Comparison between ÖGK and private health insurance
for cross-border commuters from Austria to Switzerland / Liechtenstein
An excerpt of the main differences between statutory health insurance (ÖGK) and private health insurance for cross-border commuters (cross-border commuter insurance).
Statutory health insurance
Private health insurance
Contributions
The contributions depend on the amount of the gross salary. The maximum contribution is currently € 526.79 per month (as at 2025)
The premium depends on age and state of health. The decisive factor is the age of entry – there are no age increases!
Premium surcharges due to pre-existing conditions are possible.
Acceptance procedure
There is no health check, i.e. the ÖGK cannot reject any applicant.
Risk assessment on the basis of the health questions on the application or, if necessary, by providing the relevant medical certificates.
Hospital service
Assumption of hospital costs in the general insurance. Fee class of public hospitals in Austria or in contracting states. A hospital cost contribution (deductible) is charged per day (approx. € 8.00 per day).
European cover guarantee depending on the variant in the general fee class or special class of a general public hospital in Europe, as well as private clinics and sanatoriums according to the contract directory.
Worldwide cover: In surgical cases where the medical standard in Austria is not sufficient, the costs are covered worldwide. There is no contribution to hospital costs (deductible).
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Benefits from the doctor and specialist
Customer is a health insurance patient. The treatment takes place simple, functional and must not exceed the Do not exceed what is necessary. E-Card fee of approx. € 10.85 for panel doctors, much higher deductible for deductible for elective doctors (doctors without health insurance contract).
Customer is a private patient and therefore receives preferential treatment. There is
100 % cost coverage. Direct billing with doctors is possible, i.e. fees do not have to be paid in advance by the customer (exception: foreign fee notes).
Services provided by alternative practitioners, holistic medicine
No reimbursement of costs, as these treatments are not are not recognized by social insurance.
Cost reimbursement depending on tariff – 100% cost coverage for doctors and specialists.
Medication
Only medicines approved by the statutory insurance company are paid. Prescription fees are charged per prescribed medication (as at 2017 € 5.85).
All medicines registered as therapeutic products in the EU can be obtained if they have been prescribed by a doctor. There are no prescription fees!
Visual aids
The patient is entitled to a pair of prescription glasses. A Costs for contact lenses are only reimbursed from -7.00 diopters (short-sightedness) or + 5.00 diopters (farsightedness). For visual aids a minimum deductible of EUR 75 (as at 2015). An ophthalmologist’s prescription is a condition for reimbursement of costs.
Reimbursement of costs for glasses and contact lenses depending on the tariff. For spectacles, the maximum tariff amount is available every two years. In the case of diopter changes, an annual purchase is possible. An ophthalmologist’s prescription is no longer required!
Dental treatment and dentures
Dental outpatient clinics are available. As a rule, only a small co-payment is made for dental treatment by elective dentists. The use of higher quality materials is not reimbursed. No reimbursement is provided for dentures.
Tooth extractions, fillings, root canal treatment, x-rays, oral hygiene, etc. are reimbursed at 100%. Higher-quality materials are also reimbursed. Dentures such as crowns, posts, bridges, etc. are also reimbursed up to 80%. The maximum amount per calendar year depends on the tariff.
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Daily hospital allowance
No service is provided.
If the accident insurance in CH or FL covers the costs of the stay in full after an accident, a daily allowance will be paid out.
Return service
No service is provided.
In medically necessary cases, transport home from abroad is taken over and organized worldwide.
Precaution
Annual health check-up is paid for.
Depending on the tariff selected, customers have access to first-class contract hotels for wellness stays lasting several days, health check-ups, as well as doctors and gyms for fitness training. This program can be taken advantage of every two years.
