Wahlarzt vs Kassenarzt: The Two-Track System Every Student in Austria Needs to Understand
A Kassenarzt is a doctor with an ÖGK contract — you show your e-card and pay nothing. A Wahlarzt is a private doctor without a contract — you pay €108–206 per visit upfront and get back only about 20% of the actual bill from ÖGK. This distinction shapes every healthcare decision you make in Austria.
In Vienna, roughly 50% of all doctors are Wahlärzte. In some specialties like dermatology and psychiatry, the share is even higher. As an international student, you will encounter this two-track system quickly — especially when searching for English-speaking doctors, shorter waiting times, or specific specialists.
This guide explains exactly how both systems work, what you actually pay at a Wahlarzt, how the reimbursement process works, and when supplementary insurance (Zusatzversicherung) makes financial sense. For the basics of Austrian student health insurance, see our ÖGK Selbstversicherung guide.
Kassenarzt: The Public System Doctor
A Kassenarzt (also called Vertragsarzt) has a contract with the ÖGK. This contract sets fixed fees for every service. You, the patient, never see those fees.
How It Works
- You walk into a Kassenarzt’s office
- You show your e-card at the reception
- The doctor treats you
- You leave — without paying anything (except €7.55 per prescription if you need medication)
That is it. No invoices, no reimbursement forms, no surprises.
What You Get
- GP visits (Allgemeinmediziner): Unlimited, no referral needed
- Specialist visits: With a referral (Überweisung) from your GP — one specialist per specialty per quarter
- Lab tests and imaging: Ordered by your doctor, billed directly to ÖGK
- Prescriptions: You pay only the Rezeptgebühr of €7.55 per item
The Downside: Waiting Times
This is where the Kassenarzt system struggles. A 2026 study based on 1,591 mystery calls across Austria found these average waiting times for a first appointment:
| Specialty | Kassenarzt Wait | Wahlarzt Wait | Ratio |
|---|---|---|---|
| Ophthalmology (Augenheilkunde) | 52 days | 4 days | 13x longer |
| Orthopedics | 24 days | 2 days | 12x longer |
| Dermatology | 33 days | 5 days | 7x longer |
| Internal medicine | 28 days | 4 days | 7x longer |
| Gynecology | 18 days | 3 days | 6x longer |
| General practice (GP) | 5 days | 1 day | 5x longer |
Source: Wahlarzt-Kassenarzt Wartezeiten-Studie 2026, based on data collected November 2025 – February 2026.
For a GP, 5 days is manageable. For a dermatologist or ophthalmologist, waiting nearly two months can be a problem — especially if you have an acute issue.
How to Find a Kassenarzt
Use the ÖGK doctor search at gesundheitskasse.at. Filter by:
- Fachrichtung (specialty)
- Bundesland/Bezirk (state/district)
- Sprache (language) — some offer English
In Vienna, the Ärztekammer Wien doctor search also lets you filter for contract status.
Wahlarzt: The Private Doctor
A Wahlarzt (literally “doctor of choice”) is a licensed physician who does not have a contract with ÖGK. The doctor sets their own fees. You pay the full bill. ÖGK reimburses a fraction afterward.
Why Wahlärzte Exist
Austria has too few Kassenarzt positions (Kassenplanstellen) relative to the number of practicing doctors. Many qualified specialists choose to work privately rather than wait for a contract position or accept the lower, fixed ÖGK fees. The result: in Vienna, more than half of practicing doctors are Wahlärzte.
Why Students Go to Wahlärzte
Despite the cost, Wahlärzte attract students for specific reasons:
- Shorter waiting times: Days instead of weeks or months
- Longer appointments: 20–45 minutes instead of the typical 5–10 minutes at a Kassenarzt
- English-speaking doctors: Especially in Vienna, many Wahlärzte market to an international clientele
- Specific specialists: Some subspecialties are only available through Wahlärzte
- Availability outside business hours: Some Wahlärzte offer evening or Saturday appointments
Real Costs: What Wahlärzte Charge in 2026
The Wahlarzt-Kosten-Report 2026 surveyed actual first-visit fees (Erstordination) across Austria. Here are the averages:
| Specialty | Average First Visit Cost | Range |
|---|---|---|
| General practice (Hausarzt) | €108 | €60–180 |
| Dermatology | €149 | €90–250 |
| Orthopedics | €178 | €120–300 |
| Internal medicine | €181 | €100–280 |
| Gynecology | €202 | €120–350 |
| Psychiatry | €206 | €150–300 |
Source: Wahlarzt-Kosten-Report 2026, data collected November 2025 – February 2026, based on standardized price inquiries as potential new patients with ÖGK insurance.
Cost Examples: What You Actually Pay
Let us walk through three real scenarios:
Scenario 1: GP Visit
- Wahlarzt bill: €108
- ÖGK Kassentarif for same service: ~€25
- ÖGK reimburses: €20 (80% of €25)
- Your cost: €88
Scenario 2: Dermatologist Visit
- Wahlarzt bill: €149
- ÖGK Kassentarif: ~€35
- ÖGK reimburses: €28 (80% of €35)
- Your cost: €121
Scenario 3: Psychiatrist Visit
- Wahlarzt bill: €206
- ÖGK Kassentarif: ~€45
- ÖGK reimburses: €36 (80% of €45)
- Your cost: €170
The pattern is consistent: ÖGK reimburses about 15–25% of the actual Wahlarzt bill, not the 80% many students expect. The 80% refers to the Kassentarif, which is far below the actual private fee.
How Wahlarzt Reimbursement Works
The Step-by-Step Process
Step 1: Visit the Wahlarzt
You receive treatment. At the end, the doctor gives you an invoice (Honorarnote). Pay in full — cash, card, or bank transfer, depending on the practice.
Step 2: The Doctor Submits Your Invoice (WAHonline)
Since July 2024, all Wahlärzte with more than 300 patients per year are legally required to submit your invoice electronically to ÖGK via the WAHonline system. The doctor must verify your identity using your e-card. This makes the process faster and largely automatic.
Step 3: ÖGK Calculates Your Reimbursement
ÖGK calculates 80% of the Kassentarif for the services listed on the invoice. This amount is credited to your Austrian bank account.
Step 4: You Receive the Money
- If submitted via WAHonline: Reimbursement arrives within 2 weeks (often faster)
- If submitted by post (paper): Reimbursement takes 2–12 weeks
- Deadline: You can submit invoices up to 42 months (3.5 years) after the service date
What You Need for Reimbursement
The Honorarnote (invoice) must contain:
- Doctor’s name and address
- Your name and insurance number (Sozialversicherungsnummer)
- Date of treatment
- Description of services performed
- Amount charged
- Payment confirmation (paid stamp or bank transfer receipt)
Online Reimbursement Tracking
Track your reimbursement status at meineoegk.at with your ID Austria login.
Private Hospitals (Privatkliniken) vs Public Hospitals
The Kassenarzt/Wahlarzt distinction extends to hospitals:
Public Hospitals (Öffentliche Krankenanstalten)
- AKH Wien, LKH Graz, LKH Innsbruck, etc.
- ÖGK covers treatment in the Allgemeine Gebührenklasse (general class)
- Shared rooms (4–8 beds)
- Treatment by the hospital team
- Daily co-payment: €12–15/day for first 28 days
- No choice of specific doctor
Sonderklasse (Special Class) in Public Hospitals
Many public hospitals offer a Sonderklasse — a premium ward within the same hospital:
- Single or double room
- Treatment by a specialist of your choice (Chefarzt)
- Better food, more comfort
- Not covered by ÖGK — costs €300–800/day depending on hospital and state
- Covered by Zusatzversicherung (Sonderklasse-Tarif)
Private Hospitals (Privatkliniken)
- Rudolfinerhaus, Confraternität, Goldenes Kreuz, Wiener Privatklinik, etc.
- Not covered by ÖGK at all
- Daily rates: €500–2,000+ depending on treatment
- Typically covered by Zusatzversicherung or paid out of pocket
- Shorter waiting times, hotel-like comfort, specific doctor choice
For Students: When Does This Matter?
For planned surgery or longer hospital stays, the difference is significant. For emergency care, all public hospitals admit you regardless — you will always receive treatment. The quality of medical care in Austrian public hospitals is excellent. The difference is comfort, waiting time, and doctor choice.
Zusatzversicherung: Closing the Wahlarzt Gap
If you visit Wahlärzte regularly or want private hospital access, Zusatzversicherung (supplementary private insurance) bridges the gap between what ÖGK pays and what you actually spend.
What Zusatzversicherung Covers
| Feature | Without | With Zusatzversicherung |
|---|---|---|
| Wahlarzt reimbursement | ~20% of bill | 80–100% of bill |
| Specialist wait time | Weeks to months | Days |
| Hospital class | General (4–8 bed room) | Sonderklasse (single/double) |
| Hospital doctor | Team doctor | Choose your specialist |
| Dental prosthetics | Not covered | 50–80% coverage |
| Alternative medicine | Not covered | Often included |
Austrian Zusatzversicherung Providers for Students
The three main providers with student-relevant offerings:
Generali:
- Wahlarzt-Tarif from ~€35/month (20s age group)
- Sonderklasse-Tarif available as add-on
- Good online portal for claims
Uniqa:
- MedPrivat and MedKomfort tariffs
- Wahlarzt + Sonderklasse from ~€45/month (20s)
- No referral needed for Wahlarzt claims
Wiener Städtische:
- MedPlus tariff line
- Combined Wahlarzt + Sonderklasse from ~€50/month (20s)
- Widely used by Austrian students
Cost-Benefit Analysis for Students
| Scenario | Monthly Extra Cost | Annual Savings If You Visit 3x |
|---|---|---|
| No Zusatz, 3 Wahlarzt visits/year | €0/month | You pay ~€300–500 out of pocket |
| Basic Wahlarzt Zusatz (€35/month) | €35/month (€420/year) | You get back ~€250–400 more |
| Full Zusatz + Sonderklasse (€60/month) | €60/month (€720/year) | Worth it only with hospital stays |
Bottom line: If you visit Wahlärzte fewer than 3 times per year, paying out of pocket is cheaper than Zusatzversicherung. If you visit regularly (English-speaking therapist, dermatologist, gynecologist), the insurance pays for itself.
Important: Pre-existing Condition Waiting Periods
Most Zusatzversicherung plans have waiting periods of 3–12 months for pre-existing conditions. Apply early — ideally at the start of your studies, when you are healthy. Dental waiting periods are typically 6–12 months.
Special Case: Psychotherapy and Mental Health
Mental health is one area where the Kassenarzt/Wahlarzt divide hits students hardest.
Kassenarzt Psychotherapy
- ÖGK covers psychotherapy at Kassenplatz therapists (fully funded slots)
- Waiting lists: 3–6 months in Vienna for a funded slot
- Free once you have a spot
Wahlarzt Psychotherapy
- No waiting — find a therapist this week
- Cost: €80–150/session
- ÖGK reimburses: ~€28/session (Kostenzuschuss)
- Your out-of-pocket: €52–122/session
- Weekly therapy at €100/session = €400/month, minus €112 ÖGK = €288/month out of pocket
Student Counseling (Free)
Before paying for private therapy, check these free options:
- University psychological counseling (Psychologische Beratungsstelle) — free, no e-card needed
- Student support services (ÖH Sozialberatung) — can help navigate the system
- Crisis hotline (Telefonseelsorge): 142 — 24/7, free, anonymous
For more on mental health coverage, see our guide on mental health coverage for international students.
Practical Decision Guide: Kassenarzt or Wahlarzt?
Always Choose Kassenarzt For:
- Routine checkups — annual Vorsorgeuntersuchung, blood tests
- Chronic conditions — regular follow-ups, medication refills
- Hospital referrals — Kassenärzte refer directly within the public system
- Lab work — blood tests, urine tests (free at Kassenarzt, charged at Wahlarzt)
- Prescriptions — same €7.55 Rezeptgebühr either way, but Kassenarzt visits are free
Consider Wahlarzt For:
- Urgent specialist needs — when waiting 4–8 weeks is not an option
- English-speaking doctors — especially outside Vienna
- Second opinions — before major procedures
- Sensitive topics — longer appointments, more privacy
- Specific subspecialties — some are only available privately
The Hybrid Approach
Most students in Austria use a hybrid approach:
- GP (Hausarzt): Kassenarzt — for routine visits, referrals, prescriptions
- Specialists: Kassenarzt first, Wahlarzt only when urgent or unavailable
- Therapy: Kassenplatz waitlist + university counseling, Wahlarzt only if needed immediately
- Dental: Kassenarzt for checkups and fillings, pay out of pocket for cleanings
This approach keeps costs minimal while ensuring access when urgency demands it.
How to Find Doctors in Austria
Finding Kassenärzte
- ÖGK doctor search: gesundheitskasse.at — filter by Kassenarzt status
- DocFinder: docfinder.at — patient reviews, filter by Kasse
- Ärztekammer: aerztekammer.at — official directory
Finding Wahlärzte
- DocFinder: Same platform, filter by Wahlarzt
- Google Maps: Search “Wahlarzt [specialty] [city]” — reviews in English often available
- University notice boards: International student offices sometimes share lists of English-speaking doctors
- Expat forums: Vienna Expats Facebook groups, Reddit r/Austria
Checking Doctor Status
Before booking, always verify whether a doctor is Kassenarzt or Wahlarzt:
- Call the practice and ask: “Haben Sie einen Kassenvertrag mit der ÖGK?”
- Check on DocFinder (marked as “Alle Kassen,” “ÖGK,” or “Wahlarzt”)
- Check on the ÖGK website (only lists Kassenärzte)
Checklist: Before Your Wahlarzt Visit
Before booking a Wahlarzt appointment, run through this checklist:
- Check Kassenarzt availability: Is there a contracted doctor nearby in the same specialty with acceptable wait times? Use the ÖGK doctor search.
- Clarify costs upfront: Call the practice and ask about first-visit fees. Many practices list prices on their website.
- Payment methods: Confirm whether you can pay by card, cash, or bank transfer. Not all private practices accept credit cards.
- Bring your e-card: Even at a Wahlarzt, you need your e-card — since January 2026, e-card verification is mandatory for WAHonline invoice submission.
- Bring previous results: If you have earlier lab results, X-rays, or specialist reports, bring them. This saves time and avoids duplicate tests.
- Know your reimbursement rights: Ask the practice whether your Honorarnote will be submitted automatically via WAHonline to ÖGK. If yes, reimbursement arrives within 2 weeks.
5 Strategies to Reduce Wahlarzt Costs
Strategy 1: First Visit vs Follow-Up
The Erstordination (first visit) is always more expensive than follow-ups. Subsequent visits typically cost 20–40% less. If you need a Wahlarzt regularly, costs drop after the initial appointment.
Strategy 2: Always Submit Your Reimbursement
Even when the reimbursement is low — always submit it. For a €149 dermatologist visit, you get back about €28. Over a year with 3 visits, that is €84 saved.
Strategy 3: Combine Kassenarzt + Wahlarzt
Get standard tests (blood work, urine) done at a Kassenarzt — free of charge. Visit the Wahlarzt only for the specialist assessment and specialized tests. This saves you lab costs.
Strategy 4: Ask About Student Discounts
Some Wahlärzte offer informal student discounts. It never hurts to ask — especially for recurring visits (e.g., weekly therapy sessions).
Strategy 5: Get Zusatzversicherung Early
If you know you will need Wahlärzte regularly (therapy, dermatology, gynecology), sign up for Zusatzversicherung at the start of your studies — before pre-existing conditions are diagnosed. Waiting periods begin from the contract start date.
Frequently Asked Questions
What is the difference between Kassenarzt and Wahlarzt?
A Kassenarzt has a contract with ÖGK. You show your e-card and pay nothing (except €7.55 per prescription). A Wahlarzt has no ÖGK contract. You pay the full bill upfront. ÖGK reimburses 80% of the much lower Kassentarif — in practice, about 15–25% of the actual bill.
How much does a Wahlarzt visit cost in Austria?
Average first-visit costs in 2026: GP €108, dermatologist €149, orthopedist €178, internist €181, gynecologist €202, psychiatrist €206. These are nationwide averages — Vienna tends to be higher. Follow-up visits are typically 20–40% less than first visits.
How much does ÖGK reimburse for Wahlarzt visits?
ÖGK reimburses 80% of the Kassentarif (the fee ÖGK would pay a contracted doctor), not 80% of the Wahlarzt bill. The Kassentarif is much lower than private fees. In practice, you get back about 15–25% of the actual bill. Example: €149 dermatologist bill, €28 reimbursement, €121 out of pocket.
How long does Wahlarzt reimbursement take?
If the doctor submits via WAHonline (mandatory for most doctors since July 2024): about 2 weeks. If submitted by paper: 2–12 weeks. You can submit invoices up to 42 months after treatment.
Is it worth getting Zusatzversicherung as a student?
It depends on your usage. If you visit Wahlärzte 3+ times per year or want private hospital rooms (Sonderklasse), Zusatzversicherung from €35–60/month can save money. If you rarely visit doctors and are happy with the Kassenarzt system, the €78.84/month ÖGK alone is sufficient.
Can I see a Wahlarzt without ÖGK insurance?
Yes. Anyone can visit a Wahlarzt — you simply pay the full bill with no reimbursement. Having ÖGK means you get partial reimbursement (80% of the Kassentarif). Without any insurance, the cost is identical; you just get nothing back.
Do Wahlärzte speak English?
Many do, especially in Vienna and other university cities. Wahlärzte who cater to international patients often list English on their website or DocFinder profile. Kassenärzte may also speak English, but it is less commonly advertised.
Why are there so many Wahlärzte in Vienna?
Austria has a limited number of Kassenplanstellen (contracted positions). Many qualified doctors cannot get a contract or choose not to accept one due to lower fees and higher administrative burden. In Vienna, the ratio of Wahlärzte to Kassenärzte is roughly 50:50. In smaller cities and rural areas, the ratio is better.
Can a Wahlarzt refer me to a public hospital?
Yes. A Wahlarzt referral is accepted by public hospitals. However, some specialized referrals (like MRI or physiotherapy) may have limited ÖGK coverage if initiated by a Wahlarzt rather than a Kassenarzt. Check with ÖGK if you are unsure.
What is Sonderklasse in Austrian hospitals?
Sonderklasse is the premium ward in a public hospital — single or double room, choice of doctor, better amenities. It is not covered by ÖGK. Costs €300–800/day. Covered by Zusatzversicherung with a Sonderklasse tariff. The standard Allgemeine Gebührenklasse (shared room, team doctor) is what ÖGK covers.
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