If you live in Europe you are entitled to certain health benefits via the EHIC, the European Health Insurance card. So what is it, and how does it work? I thought it would be useful to look into the benefits and downsides of the EHIC.
What is a European Health Insurance card?
The EHIC card lets people get state-run healthcare at a reduced cost, sometimes completely free. It covers you for any medical treatment you need, for illnesses and accidents, so you can continue your trip and don’t have to travel home early. Unlike travel insurance it includes cover for pre-existing medical conditions and you get cover for routine maternity care. It doesn’t cover you if you travel to another country especially to give birth or for any other kind of treatment. But if you give birth unexpectedly while you’re travelling, it covers the medical treatment needed for you and your child.
The EHIC is valid for Europeans over the age of 16. It applies right across all 28 countries in the European Economic Area. But you need to bear in mind that if a country doesn’t have a state healthcare system to claim on, your EHIC won’t help if you need treatment.
European countries where your EHIC is valid
- Czech Republic
Does it replace travel insurance?
An EHIC doesn’t replace travel insurance. It doesn’t include cover for private medical healthcare and, unlike travel insurance, it doesn’t pay for expensive services like mountain rescue and repatriation and you can’t claim for lost or stolen property. In fact, many insurers insist you have both: an EHIC and travel cover.
Does it replace international health insurance?
No. You can use your card when you visit a country in the EEA, for example for a holiday or business trip. But you can’t use it if you’re moving abroad to live, work or study. As an expat you will need good quality health insurance to cover every eventuality in your new home country in the longer term.
Who needs one?
Everyone in your family applies for their own card. If you have children you apply for their cards under your own name, with them as your dependants.
How long does it last?
An EHIC is valid for five years and you can renew it up to six months before the expiry date. If you lose it or it’s stolen, you can apply for a Provisional Replacement Certificate which covers you until you get back to your home country.
What does a European Health Insurance Card cover?
Every country’s state-run healthcare system is different. In principle the card covers anything you’d get free in your home country, and the same treatment as anyone else who lives in the country you’re visiting.
Some countries will ask you for a patient contribution or ‘co-payment’, some of which you can claim back either in the country in which you are treated or in your home country.
The EHIC even includes oxygen and kidney dialysis, both of which you have to book in advance before you leave your home country. Because the EHIC doesn’t include private healthcare, you need to make sure you book with a state-run medical facility.
If you are an expat pensioner or an expat on long-term incapacity benefit, you might qualify for state healthcare in your new country, paid for by your home country. Using your EHIC, you will be able to get treatment on the same same basis as any other resident of your new home country.
You are covered abroad even you don’t have your card with you, and you are covered from the date you apply.
How do I get an EHIC?
The card is free as long as you apply through the official channel. It usually arrives in seven days or less. You can apply for and renew cards elsewhere online, through unofficial sites, but they charge anything from £25 per card for the service. There have been many complaints and these companies have recently been investigated by the UK Office of Fair Trading, who conclude there is very little ‘customer detriment’ involved and are not taking action. Here’s what the OFT says about the matter:
“The OFT has closed its investigation into websites which charge consumers for processing applications for government services e.g. EHICs, which are available free or at a low cost if obtained directly.
The OFT has concluded that potential for significant consumer detriment is low and there is insufficient evidence of breaches of consumer protection legislation to warrant prioritising formal enforcement action in this instance. It may reconsider its decision in the future if it receives further evidence of suspected infringements, or its prioritisation assessment changes.”
Where to apply for a FREE card
This is the official UK NHS application page: NHS Business Services EHIC application. You can also apply by telephone on 0300 3301350, download an application form or apply by post.
Sites to avoid – These websites charge for UK EHIC applications and renewals:
Can a country refuse treatment under my EHIC?
Yes, it has happened. As the Money Saving Expert website says:
The European Commission’s confirmed EHIC refusal has been reported in some parts of Spain, particularly in Andalucia and Catalonia. These areas include popular destinations such as Barcelona, Malaga and the Costa del Sol.
Hospitals have reportedly insisted people take private treatment, which costs money, and in some cases individuals have been asked to sign a ‘medical consent form’. This is actually a consent form for private treatment.
The UK’s Department of Health has confirmed it’s had reports of similar EHIC refusal problems in Greece, though it’s had fewer complaints about this.
The Spanish authorities told the European Commission that in July 2013 they gave extra guidance, reiterating Spanish public health services shouldn’t ask for additional insurance if EU citizens present an EHIC. The Commission says it’s monitoring how this is applied before deciding if further action’s necessary.
If you’ve got travel insurance, then you may be in luck. Assuming the condition you have is covered by insurance, you should be able to claim.
However, most policies have an excess, which means you’re responsible for the first part of any claim. Say the excess is £50, if you claimed for something worth £200, you would only get £150 back as the first £50 is your responsibility. Therefore, factor in the excess to any payouts.
The European Commission tells us some private insurance companies waive their excess if you use an EHIC – yet if you’ve had your EHIC refused this may not apply, so always check.
Sadly if you don’t have insurance, or you’re not covered for the condition, it’s highly unlikely you’ll be reimbursed. You can report the problem to the local British Embassy or the European Commission’s SOLVIT system. However, these probably won’t get you your money back.
Non-European countries with reciprocal healthcare agreements
Plenty of non-European countries that have reciprocal healthcare agreements with the UK. Here they are. You’ll find full details about the agreements here, on the NHS website.
- Bosnia and Herzegovina
- British Virgin Islands
- Falkland Islands
- Isle of Man
- New Zealand
- St Helena
- Turks and Caicos Islands
The EU emergency phone number
If you have an emergency during your visit in Europe, there’s a free European emergency number. Just dial 112 to access emergency services including ambulances and police, from landlines andmobiles.