Rezeptgebühr (Prescription Fee, Austria)

Concept

The Rezeptgebühr is the statutory, annually indexed co-payment that members of Austria’s statutory health insurance must pay for each medicine package dispensed on a health-fund prescription. It is the most common and practically most relevant form of cost-sharing in statutory health insurance and is levied at the same amount by the Austrian Health Insurance Fund (ÖGK) and the other health insurance carriers.

Exemptions and the annual cap

Certain groups are exempt from the Rezeptgebühr or pay a reduced amount, in particular low-income individuals, chronically ill persons with elevated medicine needs, and recipients of certain social benefits. An annual cap also applies: if the prescription fees paid in a calendar year exceed two percent of net annual income, further fees are automatically refunded or no longer charged.

Relevance for insurance practice

For advising on private supplementary health insurance, the Rezeptgebühr is usually of secondary importance, since it represents a small amount compared with private-physician or private-hospital-room costs; it nevertheless remains a typical example of Austria’s statutory health insurance co-payment system and is occasionally offered as a covered ancillary benefit within supplementary health insurance tariffs.