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Cross-border social security: Positive results of the European Health Insurance Card

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On Europe Day, May 9, 2026, the umbrella organization of social security institutions (DVSV) draws a positive conclusion regarding cross-border healthcare. Currently, over 8,7 million people in Austria possess the European Health Insurance Card (EHIC), which is located on the back of the standard e-card.

This system provides insured individuals in 35 countries with unbureaucratic access to medically necessary services, without the need for prior applications or significant out-of-pocket expenses. The number of valid cards has increased by approximately 6,3 percent since 2015, underscoring the growing importance of European mobility.

Economically, the system of reciprocal reimbursement proves extremely advantageous for Austria. While the Austrian social security system spent approximately €31,3 million on the treatment of Austrian insured persons abroad in 2024, the treatment of foreign patients in Austria generated revenue of around €158,1 million. Germany, Croatia, and Italy top the list of countries where Austrians seek medical assistance. The resulting surplus of approximately €126,8 million flows directly back into the domestic healthcare system and covers the costs of providing care to European patients at Austrian quality standards.

However, the coordination of social security is not limited to acute illnesses. A key aspect of European integration is the aggregation of insurance periods for pension purposes. Those who have worked in different EU member states retain their entitlements, as periods of employment from different countries are added together for their future pension claim. Beyond the borders of the Union, Austria also maintains bilateral agreements with countries such as Japan, Brazil, and Serbia to ensure the protection of workers and travelers worldwide through a comprehensive network of social security agreements.

Despite the comprehensive coverage, the umbrella organization points out that the EHIC (European Health Insurance Card) applies exclusively to treatments within the public healthcare system of the respective host country. Services provided by private doctors are not covered and must be paid for by the insured themselves. Furthermore, the coverage only extends to medically necessary procedures that cannot be postponed until returning to the home country. For travel to countries outside the agreement area, as well as to cover any deductibles or repatriation costs, taking out private travel insurance is still recommended to ensure uninterrupted coverage.

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