Retiring in Austria: health insurance for pensioners from the US, the UK and the EU (2026)

By Rudolf Adlmanninger, insurance broker (Versicherungsmakler) · Last updated 9 September 2026

In short: Which route you take depends on the country that stays responsible for your healthcare, not on your passport. Where a statutory system abroad remains competent — normal for most EU and EEA states, Switzerland and the United Kingdom — it issues an S1; you register that with the Austrian Health Insurance Fund (ÖGK) and are then treated like any Austrian resident, on an e-card, at that system’s expense. You will probably not need a separate Austrian private policy, though contributions can continue in the system that pays. Where no coordinated entitlement applies, the normal case for Americans, Canadians and Australians, you need a residence title — usually the settlement permit with gainful employment excepted — and it requires proof of health insurance covering all risks and paying out in Austria, in the file at the time of application. In practice that means a private policy the authority accepts: voluntary statutory health insurance with the ÖGK (Selbstversicherung) costs €565.25 a month, normally has a six-month waiting period, and requires the very permit you are applying for. Cover of that kind can be taken out before you move — applying before you travel also removes the 31-day waiting period in the Care Austria terms, though cover itself starts no earlier than the day you enter Austria. We advise on insurance, not on immigration law; we advise in English by video call; and nearly all of this can be settled before you land.

How does POINTNER finanz help — in English, before you arrive?

1. A 15-minute callTell us which country pays your pension, how you are insured today and when you plan to move. We tell you whether an S1 is likely, what the authority will ask for and in which order to do things.
2. We sort out your caseWe check the accepted policies against your age and health history, the entry-age limits and what a policy does after 75. On request we go through the terms on a shared screen.
3. Quote and applicationYou receive a written quote; Care Austria you can price and take out yourself online through our partner link before you travel, so the certificate is in the file when you apply.

We are based in Austria and use Central European Time, switching to summer time in summer — roughly one hour ahead of the UK, six ahead of New York and three and a half to four and a half hours behind Delhi, depending on the season. Early-morning and evening slots exist for exactly that reason; please check the time zone shown when booking.

Which of the four routes applies to me?

Nearly every retirement case lands on one of four routes. The deciding question is not nationality but which institution is competent for your healthcare — and whether you already hold an Austrian residence title.

Your situation	The route	Roughly what it costs	What to watch
A statutory system in the EU, the EEA, Switzerland or the UK stays competent for your healthcare, and Austria pays you no pension	S1 from that system, registered with the ÖGK	No Austrian premium; contributions may continue in the paying system	The S1 does nothing until you register it, and it does not cover private hospital accommodation and treatment (Sonderklasse)
You take up work in Austria, or you draw an Austrian pension	Austrian compulsory insurance	A percentage of earnings or pension	Even a small Austrian pension can shift competence to Austria; a 6 per cent health insurance contribution can then apply to foreign statutory pensions covered by the EU coordination rules or a social security agreement
You live here without work and without an S1 — and you already hold a residence permit	Voluntary self-insurance with the ÖGK (Selbstversicherung)	€565.25 a month in 2026; a reduction can be applied for	Six-month waiting period unless it is waived; third-country nationals must produce a valid residence permit
You are applying for your first residence title, or bridging an ÖGK waiting period	Private cover the immigration authority accepts, for example Care Austria (partner link)	From €219 a month at 65–74 on the 364-day plan; €510 open-ended	Entry-age limits, an excess for pre-existing conditions, and cover that ends once an open-ended residence title is granted

Sources: Your Europe: Health insurance cover when living abroad, ÖGK: Selbstversicherung in der Krankenversicherung (German) and Pensionsversicherungsanstalt: Krankenversicherung in der Pension (German) (accessed September 2026)

What do I need to arrange before I move to Austria?

The order matters, because two requirements point at each other: the immigration authority wants proof of health insurance before it grants your residence title, and the ÖGK asks third-country nationals for a valid residence permit before it insures them. Start with the ÖGK and you go round in a circle. So the sequence is residence title, financial requirement, private policy, then the first application at the Austrian embassy or consulate — or, where a foreign system stays competent, simply S1, arrival, residence registration, ÖGK. Advice and applications can often be arranged before you travel.

Two details catch people out. Living on savings is not the same as drawing a pension: a private pension, an annuity or drawdown from savings makes no statutory system competent for you, so it produces no S1 — whereas an early statutory retirement pension may well make one competent, which is worth checking rather than assuming. And couples are assessed one by one — it is normal for one spouse to arrive on an S1 while the other needs private cover, though cover as a dependant of the S1 holder is the first thing to check before buying a separate policy. Two things this page leaves out: tax, because where your pension is taxed depends on the double taxation agreement and belongs with a tax adviser; and immigration law itself — we advise on insurance, not on immigration law.

Sources: migration.gv.at: Other forms of settlement and NHS Business Services Authority: Applying for healthcare cover for living abroad (accessed September 2026)

I am American, Canadian or Australian — which residence title do I need?

Austria has no separate “retirement visa”. People searching for one almost always mean the settlement permit — gainful employment excepted (Niederlassungsbewilligung – ausgenommen Erwerbstätigkeit), in plain words the residence permit for financially independent people; Austria’s migration platform names pensioners as the typical case.

It is subject to an annual quota that nobody can accelerate, the first application is as a rule filed abroad with the competent Austrian consular representation, German at A1 must normally be proved before you immigrate, and you need a legal title to adequate accommodation. The exemptions are narrow — the law names minors and certified physical or psychological grounds, and age by itself is not one — and in the cases where an application may be filed inside Austria, filing it creates no right to stay beyond the visa-free or visa period you already have. It is normally issued for one year, three years after Integration Agreement Module 1 and two uninterrupted years of lawful residence.

The financial requirement is double the ordinary one. Most titles are measured against the equalisation supplement reference rate under the General Social Insurance Act (ASVG) — from 1 January 2026, €1,308.39 a month for a single person, €2,064.12 for a couple, €201.88 per child. For this permit the published rates are doubled: €2,616.78, €4,128.24 and €403.76. Read them as a floor, not a pass mark: the authority weighs regular income against fixed outgoings, rent included.

Sources: migration.gv.at: Other forms of settlement and migration.gv.at: General requirements for a residence title and RIS: §§ 21 and 21a Niederlassungs- und Aufenthaltsgesetz (German) (accessed September 2026)

Which health insurance does the authority accept?

Austrian law is short and strict here. Under § 11 of the Settlement and Residence Act (NAG), a title may only be issued if the foreign national holds cover for all risks that also pays out in Austria, and the proof must be in the file at the time of application. Vienna’s immigration authority MA 35 publishes the only public list we know of naming products it has examined. Some need a signed supplementary declaration from the insurer, written into your contract word for word; others do not. According to that list, no declaration is required for the Allianz Elementar policy “Meine Gesundheitsversicherung für Nichtsozialversicherte” or for “Care Austria” and “Care Austria Education”; the 364-day variants are listed only with one, as are policies from DONAU, Generali, UNIQA and Wiener Städtische — for Care Austria the distinction makes little difference in practice, because Care Concept issues the supplementary declaration automatically with the policy. An unlisted insurer can work too, if it signs the authority’s general declaration and the cover corresponds essentially to Austrian statutory insurance.

Two notes belong next to that: the Vienna list is the published reference and the other provinces decide independently, though in our experience the district authorities across Austria accept Care Austria as well; and the same page records that Care Austria and Care Austria Education end automatically once you are granted the title “Daueraufenthalt EU” (long-term resident — EU).

Sources: RIS: § 11 Niederlassungs- und Aufenthaltsgesetz (German), migration.gv.at: Frequently asked questions and City of Vienna (MA 35): accepted private health insurance policies (German) (accessed September 2026)

What does Care Austria cost at 65 or 70 — and what do the terms say?

Care Austria (partner link) is private health insurance for people moving to Austria, arranged by Care Concept AG in Bonn; the risk carrier named in the terms is Advigon Versicherung AG in Liechtenstein. Premiums according to Care Concept, as at September 2026:

Care Austria Standard, age	Term up to 364 days	Open-ended term
0–49	€95.00 a month	€155.00 a month
50–64	€95.00 a month	€222.00 a month
65–74	€219.00 a month	€510.00 a month

Six things to know before treating that table as a retirement plan.

Premiums are adjusted in steps. The terms set out a premium table that is adjusted every fourth insurance year, the next step on 1 January 2028, when the open-ended premium for the 65-plus group goes from €510 to €617 a month; statutory ÖGK contributions are adjusted every year as well. Age counts as the calendar year minus your year of birth, so the step into that group falls on 1 January, not on a birthday. Every adjustment carries a special right of cancellation, and we go through both routes with you before you sign.

Cover is the general ward. Whatever the marketing table suggests, the terms provide the general nursing class in a multi-bed room without private medical services. Bills from a private clinic or from a doctor without a contract with your statutory fund (Wahlarzt) are reimbursed subject to the policy’s benefit rules and limits, but this is no substitute for Austrian supplementary insurance for private hospital accommodation and treatment (Sonderklasse).

Pre-existing conditions are included — read with the Austria clause. Known illnesses, accident consequences and infirmities are covered. The base terms put an excess of €5,000 per insured person per started insurance year on anything arising from them and cap the insurer’s payments for those conditions at €30,000 across the whole contract term; nothing is paid where the claim was already certain at application. An insurance year is the calendar year on the open-ended plan and, on the 364 plan, the 364 days from the start of the first contract, follow-on contracts included. What changes the picture is the Austria clause both sets of terms carry: for a stay in Austria, every health risk the ÖGK would cover as a statutory benefit counts as covered by the insurer, exclusions and limits that cannot be reconciled with that are waived, and the stated caps and excesses apply only at the level the ÖGK’s own cost-sharing would reach (§ 15 of the open-ended terms; § 7 III no. 2 and § 9 no. 4 of the 364 terms). For treatment the ÖGK would pay for, that brings the €5,000 excess down close to statutory cost-sharing; outside that scope, and outside Austria, it stands in full. Have the position for your own conditions confirmed in writing before you rely on it. The online form also asks health questions, and the insurer decides: it can accept the application, apply exclusions or a surcharge, or decline cover.

There is a waiting period, and you can avoid it. It is 31 days, and it falls away if you prove entry into Austria within the 31 days before your application, if the policy was taken out before you started the journey, or if it follows seamlessly on comparable prior cover. Cover itself begins no earlier than the day you cross the border. The Austria clause reaches waiting periods too: the open-ended terms name waiting and end periods expressly among what the insurer waives where they cannot be reconciled with the ÖGK’s statutory benefits during a stay in Austria.

Cover for visits to your home country is limited. A claim arising in your home country is not covered as a rule; holiday visits home count only up to 28 days — and only up to 14 days on a 364-day contract of four months or less. Beyond that the two variants differ: the open-ended contract covers the whole EU and allows 30 days a year in the remaining Schengen states, while on the 364 terms the cover applies in Austria and trips to other EU or Schengen countries are limited to 30 days in all. Every trip has to be notified to the insurer in writing before you travel, otherwise only half of the reimbursable costs are paid.

The contract ends sooner than people expect. Both sets of terms end cover when an open-ended residence permit is granted, and MA 35 records the same for Care Austria and Care Austria Education, adding that you must then take out other insurance — so plan the follow-on cover before that title arrives, not after. Beyond that the two variants read differently. The open-ended terms end insurability once you move your permanent residence to Austria, and define that as the place that is not merely temporarily the centre of your personal ties, adding expressly that someone who holds only a fixed-term residence title has not established one. The 364 terms make the point from the other side: people who intend a permanent residence title and enter Austria for that purpose remain insurable until the permanent stay takes concrete shape (§ 1 no. 4), and the supplementary declaration MA 35 requires for the 364 variants commits the insurer not to cancel the contract if a missing intention to return is established later during the agreed term. Read plainly: bridge cover for the years on a temporary title, not lifelong Austrian health insurance. Compulsory statutory insurance ends it as well — the terms exclude insurability for anyone covered by compulsory insurance under § 4 ASVG (§ 1 no. 3 b); once that cover actually exists and has been evidenced, insurability lapses (§ 1 no. 4) and the contract ends with it (§ 2 no. 6 c), without notice and without waiting for a renewal date.

Billing depends on the practice: Care Concept settles directly with doctors and hospitals that accept it; where a practice does not, you pay and send the invoice in for reimbursement (the terms provide for reimbursement against original invoices). According to Care Concept, spouses and children can be insured too, premiums on request. We usually work with Care Austria 364, whose term you choose freely from one month up to a maximum of 364 days and which then ends on expiry; that is the variant MA 35 lists only with the insurer’s supplementary declaration. It does not renew by itself: the follow-on contract has to be applied for on the insurer’s form before the current one expires and needs the insurer’s express consent, and it only covers events that arise after that application — anything from the first term counts as pre-existing, with a fresh €5,000 excess, and the eight-month waiting period for childbirth and dentures starts again. For a stay that will last years, the open-ended contract is usually the better fit; we look at that with you. A switch to the open-ended plan is not possible without a fresh health assessment — the open-ended contract is a new application with new health questions. And note what €510 means: at 65 to 74 the open-ended plan sits close to the €565.25 of ÖGK self-insurance — two different systems at a similar price, which is exactly the comparison to make together. The Allianz policy, like any other insurer, we can arrange for you after an individual check and calculation — so ask us first; Care Austria you take out through us, online through our partner link.

Sources: Care Concept AG: Care Austria — health insurance for foreign nationals in Austria (premiums as at September 2026 according to Care Concept) and Care Austria: insurance terms VB-KV 2023_10 (German PDF), §§ 1, 5, 6, 7 and 9 and the premium annex, and Care Austria 364: insurance terms VB-KV 2020_07 (CAU 364_2020_07) (German PDF), §§ 1, 2, 6, 7 and 9 and part B, and City of Vienna (MA 35): accepted private health insurance policies (German) (accessed September 2026)

Can I just insure myself with the ÖGK instead?

Eventually, often yes — but usually not for the first application.

Self-insurance costs €565.25 a month in 2026, a single figure rather than an age-based premium, which makes it comparatively good value at 70 and poor value at 30. A reduction can be applied for depending on your economic circumstances, and must be applied for again every two years. Three conditions decide whether it is open to you: no compulsory health insurance in Austria, another EU or EEA state or Switzerland; a main residence in Austria; and for applicants from outside the EU, the EEA and Switzerland, a valid residence permit. The third closes the door on a first application.

Then the waiting period. Benefits normally start after six months. It is waived if you were covered by statutory health insurance — or entitled as a dependant — for at least six uninterrupted weeks immediately beforehand, or 26 weeks in the previous twelve months, in Austria, another EU or EEA state or a state with a bilateral agreement; whether your own country’s cover counts depends on the coordination rules applying to it. Two consequences people underestimate: contributions run during the waiting period, before the entitlement to benefits begins — six full months at the undiscounted rate come to €3,391.50, on top of any private bridging cover — and MA 35 accepts self-insurance as proof only where there is no waiting period. Where there is one, private bridging cover has to run to the day benefits actually start, not to the day you file the ÖGK application.

Sources: ÖGK: Self-insurance in health insurance (English information sheet), ÖGK: Selbstversicherung in der Krankenversicherung (German) and City of Vienna (MA 35): accepted private health insurance policies (German) (accessed September 2026)

What happens when I turn 75?

Two different things get confused here, and the confusion costs money.

On the open-ended contract, an existing contract does not end at 75. The open-ended Care Austria terms say it in as many words: if the insured person completes their 75th year during the term of the contract, insurability does not lapse. Take out cover at 68, keep paying, and turning 75 is not what throws you out — the premium table simply continues in the “65 and over” group.

Care Austria 364 is worded differently. On the 364 terms people are insurable only up to the 75th birthday, and a 364-day contract ends when the chosen term expires in any case — so from 75 there is no follow-on contract on that variant. If you are close to 75 and intend to stay, the open-ended contract is the one to take; we check the dates with you.

Taking out new cover at that age is the problem. Care Austria Standard can be concluded until the day before your 75th birthday. If your 75th birthday falls on 1 October, an application concluded on 30 September still works; from the birthday itself a new contract is no longer possible. An applicant of 74 is therefore inside the entry age — what decides the case is the date, not the birthday year.

Above the entry age we will not name a product here: we have no documented market survey of which insurer still accepts a new applicant from the 75th birthday onwards for cover an immigration authority would take. We treat it as an individual enquiry — give us the age, passport, province and medical history, and we find out what is available in that case. If you are 73 and thinking about Austria “in a few years”, timing is more urgent than you think. And for US readers: Medicare does not follow you — it “usually doesn’t cover health care while you’re traveling outside the U.S.”, with only narrow exceptions.

Sources: Care Austria: insurance terms VB-KV 2023_10 (German PDF), § 1 no. 3 lit. a and part B I, Care Austria 364: insurance terms VB-KV 2020_07 (CAU 364_2020_07) (German PDF), part B II no. 1 and § 6 no. 3 e, Care Concept AG: Care Austria and Medicare.gov: Travel outside the U.S. (accessed September 2026)

I draw a UK State Pension — how does the S1 work after Brexit?

It still works, and for most British retirees it settles the insurance question. The NHS Business Services Authority issues the S1: if you are being paid your UK State Pension and are moving to an EU country, you can apply online up to 90 days before you move. You need an address in that country for the form to be issued, and a temporary one is accepted; if you need the S1 for a visa application, they will send it to your UK address. It gives you “the same healthcare cover as a resident of those countries with the UK responsible for the costs”: register it with the ÖGK, receive an e-card, be treated on the same basis as an Austrian, with the UK paying. You also get a UK-issued GHIC or EHIC, which covers necessary treatment on trips — it is not a substitute for cover where you live.

But an S1 is not a right to live in Austria. British nationals moving here now are treated as third-country nationals; Withdrawal Agreement rights exist only for people already lawfully resident before 1 January 2021, and UK government guidance tells new arrivals to check which Austrian visa or residence permit they need. The S1 answers the insurance question in your file — not the quota, the financial requirement or the language requirement.

Three more things it does not do:

• It is not automatic. “You will not have healthcare cover automatically when you get an S1 from us. You’ll need to register your S1 with the relevant authority in the country you’re living in.”
• It does not cover private healthcare — meaning private hospital accommodation and treatment (Sonderklasse). A doctor without a contract with your statutory fund (Wahlarzt) is not off limits, but is only partly reimbursed; see below.
• Dependants are classified differently here, as UK guidance says itself, so check locally when you register. And if you hold an S1 as the dependant of a State Pensioner and then start claiming your own UK State Pension, that cover is cancelled and a new S1 issued — it has to be registered again in Austria, or your cover lapses.

Sources: NHS Business Services Authority: Applying for healthcare cover for living abroad, GOV.UK: Healthcare for UK nationals living in Austria and GOV.UK: Living in Austria (accessed September 2026)

I draw a pension from an EU or EEA state or Switzerland — do I buy anything?

Usually you will not need a separate Austrian private policy. For pensioners the EU coordination rules settle one question: which country is competent. Articles 23 to 25 of Regulation (EC) No 883/2004 work like this.

• If Austria pays you a pension too, Austria takes over. Someone drawing pensions from two or more member states, one of them the state of residence, and entitled to benefits in kind there, receives them “from and at the expense of the institution of the place of residence”. A German pensioner with a small Austrian pension is therefore an Austrian case — and a health insurance contribution of 6 per cent can then be levied on the foreign pension as well. That reaches statutory pensions falling under the EU coordination rules or a bilateral social security agreement, and it presupposes an Austrian entitlement to health insurance benefits; it is not a charge on every private pension or drawdown, and the pension and health insurance institutions decide which payments are included.
• If Austria pays you nothing, your pension country pays. Someone not entitled to benefits in kind under the law of the state of residence still receives them, at the expense of the state competent for the pension. That is the S1 situation.
• With several pension countries and none of them Austria, the cost falls to one of them under the regulation.

The steps are the same every time: request the S1 from the health insurance institution in the competent country before you move, register your residence, hand the form to the ÖGK, wait for the e-card. There is also a deadline on the residence side: EEA and Swiss citizens staying longer than three months must register with the settlement authority within four months of arrival, and applicants who are not employed must show sufficient means of subsistence and comprehensive health insurance cover.

German pensioners: the model German private insurance terms provide that when an insured person moves their habitual residence to another EU or EEA state the contract continues — but the insurer remains liable at most for the benefits it would owe for a stay in Germany, and your own contract may deviate from that wording. Add the KVdR, German care insurance and Austrian Pflegegeld, and it is its own subject; we have written it up in German: Rentner nach Österreich: Krankenversicherung richtig regeln. Do not cancel a German private policy before you have read it.

Sources: EUR-Lex: Regulation (EC) No 883/2004, Articles 23–25, Your Europe: Health insurance cover when living abroad, oesterreich.gv.at: Registration certificate for EEA and Swiss citizens and Association of Private Health Insurers: model terms MB/KK, § 1 (5) (German PDF) and RIS: § 73a ASVG (German) (accessed September 2026)

How do I get an e-card, and what will it not pay for?

Once you are registered with an Austrian fund — through an S1, through self-insurance or because you take up work — the e-card is issued and posted to you. You do not apply separately, and the card is not what starts your entitlement: that depends on your insurance route and its confirmed start date, including any waiting period — with self-insurance, for instance, benefits can begin months after you are registered. What regularly delays it is the photograph. New e-cards carry one, taken automatically where Austria already holds a photo of you: from an Austrian passport, identity card, card-format driving licence or the foreigners register, which includes residence permits. If none exists — normal for a pensioner arriving with only a home passport — you must bring a passport photograph to a registration office in person, and people without Austrian citizenship present their travel document in the original. One exception matters here: people who turn 70 in the year the new e-card is issued, or who are already older, are exempt from providing a photograph, as are recipients of Austrian long-term care allowance at levels 4 to 7.

The e-card covers contract doctors and the general hospital ward, not private hospital accommodation and treatment (Sonderklasse). A doctor without a contract with your statutory fund (Wahlarzt) is not off limits: you pay the bill and the ÖGK reimburses 80 per cent of what it would have paid a contract doctor for the same treatment — 80 per cent of the statutory tariff, not of your invoice, and the gap can be large. That gap is what Austrian supplementary insurance is for, a product entirely separate from the policies used for residence permits and worth a quote even at 65: insurers ask health questions, a pre-existing condition can mean an exclusion or a refusal, and the premium depends on your age at the start, so the same cover taken out at 62 starts cheaper than at 70. Our English overview Health insurance in Austria explains how it fits together.

Sources: oesterreich.gv.at: e-card (German), chipkarte.at: Ausnahmen von der Fotoübermittlung (German) and ÖGK: Wahlärztinnen und Wahlärzte (German) (accessed September 2026)

What about long-term care — is that insured too?

Briefly, because it is a different system. Austria does not fund long-term care through the health insurance funds; it pays a separate, tax-financed long-term care allowance (Pflegegeld) in seven levels. The care requirement must be expected to last at least six months — a prognosis, not a waiting period you sit out before applying — and must exceed 65 hours a month on average; the allowance is independent of the cause of the need for care and of income, assets and age. It is a contribution towards care costs, not cover for them: it does not pay for a nursing home or a full care package, and private health insurance is not long-term care insurance.

What most pages leave out is who is entitled at all. Alongside habitual residence in Austria, the Long-Term Care Allowance Act makes the claim conditional on no other member state being competent for care benefits under Regulation (EC) No 883/2004 — and a pensioner living here on a foreign S1 is exactly such a case. Registering with the ÖGK does not by itself create an entitlement. Whether care insurance from your own country keeps paying across the border is a question for that insurer; for German readers the answer is in our guide for pensioners moving to Austria.

Sources: Federal Ministry of Labour, Social Affairs, Health, Care and Consumer Protection: Care and Support, oesterreich.gv.at: Voraussetzungen Pflegegeld (German) and RIS: § 3a Bundespflegegeldgesetz (German) (accessed September 2026)

Frequently asked questions

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