PrEP in Austria: Pay Upfront, Claim it Back

PrEP in Austria isn't technically "free at the pharmacy counter," but a robust reimbursement scheme is in place until at least the end of 2027. You will need to front the cash for both the pills and the doctor's visits, then submit the invoices to your public health insurance (ÖGK, SVS, BVAEB) to get your money back. The main catch? If you are a public servant insured by the KfA, you are currently excluded from this scheme and have to pay entirely out of pocket.

Who Can Get It

Reimbursement covers individuals at substantial risk of HIV, following the German-Austrian HIV guidelines. This typically means:

• Men who have sex with men (MSM)
• Trans individuals
• Anyone with a documented elevated risk profile

You must be HIV-negative and enrolled in one of the participating public health insurance funds. You do not strictly need to prove a recent STI, but you do need a doctor to agree you meet the risk profile.

How to Get It

1. Find a specialist: You can't just go to any general practitioner. You need a doctor specialized in HIV/PrEP. The best way to find one is to check the directory at hivprep.at for participating specialists.
2. The consultation: Your doctor will run the necessary baseline tests (HIV, kidney function, STI screen) and write your prescription. You pay the doctor upfront.
3. The pharmacy: Take the prescription to a pharmacy. Specialized pharmacies are usually cheaper, with a month's supply costing between €46 and €59. You pay upfront at the counter.
4. The claim: Submit the doctor's invoice and the pharmacy receipt to your health insurance provider's online portal or via post. They will reimburse €25 per quarter for the medical checks and up to €60 per month for the medication, effectively covering the cost if you use a well-priced pharmacy.

If You Can't Wait

Austria doesn't suffer from the massive public waitlist crises seen in the UK, but finding a specialized doctor taking new patients can sometimes take a few weeks.

• The self-pay route: If you are uninsured, insured with KfA, or just want to bypass the insurance paperwork to protect your privacy, you can pay out of pocket.
• Self-sourcing generics: Importing generic PrEP for personal use from outside the EU is technically restricted by Austrian customs. With local pharmacy prices dropping to around €50 and the reimbursement scheme in place, self-sourcing online is much less common and less necessary than it used to be.

Test before you start. Never start PrEP (whether prescribed or self-sourced) without a negative 4th-generation HIV blood test or PCR. Starting PrEP with an undetected HIV infection can cause drug-resistant HIV and makes treatment much harder.

What Happens After

To keep getting your prescriptions reimbursed safely, you must do quarterly check-ups:

• Every 3 months: HIV test and full STI screening. You must actively ask for three-site testing (throat, rectum, genitals) for gonorrhea and chlamydia. If you don't ask, a busy clinic might just test your urine, which misses the vast majority of infections in gay men.
• Kidneys: Your creatinine/eGFR must be checked at every visit, as standard oral PrEP (TDF/FTC) is processed by the kidneys.
• Vaccines: Use these visits to check if you need Hepatitis A, Hepatitis B, HPV, or Mpox boosters.

What's Available

• Daily oral PrEP: The standard generic TDF/FTC.
• On-demand (2-1-1): Taking pills only around the time of sex (two pills before, one 24 hours later, one 48 hours later) is endorsed by guidelines. Talk to your doctor to ensure this fits your lifestyle.
• Injectable (CAB-LA / Apretude): As of 2026, injectable PrEP is not broadly funded as the primary option under the standard reimbursement scheme. Stick to oral unless your specialist advises you are eligible for an exception or trial.