have a contract with public health insurance or not. An "elective" doctor, also known as Wahlarzt, is not connected to public insurers such as ÖGK and SVS, but a "contract doctor" is. But why does this matter, and what does it change in health services?
Physicians linked to the Wahlarzt system typically practice in private settings, in private clinics, hospitals or in their own practices.They are independent and have the possibility to create their own schedules, fees, and treatment plans. If you choose to visit a Wahlarzt, you need to be prepared for out-of-pocket expenses, as many services are not covered by mandatory health insurance.
A contract doctor, on the other hand, gets paid directly by the public insurance but then has their fees set by them as well (as a patient, you only present your e-card and won't have to pay anything upfront). They need to follow some strict regulations set by the insurance companies and states, including how many hours a week their offices are open (usually around 20 hours a week, but they must offer appointment times in the mornings, afternoons and evenings).
READ MORE: How the Austrian healthcare system works
Pros and cons
Since a Wahlarzt sets their own fees (and they tend to be higher than the insurance doctors), you typically experience shorter waiting times and have more time with the doctors. Facilities are often more modern, and they can provide more personalised treatment plans.
Services from a Wahlarzt physician also come with a higher cost, and even if a portion is reimbursed by a patient's public health fund, the amount can vary. Additionally, patients are required to pay the full price at the time of the appointment, making the service less accessible to everyone.
READ ALSO: Everything foreigners need to know about the Austrian healthcare system
How can I get a refund for a Wahlarzt appointment?
In general, when receiving medical services from a Wahlarzt, you are likely to be reimbursed by your insurance fund after the treatment.
The amount of money you can get back if you go to a Wahlarzt in Austria varies depending on several factors, including your health insurance coverage and the specific services provided by the Wahlarzt.
For example, with the most common public insurance, ÖGK, around 80 percent of the amount that ÖGK would have spent if the doctor were linked to the public system is reimbursed.
READ ALSO: What you need to know about Austria's new healthcare reform
It is important to note that this does not correspond to 80 percent of your medical bill but 80 percent of what ÖGK would have paid for your treatment at a public doctor, which is significantly lower than the amount listed on your bill.
Getting the reimbursement is relatively easy - you can do it online by submitting the doctor's invoice and a paid fee note (proof of payment) to your health insurance provider. ÖGK's page is HERE. Some people choose private insurance in addition to the mandatory public one to cover the costs of their Wahlarzt visits. In those cases, usually, you first pay the doctor the full fee. Then, you submit an invoice to the public health insurance and wait until you receive the refund from the public insurance.
Finally, you submit the documents from the doctor and from the public insurance to the private insurance to receive the remaining amount refunded to your bank account.
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In Austria, there are many different healthcare options available, as doctors can choose to have a contract with public health insurance or not. An "elective" doctor, also known as Wahlarzt, is not connected to public insurers such as ÖGK and SVS, but a "contract doctor" is. But why does this matter, and what does it change in health services?
Physicians linked to the Wahlarzt system typically practice in private settings, in private clinics, hospitals or in their own practices.They are independent and have the possibility to create their own schedules, fees, and treatment plans. If you choose to visit a Wahlarzt, you need to be prepared for out-of-pocket expenses, as many services are not covered by mandatory health insurance.
A contract doctor, on the other hand, gets paid directly by the public insurance but then has their fees set by them as well (as a patient, you only present your e-card and won't have to pay anything upfront). They need to follow some strict regulations set by the insurance companies and states, including how many hours a week their offices are open (usually around 20 hours a week, but they must offer appointment times in the mornings, afternoons and evenings).
READ MORE: How the Austrian healthcare system works
Pros and cons
Since a Wahlarzt sets their own fees (and they tend to be higher than the insurance doctors), you typically experience shorter waiting times and have more time with the doctors. Facilities are often more modern, and they can provide more personalised treatment plans.
Services from a Wahlarzt physician also come with a higher cost, and even if a portion is reimbursed by a patient's public health fund, the amount can vary. Additionally, patients are required to pay the full price at the time of the appointment, making the service less accessible to everyone.
READ ALSO: Everything foreigners need to know about the Austrian healthcare system
How can I get a refund for a Wahlarzt appointment?
In general, when receiving medical services from a Wahlarzt, you are likely to be reimbursed by your insurance fund after the treatment.
The amount of money you can get back if you go to a Wahlarzt in Austria varies depending on several factors, including your health insurance coverage and the specific services provided by the Wahlarzt.
For example, with the most common public insurance, ÖGK, around 80 percent of the amount that ÖGK would have spent if the doctor were linked to the public system is reimbursed.
READ ALSO: What you need to know about Austria's new healthcare reform
It is important to note that this does not correspond to 80 percent of your medical bill but 80 percent of what ÖGK would have paid for your treatment at a public doctor, which is significantly lower than the amount listed on your bill.
Getting the reimbursement is relatively easy - you can do it online by submitting the doctor's invoice and a paid fee note (proof of payment) to your health insurance provider. ÖGK's page is HERE. Some people choose private insurance in addition to the mandatory public one to cover the costs of their Wahlarzt visits. In those cases, usually, you first pay the doctor the full fee. Then, you submit an invoice to the public health insurance and wait until you receive the refund from the public insurance.
Finally, you submit the documents from the doctor and from the public insurance to the private insurance to receive the remaining amount refunded to your bank account.
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