Article updated on 11.01.2021 with information about the new UK Global Health Insurance Card 

The European Health Insurance Card (EHIC) is very useful in that it provides Europeans with medical coverage during a temporary stay in another European country. However, the coverage offered by the EHIC is limited: it’s only valid for medically necessary and unplanned treatment. It doesn’t cover private healthcare. Subsequently there are many instances where the EHIC may not be sufficient or even completely invalid. This article outlines the main ‘need to know’ facts related to the European Health Insurance Card.

What exactly is the EHIC and what benefits does it provide?

The European Health Insurance Card allows you to benefit for healthcare which is medically necessary and unplanned/unforeseen, during your temporary stay in one of the 27 countries of the European Union, as well as Switzerland, Norway, Iceland, and Liechtenstein.

This includes things like:

• emergency treatment and visits to A&E
• treatment for a long-term or pre-existing medical condition
• routine medical care for pre-existing conditions that need monitoring
• routine maternity care, as long as you’re not going abroad to give birth
• oxygen and kidney dialysis

All care that is planned in advance is excluded. If you are going abroad to receive treatment for something that has been diagnosed in your country of residence the EHIC will not cover you.

To obtain an EHIC you must apply in your country of residence. The EHIC is issued free of charge. The validity period of the new EHIC depends on where it was issued, for example if it is issued in France it is valid for two years. Please note that the long term validity of the EHIC does not mean that you can use it during an expatriation. If you become a resident of another European country, you will need to sign-up to the social security system of your host country. Your previous EHIC becomes invalid and you will need to reapply for an EHIC with the authorities of your new country of residence.

The EHIC is individual: each family member must have their own card, including children.

The EHIC in the UK after Brexit 

Under the terms of the EU–UK Trade and Cooperation Agreement, the UK and the EU agreed that reciprocal healthcare provision would continue. This means that UK residents will still be able to access healthcare in European countries and European residents will still be able to access healthcare in the UK, within the same conditions as the EHIC. 

EHICs issued before the 1st January 2021 will continue to be valid until their expiry date. 

People who don’t have an EHIC will be able to use a provisory replacement certificate instead (which needs to be requested from their local health authority before travelling).

In the long run, the EHIC will be replaced by another document:

• For UK residents, the EHIC will be replaced by a UK Global Health Insurance Card (GHIC). 
• For EU citizens, it is not yet known which document will replace their EHIC when travelling to the UK for a short stay.

Regarding the GHIC, there is one important difference with the EHIC. It is not valid in as many countries as the EHIC. British residents won’t be able to use their GHIC in Norway, Iceland, Liechtenstein or Switzerland, as was possible with the EHIC.

Will my healthcare be free?

The EHIC only gives access to the public health care system of your host country. If you are treated privately the EHIC will not reimburse you.

With regards to care in the public sector, the EHIC gives you access to the same level of care as nationals of the country you’re visiting. Thus, if a national enjoys free treatment, you will have nothing to pay. However, as each country has its own rules and regulations on pricing of healthcare, it may be that care is free in your country of residence, but not necessarily in the country that you are visiting. In that case, the EHIC does not allow reimbursement above what the nationals of the host country receive; e.g. in France you are covered for up 80% of the costs, but the remaining 20% must be paid by you, not by the EHIC.
Regarding treatments that are fully covered, two scenarios are possible depending on the regulations of the country to which you are travelling:

• Either you do not have to advance any medical expenses;
• Or you have to advance your medical expenses and you will be reimbursed through the social security system of your host country, or on your return, via the system of your country of residence. It is often simpler to be reimbursed when you return, as you are dealing with a familiar system in a familiar language, rather than a foreign system in a foreign language. In the UK, the claims centre will also verify that you have been correctly charged. The disadvantage of this is that reimbursements can sometime take several weeks.

The costs that the EHIC will not reimburse

Sometimes, the EHIC is not sufficient to cover all costs related to the medical problems that you may encounter abroad. For example, once your condition has stabilised, the EHIC does not cover repatriation to your home country. So if you are too sick to go home and do not have means to pay the medical transportation, you will be forced to stay.
To cover the costs that the EHIC does not support, it is advised that you take out travel insurance. Travel insurance can cover:

•  The patient co-payment charge in the public sector
• Repatriation or rescues
• The costs if you have been referred to a private hospital

An EHIC is not a substitute for international medical insurance

In light of what has been stated above, it is important not to regard the European Health Insurance Card as free expatriate insurance in Europe. To summarise, here are the main limitations of the EHIC:

• The card only covers you if you fall ill abroad. However, if the purpose of your trip is to seek treatment, this would count a planned treatment and the card would not be valid
• The EHIC does not guarantee free services, you are only guaranteed the same treatment as the nationals of your host country
• The use of private healthcare is not supported
• The EHIC is only valid in European countries
• If you become a resident in your host country, your EHIC loses its validity

Overall, an EHIC is very useful when you travel occasionally – holidays and business trips for example. However, it is best to take out additional travel insurance to ensure that all expenses related to your medical issues are covered. If you are expatriated, you will join the health system of your host country and depending on your situation and requirements, you may need an international medical insurance.

Expat Assure can help you to find the international medical cover best suited to your needs. Feel free to contact us directly or fill in a form online to request your insurance comparison.

You may also be interested in these articles:

What is the best international health insurance? 

8 reasons why you need expat insurance