Guide · Insurance & costs · Vienna
Wahlarzt, Sonderklasse, reimbursement, direct billing – the Austrian healthcare system uses a lot of terms that no one explains until you need them. If you have moved to Vienna or are treated here, this page answers the most common questions clearly and neutrally. So you know what to expect – and what not to worry about.
Both are fully qualified specialists – the difference lies only in the contract with the statutory health insurer and in how billing works.
Important to know: the 80% refers to the statutory tariff for the service – not 80% of the invoice. How much that is in practice depends on the service and the insurer (ÖGK, SVS, BVAEB).
Sonderklasse is a private supplementary insurance for hospital stays – over three million people in Austria have it, often for years without ever needing it. It is precisely for a planned operation that it shows its strengths.
Providers include UNIQA, Generali, Wiener Städtische, Allianz and Merkur. Whether and how much you are covered is in your policy – a five-minute call to your insurer asking "Am I covered for Sonderklasse and what is included?" settles it.
Free choice of doctor: you decide who operates on you – not the roster
Short waiting time: surgery date at a private hospital usually within 1–2 weeks
Private hospital or private ward: single or twin room, more calm for recovery
Cost coverage: surgeon's fee, operation, anaesthesia and stay generally covered in full for an approved operation
"Do I have to pay upfront?" is the most common worry – and the answer is no. With direct billing, the entire settlement runs between the hospital, the surgeon and your insurer.
In the practice we clarify the diagnosis, the treatment options and whether an operation is really the right step.
I prepare the cost estimate and take care of the approval by your insurer – you don't have to organise anything.
Surgery date usually within 1–2 weeks at one of Vienna's leading private hospitals (Klinikum Währing/Atomos, Wiener Privatklinik, Privatklinik Döbling or Rudolfinerhaus) – performed personally by me.
Hospital and surgeon settle directly with your insurer. No upfront payment, no submitting invoices – at most an agreed deductible, depending on the contract.
A visit to the practice is not covered by inpatient Sonderklasse, but by the outpatient / private-doctor module of your policy – if you have one. The route is two-step: the invoice goes first to your statutory insurer (80% of the statutory tariff back), the remainder to your supplementary insurer.
Sounds like paperwork? I support you with the submission – you receive all documents prepared so that reimbursement runs as smoothly as possible.
What this means with me, in practice
A Kassenarzt has a contract with the statutory health insurer – you pay nothing directly, but waiting times are often longer and time per patient is shorter. A Wahlarzt (private physician) has no such contract: you receive an invoice, submit it to your statutory insurer and get back 80% of the corresponding statutory tariff. A private supplementary insurance with outpatient cover reimburses a large part to all of the remainder, depending on your policy.
Sonderklasse is a private supplementary insurance for hospital stays. It allows free choice of your surgeon, treatment in a private hospital or the private ward of a public hospital, a single or twin room – and, in practice, much shorter waiting times for the surgery date.
For an approved inpatient operation, Sonderklasse insurance generally covers the full costs: surgeon's fee, the operation, anaesthesia, the hospital stay and accommodation. Your statutory insurance also contributes. Before surgery a cost estimate is sent to the insurer for approval, so there are no surprises. Depending on the contract there may be a deductible.
No. With direct billing, the hospital and surgeon settle directly with your Sonderklasse insurer. The process: a cost estimate is created, the insurer approves it, you have the operation – and the billing happens in the background. You neither pay upfront nor submit invoices.
Yes. For a practice visit the same path applies as for any Wahlarzt patient: you receive an invoice and, if you have Austrian statutory insurance, get back about 80% of the statutory tariff; private or international insurers reimburse according to your policy. An operation in a private hospital is also possible as a self-payer, with a transparent cost estimate in advance. Bring your insurance details to the first consultation and we clarify your situation together.
You can still be treated. For the consultation the Wahlarzt route applies (invoice, then partial reimbursement from statutory insurance if you have it). An operation in a private hospital is possible as a self-payer with a transparent cost estimate, or I can operate within the public system – then the public waiting times apply.
Every policy is different. Simply bring your insurance details to the first consultation – we'll work out together what is covered for you. In English.
1040 Vienna: +43 1 585 62 60 · 1020 Vienna: +43 1 890 45 20
By prior appointment only · 1040 Vienna-Wieden (Große Neugasse 28/2) · 1020 Vienna-Leopoldstadt (Vorgartenstrasse 206c)