Medical Treatment in Another Member State

Interstate social security

Since the early 1950s, international economic relations between Austria and other states have been steadily growing in importance. 

Due to the steadily increasing internationalisation of economic processes and the resulting mobility of workers, regulations were needed to protect the social rights of people working across borders, for example.

Bilateral agreements

With this in mind, Austria has concluded bilateral agreements with a number of states.

These agreements, concluded between two states, are generally based on the following internationally recognised principles:

  • Equal treatment of nationals in the area of social security,
  • Consideration of insurance periods completed in the other contracting state for entitlement to benefits,
  • Specification of the state in which the insurance applies,
  • Calculation of pensions according to the insurance periods completed in each contracting state,
  • Export of cash benefits to contracting states and
  • Granting benefit assistance in health and accident insurance by the insurance institutions in the contracting states.

Multilateral agreements

Apart from the bilateral agreements, multilateral agreements also exist (concluded between several states). The “Agreement on the European Economic Area” (EEA Agreement), which came into force on 01.01.1994, is worthy of particular mention.

Since this time, the relevant provisions of European Community Law have been binding in the area of social security in the relationship between Austria and the EU or EEA states. Since the EEA Agreement has been in force since 1994, Austria's accession to the European Union (EU) on 01.01.1995 did not result in any changes with regard to social security.

Since 01.06.2002, Community Law has also applied to the relationship between Switzerland and the EU states.

As a result of Regulation No. 859/2003, which has been in force since 01.06.2003, and Regulation No. 1231/2010, which entered into force on 01.01.2011, third-country nationals are also covered by the relevant coordination provisions of European Community Law. However, the prerequisite for this is that their legal residence is in an EU state and a cross-border situation exists.

However, nationals of third countries that have points of contact with Denmark, the EEA (Iceland, Liechtenstein, Norway) and Switzerland in the area of social security are excluded from this equivalence.

European Community Law has only been applicable between Switzerland and the EEA States since 01.01.2008.

In summary, it should be noted that for all citizens from EU or EEA states as well as Swiss citizens (in part also for third-country nationals with legal residence in an EU state and cross-border situations), generally speaking, the coordination provisions of European Law regarding social security must now be applied.

Page 8 ff. explains in more detail whether the current Regulation No. 1408/71 or Regulation No. 883/2004, which has been in force since 01.05.2010, should be used. The above-mentioned regulations will be referred to in the following as Regulation 1408/71 and Regulation 883/2004 for short.

Due to the withdrawal of the United Kingdom from the EU, the coordination of social security systems (for transitional cases) is carried out by the since-concluded Withdrawal Agreement and by the Trade and Cooperation Agreement (TCA) since 2021.

Agreement or European Law?

Compared to the bilateral agreements still in force between Austria and the EU/EEA states or Switzerland, European Community Law ensures more comprehensive protection for the migrant workers in question.

Due to the inclusion of third-country nationals now, these bilateral agreements are only applied in a few exceptional cases and are largely replaced by European law.

However, in those areas where the bilateral agreements contain more favourable provisions than the regulations, they should still be applied.

National Law

In some cases, there are also provisions in the respective national social security law under which specific conditions compulsory insurance in the home country is maintained when working abroad. These regulations, which are included in the General Law on Social Insurance (ASVG), apply, for example, to posts outside the EU or the EEA and Switzerland, and to states with which there is no corresponding bilateral agreement.

National provisions that regulate matters with foreign implications are subordinate to European Law or bilateral agreements.