Outpatient Insurance Vienna 2026: Private Doctor Guide

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Vienna has more private doctors (Wahlarzt) than public ones. What that means for you as a patient: you wait six weeks for an appointment with a dermatologist who accepts public insurance. At a private doctor, you sit in the treatment room within two days, but pay EUR 150 out of pocket. The OeGK reimburses maybe EUR 40. The rest stays with you.

Outpatient supplementary insurance (ambulante Zusatzversicherung), also called private doctor insurance (Wahlarzt Versicherung or Privatarzt Versicherung), covers exactly that gap. This guide explains what it costs in Vienna, which providers offer it, and whether signing up makes sense for your situation. For a broader overview of the Austrian system, see our Health Insurance Guide for Austria.

Wahlarzt, Privatarzt, Kassenarzt: what is the difference?

These three terms cause regular confusion in Austria, especially for expats. Here is how they differ:

A Kassenarzt (public doctor) has a contract with the Austrian Health Insurance Fund (OeGK). Your treatment is billed directly via the e-card. You pay nothing extra.

A Wahlarzt (private doctor) has no public insurance contract. You pay the bill yourself and can then claim a partial refund from OeGK (roughly 80% of the public tariff rate, not 80% of your actual bill).

Privatarzt is not an official legal term, but insurers like UNIQA, Allianz, and Generali use it interchangeably with Wahlarzt. When durchblicker.at talks about "Privatarzt Versicherung," they mean the same product as Wahlarzt insurance.

Source: OeGK, Information on Wahlaerztinnen und Wahlaerzte (gesundheitskasse.at)

Why Vienna is particularly affected

The numbers paint a clear picture: across Austria, there are 11,802 Wahlaerzte but only 8,236 Kassenaerzte (as of 2025, source: krankenversichern.at). In Vienna, the ratio is even more extreme. Around 43% of all doctor visits in the capital happen at private practices.

Why do so many doctors give up their public contracts?

The reasons are straightforward: a Kassenarzt has an average of 10 minutes per patient. A Wahlarzt takes 30 to 60 minutes. Add better fees, no budget caps from the insurance funds, and freedom to run the practice as they like. For doctors, that is attractive. For patients, it means: if you need a fast appointment, you pay extra.

According to a study involving 1,591 calls to public doctors, the average wait for a specialist appointment in Vienna was 63 days (source: krankenversichern.at Wahlarzt cost report 2026).

Wait times in Vienna: public vs. private

Specialist	Public doctor (wait)	Private doctor (wait)
Dermatologist	4-8 weeks	1-3 days
Orthopedist	6-10 weeks	1-5 days
Internist	4-6 weeks	1-3 days
Gynecologist	3-6 weeks	1-4 days
Ophthalmologist	6-12 weeks	1-5 days
MRI appointment	8-14 weeks	1-3 days

Based on data from krankenversichern.at (2026). Actual wait times vary by district and season.

What does a private doctor visit cost in Vienna?

This is where it gets uncomfortable for many patients. The OeGK reimburses roughly 80% of the public tariff rate. That sounds decent at first. But the public tariff is far below what a Wahlarzt actually charges. In practice, you get only 20-40% of your real costs back.

Service	Private doctor cost	OeGK reimbursement	Your out-of-pocket
General practitioner	EUR 80-120	approx. EUR 30-40	EUR 50-80
Specialist (internist)	EUR 120-180	approx. EUR 40-50	EUR 80-130
Gynecologist (checkup)	EUR 100-150	approx. EUR 35-45	EUR 65-105
MRI (knee/back)	EUR 300-450	approx. EUR 130-160	EUR 170-290
Ultrasound (abdomen)	EUR 80-150	approx. EUR 40-60	EUR 40-90

Cost ranges based on experience values from Vienna (2025/2026). Individual fees may differ.

With five private doctor visits per year, out-of-pocket costs add up to EUR 400-600 quickly. And that is without an MRI or specialized diagnostics.

What does outpatient supplementary insurance cover?

Outpatient supplementary insurance (Wahlarzt insurance) pays the difference between your private doctor bill and the OeGK refund. Depending on the plan, 70% to 100% of your remaining costs are covered.

Specifically covered:

• Private doctor fees (general practitioners and specialists)
• Diagnostics at private practices (MRI, CT, ultrasound, X-ray)
• Medical aids like glasses, orthopedic insoles, hearing aids
• Alternative medicine: acupuncture, homeopathy, Traditional Chinese Medicine
• Physiotherapy and occupational therapy
• Psychotherapy subsidy (EUR 50-80 per session depending on plan)
• Private prescriptions (with some plans)

Not covered are typically dental treatments (there is a separate dental insurance) and hospital stays (that would be Sonderklasse insurance).

Does it pay off? A real-world example

Take a 32-year-old woman in Vienna who visits private doctors five times a year (three specialists, one GP, one MRI).

Item	Without insurance	With private doctor insurance (80%)
Total private doctor bills	EUR 900	EUR 900
OeGK reimbursement	-EUR 250	-EUR 250
Out-of-pocket	EUR 650	EUR 650
Insurance reimbursement (80%)	EUR 0	-EUR 520
Annual premium (comfort plan, age 32)	EUR 0	EUR 480
Total cost per year	EUR 650	EUR 610

At five visits, the insurance just about breaks even. The real advantage is elsewhere: you can see a private doctor whenever you need to without worrying about the bill each time. If you only go once or twice a year, you are better off without.

Providers at a glance: who offers what?

Several Austrian insurers offer outpatient supplementary plans. Premiums depend on age, deductible, and coverage level. Here is an overview for a 30-year-old (as of 2026):

Provider	Plan variants	Premium from (age 30)	Alternative medicine
UNIQA	Start, Optimal, Optimal Plus, Premium	approx. EUR 55/month	From Optimal
Allianz	Comfort, Extra, Max	approx. EUR 60/month	From Extra
Generali	Privatarzt, Privatarzt + Prevention	approx. EUR 65/month	Yes (incl. wellness)
Wiener Staedtische	MEDplus Smart, Basic, Premium	approx. EUR 50/month	From Basic
GRAWE	MyMEDdoc	approx. EUR 55/month	Yes
Merkur (now UNIQA)	Modular plans	approx. EUR 50/month	Optional
muki	Standard, Premium (Medium/Large)	approx. EUR 45/month	Varies by plan

Premiums are indicative for 30-year-olds without deductible. Individual premiums vary based on age, health status, and chosen deductible. For binding quotes, contact the insurers directly. Sources: provider websites (April 2026).

For a detailed provider comparison, see our article UNIQA vs. Merkur Health Insurance.

What to look for when choosing a plan:

• Annual budget: What is the maximum reimbursement per year? With frequent doctor visits, EUR 1,500 runs out fast.
• Deductible (Selbstbehalt): A 20% deductible lowers the premium, but you always pay a share yourself.
• Alternative medicine: If you use acupuncture, homeopathy, or TCM, make sure your plan covers it.
• Psychotherapy: Demand is rising, but not every plan reimburses psychotherapy costs.
• Waiting period: Most plans have a 3-month waiting period. Group plans through your employer often only 1 month.

Outpatient insurance vs. Sonderklasse

This question comes up in almost every consultation: do I need outpatient insurance, Sonderklasse insurance, or both?

Outpatient supplementary insurance (Wahlarzt insurance):

• Pays for doctor visits outside the hospital
• Private doctor cost reimbursement, diagnostics, medical aids
• Makes sense with frequent doctor visits

Sonderklasse insurance (private room):

• Pays for hospital stays (private room, chief physician)
• Free hospital choice
• Makes sense for planned surgeries or births

For Vienna residents, outpatient insurance is usually more important. Vienna has plenty of hospitals with solid public care. But in everyday life, you visit doctors far more often than hospitals. And that is exactly where, in the outpatient sector, wait times are the bigger problem.

If you want both covered: many providers offer combined plans that are cheaper than two separate policies (Polizzen).

Private doctor insurance for children and families

The shortage of public doctors is especially noticeable for children in Vienna. Finding a pediatrician with a public contract is getting harder every year. According to the Austrian Medical Chamber, 55% of OeGK doctors will reach retirement age within the next six years.

Children's plans cost less than adult ones. muki (FamilyPlus) and UNIQA offer specific family plans where children can be insured from around EUR 35/month. If you already have outpatient insurance yourself, ask your provider about a family rate. That is usually cheaper than separate contracts.

Pre-existing conditions and health questions

Anyone applying for a Wahlarzt insurance policy must answer health questions (Gesundheitsfragen). Insurers ask about existing conditions, ongoing treatments, and medications. Depending on your answers, you might face surcharges, exclusions, or rejection.

What does that mean in practice?

• Chronic conditions (e.g. diabetes, asthma) can lead to a surcharge of 20-50%
• Mental health history often results in exclusion of psychotherapy benefits
• Recent surgeries may trigger an extended waiting period
• False statements on health questions can void your coverage in case of a claim

Tip: Sign up as early as possible while you are healthy. Premiums increase with age, and existing conditions cannot be "insured away" after the fact. Someone who signs up at 25 pays significantly less than someone at 45. More on this in our guide Health Insurance Over 50.

How to submit your private doctor invoice

Since July 2024, the WAHonline system has simplified cost reimbursement with OeGK. Here is how it works:

Step 1: You visit a Wahlarzt and pay the invoice (cash or card).

Step 2: You submit the invoice to OeGK. This works online via MeineSV (meinesv.at), by app, or by mail. OeGK reimburses roughly 80% of the public tariff.

Step 3: You submit the same invoice to your supplementary insurer (plus the OeGK statement showing what you already received). Many insurers accept submissions via app or email.

Step 4: The insurer transfers the agreed percentage of the remaining amount.

Some insurers offer direct billing (Direktverrechnung). In that case, you do not need to pay upfront at all. Ask your insurer which Wahlarzt practices in Vienna participate in direct billing.

Source: Austrian Ministry of Social Affairs, Simplified Wahlarzt Reimbursement (sozialministerium.gv.at, 2024)

What does private doctor insurance cost by age?

The premium depends heavily on the age at entry. Here is an orientation for outpatient plans in Austria:

Age at entry	Basic plan (monthly)	Comfort plan (monthly)	Premium plan (monthly)
Children (0-18)	EUR 25-35	EUR 35-50	EUR 50-70
25-30 years	EUR 35-50	EUR 50-70	EUR 70-100
31-40 years	EUR 45-65	EUR 65-90	EUR 90-130
41-50 years	EUR 65-90	EUR 90-130	EUR 130-188
51-60 years	EUR 90-130	EUR 130-180	EUR 180-250+

Indicative values based on Austrian insurer market data (2025/2026). Individual premiums vary by health status and deductible. Industry-wide premiums rose by an average of 8% in 2025 (source: krankenversichern.at PKV market analysis 2025).

For detailed cost breakdowns and savings tips, read our separate guide.

Checklist: signing up for outpatient insurance

Before you decide on a plan, answer these questions:

• [ ] How often do you visit a Wahlarzt per year? (From 3-4 visits, insurance usually pays off)
• [ ] Which specialists do you see regularly?
• [ ] Do you need alternative medicine (acupuncture, homeopathy, TCM)?
• [ ] Is psychotherapy coverage important to you?
• [ ] Do you also want hospital coverage (Sonderklasse)?
• [ ] Do you have pre-existing conditions you need to disclose?
• [ ] Are there group plans through your employer?

Frequently Asked Questions

What is the difference between a Kassenarzt and a Wahlarzt?

A Kassenarzt has a contract with OeGK (Austrian public health insurance). Treatment is billed directly via the e-card. A Wahlarzt has no public contract. You pay the bill yourself and can claim a partial refund (roughly 80% of the public tariff) from OeGK.

How much does OeGK reimburse for a Wahlarzt visit?

OeGK reimburses roughly 80% of the public tariff rate, not 80% of your actual bill. Since Wahlarzt fees are well above the public tariff, you effectively get only 20-40% of your costs back.

How much does outpatient insurance cost in Vienna?

Premiums start at around EUR 25-35/month for basic children's plans and sit around EUR 50-70/month for a comfort plan for a 30-year-old adult. The exact premium depends on your age, health status, and chosen plan.

How does the billing process work?

You pay the Wahlarzt bill, submit it to OeGK (for the public tariff reimbursement), and then to your supplementary insurer (for the remaining amount). Since July 2024, OeGK submissions also work digitally via MeineSV or the WAHonline app.

Is Wahlarzt insurance worth it?

With three to five Wahlarzt visits per year, the insurance usually pays off. With one to two visits, usually not. Beyond financial savings, the value lies in being able to see a specialist quickly whenever you need one.

Is there outpatient insurance without a waiting period?

Individual contracts typically have a 3-month waiting period. Group plans through your employer can shorten this to one month. Pregnancy often has an extended waiting period of eight months.

Can I get private doctor insurance with pre-existing conditions?

In principle yes, but with restrictions. Depending on the condition, you may face surcharges (20-50% higher premium), exclusions for certain areas, or rejection. False statements on health questions can void your coverage.

What is the difference between Sonderklasse and outpatient insurance?

Outpatient insurance covers doctor visits outside the hospital (Wahlarzt, diagnostics, therapies). Sonderklasse insurance covers hospital stays (private room, free hospital choice). For Vienna residents, outpatient coverage is usually more relevant in daily life.

Conclusion

For Vienna residents who regularly visit private doctors, outpatient supplementary insurance is a solid investment. The city has more Wahlaerzte than Kassenaerzte. Wait times at public doctors are long. And OeGK reimbursement covers only a fraction of actual costs.

If you want coverage, do two things: first, add up your annual Wahlarzt costs and compare them against the premiums. Second, sign up as early as possible, before pre-existing conditions or age drive up your rates.

Related guides:

• Health Insurance Guide Austria 2026
• Private Health Insurance: Monthly Costs in Austria
• UNIQA vs. Merkur Health Insurance Comparison
• Is Sonderklasse Insurance Worth It?
• Dental Insurance Austria 2026

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Disclaimer: The costs, premiums, and wait times mentioned are indicative values and may vary individually. For binding tariff offers, contact the insurance providers directly. This article does not constitute insurance advice. Last updated: April 2026.