Austria health insurance: Ensuring financial security in case of care needs
14 Jun 2025
8
Minutes
Katrin Straub
CEO at nextsure
The need for care can affect anyone and presents financial challenges for both those affected and their families. The Austrian system of care insurance provides basic security, but this often does not suffice. Find out how you can close your care gap.
The topic in brief and concise terms
The statutory nursing insurance in Austria (care allowance) provides basic security in seven levels, which often does not cover all care costs.
A private care insurance can close coverage gaps; premiums and benefits vary according to provider and plan.
Applying for care allowance requires an assessment of care needs, which must amount to at least sixty-five hours per month.
Understanding the Foundation: Statutory Long-Term Care Insurance in Austria (Pflegegeld)
Austria's statutory care insurance is anchored in the Federal Long-Term Care Allowance Act (BPGG) and provides financial support for people in need of care. Entitlement exists when there is a permanent need for care and assistance that is expected to last at least six months and amounts to more than sixty-five hours per month. The amount of the care allowance is based on seven care levels, reflecting the extent of care required. For the year 2025, for example, the care allowance is 200.80 euros at level one and rises to 2,156.60 euros at level seven. Many underestimate that proof of more than sixty-five hours per month is required even for care level one. Classification is done after an assessment by a doctor or a registered nurse. This solid foundation is an important pillar of health & care in Austria. The next section takes a closer look at the specific care levels and the associated benefits.
The seven care levels in detail: services and requirements
The Austrian system recognises seven care levels that represent the monthly care needs. For care level one, more than sixty-five hours of care per month are required, supported with 200.80 euros in 2025. If a person needs more than ninety-five hours of assistance, care level two applies with 370.30 euros. Care level three requires over one hundred and twenty hours of care needs and provides 577.00 euros. The exact number of hours is determined by an assessment, which can also take into account hardship allowances, such as for dementia. The benefits further increase:
Care level four (more than one hundred and sixty hours): 865.10 euros
Care level five (more than one hundred and eighty hours with exceptional care needs): 1,175.20 euros
Care level six (more than one hundred and eighty hours with uncoordinatable care measures or constant presence): 1,641.10 euros
Care level seven (more than one hundred and eighty hours without targeted movements of the four extremities possible): 2,156.60 euros
These graduated amounts are intended to enable individual care insurance. But how is the need specifically determined and applied for?
Application and Assessment: The Path to Care Allowance
The application for care allowance can be made by the affected person themselves, relatives, or legal representatives. The responsible body is usually the pension insurance provider, which also pays out the pension; otherwise, it is the pension insurance institution. After the application is submitted, an assessment is carried out by an expert, usually a doctor or a qualified care nurse, often in the form of a home visit. During this examination, the individual care needs are determined based on criteria such as personal hygiene, nutrition, mobility, and necessary assistance tasks. It is advisable to have all relevant medical documents ready for the assessment appointment and, if necessary, to bring along a trusted person. The decision on the care level is based on this assessment. A private supplementary care insurance can be sensible regardless of this. Below you will learn why the state care allowance is often insufficient.
When the state care allowance is not enough: The necessity for private provision
Although the state care allowance provides important financial support, it often does not cover the full costs of care, especially with intensive supervision. For example, 24-hour care can quickly cost between 2,000 and 2,500 euros per month. The care allowance at level three (€577.00 in the year 2025) would be far from sufficient here. This gap in coverage can lead to significant financial strain for those affected and their families. Many families are unaware of these potential financial pitfalls until the need for care arises. A private care insurance in Austria can remedy this by providing additional financial resources. The premiums for such insurance can range from fifty to one hundred euros per month for adequate coverage. The obligation to have care insurance does not exist in this private form, but it is often a wise addition. The options for private provision will be explained in the next section.
Options of Private Long-term Care Insurance: Tailored Protection
Private nursing insurance in Austria provides additional financial protection to the state care allowance. The benefits are often aligned with the state care levels, but can be individually agreed upon. Some plans provide benefits from a lower care level, while others only from a higher care need. Monthly additional benefits can range from several hundred to over a thousand euros, depending on the chosen plan and premium. Taking out private nursing insurance early is often associated with lower premiums. There are various models and providers whose conditions should be compared. The following aspects are important when making a choice:
Benefit amount per care level
From which care level is payment made?
Are there any waiting periods?
How flexible is the contract with changes in life circumstances?
Which assistance services (e.g., advice, organisation of care services) are included?
A careful selection helps to find the right supplementary nursing insurance. Our expert tip: Make sure the private insurance adjusts its benefits in the event of a deterioration in health and an associated upscaling in the state system.
Expert tips for your care planning in Austria
Engaging with long-term care planning is an important step towards financial security. Our expert tip: Start planning early. The younger you are when you take out a private long-term care insurance policy, the lower the monthly premiums usually are. Compare offers from different insurers carefully. Pay attention not only to the price but also to the included benefits and the conditions for adjusting services. Document your health status and any pre-existing conditions thoroughly, to ensure you have all necessary information accessible when applying for state care benefits or private insurance. Consider what form of care you might need in case of an emergency—home care by family members, mobile services, or a nursing home—and calculate the potential costs. A comprehensive long-term care insurance in Austria takes these individual needs into account. Also, consider the possibility of state-supported long-term care planning, if offered in Austria and relevant for you. These considerations will help you make an informed decision for your future.
More useful links
Wikipedia offers a comprehensive overview of long-term care insurance.
The GKV-Spitzenverband, the umbrella association of statutory health and long-term care insurers, provides information about statutory long-term care insurance.
The Consumer Advice Centre provides independent consumer information on long-term care insurance.
The Federal Ministry of Health provides information on the care strengthening laws.
In the AOK lexicon, you will find explanations of long-term care insurance.
FAQ
Is nursing care insurance mandatory in Austria?
The state care allowance system is part of social security. A private care insurance is not mandatory in Austria, but it is often recommended to cover high care costs.
What care levels are there in Austria?
In Austria, there are seven levels of care. The classification is based on the monthly care needs in hours, starting from more than 65 hours for level one up to over 180 hours with additional criteria for the highest levels.
How do I apply for care allowance in Austria?
The application for care allowance is submitted to the relevant pension insurance institution. An assessment follows to determine the need for care.
Does the state care allowance cover all costs?
No, the state care allowance is often only partial funding. Especially with high care demands, such as 24-hour care, significant costs can remain uncovered.
What additional benefits does private long-term care insurance provide?
A private long-term care insurance policy pays an agreed monthly pension or a lump sum in the event of a claim to reduce the difference between state-funded care allowance and actual care costs.
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