Austria's health insurance may introduce co-payments for doctor visits: what the ÖGK proposed

Austria's health insurance may introduce co-payments for doctor visits: what the ÖGK proposed Austria's health insurance fund (ÖGK) is considering co-payments for doctor visits. What was proposed, who opposes it, and what already changed in Austrian healthcare in 2026. Topics: News, Healthcare, Economy.

Austria’s health insurance fund (Österreichische Gesundheitskasse, ÖGK) is for the first time publicly discussing the idea of introducing a co-payment for doctor visits — a so-called Selbstbehalt (deductible / self-payment). The idea surfaced on 1 October 2026, when the Green party published an internal strategy paper from the employer side of the fund. Health Minister Korinna Schumann (SPÖ) has already rejected the plan, but the document shows how seriously the fund is looking for savings. This article explains what ÖGK proposed, who would be affected, and what has already changed in Austrian healthcare in 2026.

What the ÖGK health insurance fund proposed

In the leaked document — a protocol of the “Strategieklausur” (strategy retreat) of the ÖGK’s employer-side faction — the proposal is a “gestaffelte Kostenbeteiligung bei Arztbesuchen”: a tiered co-payment system for doctor visits. The exact amount is not yet named, but the idea is that every visit to a Kassenarzt (a doctor with a public insurance contract) should become at least partially paid. Today, a visit to a Kassenarzt is free of charge — patients simply show their e-card (electronic health insurance card).

The second key point is abolishing reimbursement for Wahlarzt visits (private doctors who can bill public insurance). Currently patients pay out of pocket for a Wahlarzt and later receive compensation from ÖGK. If the proposal goes through, that compensation would be fully scrapped: the private doctor would become more expensive and the patient would pay everything themselves. As heute.at reports, the freed-up funds would be reinvested to attract more doctors into the public system.

Additionally, the paper mentions “improved profit extraction” from ÖGK’s own clinics and outpatient centres, as well as removing blanket exemptions from the Ambulanzgebühr (outpatient clinic fee). A income-dependent health spending cap combining prescription fees and doctor costs is also being discussed. The bottom line: the possibility of charging a Selbstbehalt is now under legal review — no decision has been made.

Which other savings ideas are on the table

Beyond co-payments for doctor visits, the employer-side strategy paper also contains a “Fairness-Beitrag”: higher social insurance contributions for people who voluntarily work part-time. The idea drew sharp criticism — Green health spokesperson Ralph Schallmeiner said part-time work is often linked to caring for children or elderly relatives, and that the “fair contribution” would essentially punish people for that.

The savings context is serious. According to Der Standard, as early as 1 June 2026 the BVAEB fund (covering public servants, railway workers and miners) raised the Behandlungsbeitrag (patient co-share of treatment costs) from 10 % to 20 % — meaning doctor visits for this group have already become twice as expensive. Since May 2026, ÖGK has applied stricter rules for reimbursement of patient transport, and the patient share for essential dental prosthetics has risen from 25 % to 30 %. All these measures are expected to save about €34.4 million per year from 2027.

Who opposes the plans and why

Virtually all sides have spoken out against the initiative. Health Minister Korinna Schumann (SPÖ) stated plainly: visits to Kassenarzt doctors must remain free. As meinbezirk.at reports, opposition also comes from the trade union federation ÖGB, the senior citizens’ association PVÖ, the conservative Seniorenbund and the opposition FPÖ.

SPÖ official Klaus Seltenheim put it simply: “It must be the e-card that counts, not the credit card.” As 5min.at writes, for him “health is a fundamental right and must not be a question of one’s wallet.” Vorarlberg SPÖ health spokesperson Manuela Auer warned that scrapping Wahlarzt reimbursement would deepen Zwei-Klassen-Medizin (two-class medicine) — the wealthy would keep seeing private doctors while everyone else waits weeks or skips examinations.

Many people visit a Wahlärztin or Wahlarzt not because they chose a paid service, but because they cannot get a timely Kassenarzt appointment or there is no public doctor nearby.

— Ralph Schallmeiner, Green Party health spokesperson

What has already changed in Austrian healthcare in 2026

Even without new co-payments, patients in Austria are already paying more in 2026. Beyond the BVAEB co-share rising to 20 %, other costs have gone up too. The Ambulanzgebühr (outpatient clinic fee) remains mandatory for most patients. For prescription medicines (Rezeptgebühr) patients pay roughly 10 % of the cost, and for dental prosthetics the patient share has risen to 30 %.

According to Gesundheit.gv.at — Austria’s official health portal — public insurance covers most Kassenarzt visits, hospital stays and prescription medicines, but with certain co-payments. The ÖGK currently insures the vast majority of employed people and their families. To understand which funds exist in Austria and how they differ, see our overview of health insurance in Austria.

What this means for patients right now

The key point: there are no new co-payments yet. The strategy paper is an internal discussion among the fund’s employer representatives — not a legislative bill. ÖGK chairman Peter McDonald confirmed to the APA news agency that the fund is exploring “completely new approaches,” but stressed that no decision has been taken and the ideas still need to be discussed with social partners. Minister Schumann has two months to answer the Green party’s parliamentary inquiry.

The practical takeaway for patients: visits to a Kassenarzt are still free, and the e-card works as before. If you currently see a Wahlarzt and receive ÖGK compensation, that also remains in place. But if a Selbstbehalt is introduced in the coming years, the public doctor will stop being “free” in the familiar sense. It pays to understand how Austrian insurance works and which co-payments already apply — our guide on what health insurance covers for dental treatment and the overview of sickness benefit Krankengeld explain the logic of the system.

What comes next and what patients should do

The idea of charging for doctor visits is being discussed against the backdrop of the fund’s chronic deficit. Supporters speak of needing “fewer ideological barriers” (McDonald), opponents of undermining solidarity. Public opinion currently leans toward rejecting the plan, but pressure on healthcare spending keeps growing.

A checklist for patients:

• Follow the debate — no decision on Selbstbehalt has been made, but signals from the fund side are already out
• Check your fund — if you are with BVAEB, your treatment co-share is already 20 %
• Keep receipts for medicines and treatment — part of the costs can be reclaimed through your annual tax return (Arbeitnehmerveranlagung)
• Review Wahlarzt compensation — it still works, but its future is being debated
• Subscribe to our newsletter so you do not miss healthcare changes in Austria

Austrian healthcare changes slowly but steadily. The question of co-payments for doctor visits is one of the most sensitive for patients, and its outcome is still open. Follow updates on how2austria.com.