The European Health Insurance Card (EHIC) is very useful in that it provides medical coverage to Europeans travelling within the EU, either on holiday or during a temporary stay. However, the parameters in which the EHIC operates are strict and well defined; subsequently there are many instances where it may not be sufficient or even completely invalid. It is important to familiarise yourself with the healthcare that you are entitled to abroad to avoid any unpleasant surprises. This article therefore 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 28 countries of the European Union, as well as Switzerland, Norway, Iceland, and Liechtenstein.
Medically necessary and unforeseen care does not only refer to serious accidents needing to a stay in A&E; for example, a cold may also be supported because it falls within the definition of necessary and unforeseen care. However, 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 and those issued in the UK are valid for five years as of 1st July 2014. The validity period of the new EHIC depends on where it was issued, for example if it is issued in France it is valid only two years. Please note that the five-year 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.
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, please bear in mind that each country has its own rules and regulations on pricing of healthcare and it may be that care is free in your country of residence, but not necessarily in the country that you are visiting. In some countries nationals do not receive completely free healthcare as in the UK and 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.
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