The EHIC, or European Health Insurance Card, is free and gets free or discounted medical care in all 27 EU countries, plus others. But over half of people in the UK don't have one, and over 3m cards will expire in 2013, so check yours urgently.
This guide tells you how and where to apply, which countries it's valid in, which may illegally reject it, and the level of cover it entitles you to.
What's an EHIC?
The free European Health Insurance Card (EHIC) entitles the holder to free or discounted medical treatment at state-run hospitals and GPs in any European Union country, plus Iceland, Liechtenstein, Norway, and Switzerland.
If you're in Europe and you've got an EHIC, you’ll be entitled to the same treatment that local citizens are entitled to - extremely useful in emergencies. It’s completely free and valid for five years. All UK residents are eligible, residents of the Channel Islands and Isle of Man are not.
Does an EHIC make treatment free?
No. You get treated the same way as a citizen of that country. If they get free medical treatment then you do too; if they pay, you pay the same rates. As this is a reciprocal agreement across Europe, it also means EU citizens can use the NHS in the same way.
It’s also worth noting that the EHIC doesn’t cover you if you're going abroad specifically to get treatment, see the NHS website for more info.
Who needs an EHIC?
Everybody who is travelling in Europe needs an EHIC. It replaced the old E111 form in 2005. Even if you've already got travel insurance, it's valuable extra protection, even if just for visiting the local GP with a query while away. There are a few important facts to note:
- Check yours hasn't expired
Over three million EHICs are due to expire in 2013, so ensure yours is valid before you go away. The expiry date is on the bottom right. If it's already expired, or is about to, renew it now.
As you can apply for a new card up to six months before the current one ends, it’s worth doing this in advance so you don’t forget.
- Kids must have their own cards
Though you must be over 16 to apply, every family member requires a card. To apply on behalf of a child, just include them as a dependant in the relevant section of the application and you'll each receive a separate EHIC
- Keep the card with you at all times
The terms stipulate you won't be covered if you haven’t got it on you, so don’t leave it behind at the hotel if you’re out and about. Take it to the beach if you have to.
If you find yourself without your EHIC in an emergency, you may be able to get a Provisional Replacement Certificate sent to where you're being treated to prove your entitlement. For this, call the NHS Overseas Healthcare Team on 0044 191 218 1999.
But as this is only for emergencies, the Department of Health still states you should always carry your card with you to be covered.
- You may need to pay and claim later
Though the EHIC allows you instant free treatment in some countries, in others you'll need to pay and reclaim the money while you're there, or when you get back to the UK. Use the country-by-country guide below to find out which applies to you, and call the NHS Overseas Healthcare Team on 0191 218 1999 if you need to make a claim.
Is it a substitute for travel insurance?
No. While very useful, it’s only about medical cover. It only gives you access to state-run hospitals which, depending on where
you travel to, can be few or far between, and more limited.
The EHIC gives valuable protection but should never be seen as a substitute for travel insurance.
Travel insurance has a much wider level of cover than the EHIC. For example:
- Using the EHIC doesn’t always mean free treatment
You may still have to pay a substantial amount in some countries, even in a state hospital. Travel insurance should cover this, though using an EHIC may mean you won't need to pay the excess
- State hospitals might not be available
While in the UK emergency treatment tends to be on the NHS, don’t assume this type of coverage will always be available. You may be taken to a private hospital.
Cancellation, delay, repatriation, baggage loss and theft aren’t covered
The EHIC is purely a medical policy, while travel insurance covers many other areas.
Country-by-country EHIC guide
The EHIC's usable in the EU’s 27 member states, plus a few others. Show your card before treatment, and keep any receipts. The NHS England site has detailed country-by-country information on what’s covered in each. See below for a quick summary:
- Austria. Treatment will be free if the doctor's contracted with one of Austria's regional health insurance offices. You'll be charged if not, but you can claim up to 80% of this back out there, and may be able to claim the remaining 20% in the UK. See NHS Austria healthcare.
- Belgium. Though the majority of doctors in Belgium provide private healthcare, some offer both. You'll have to pay for healthcare, but you may be able to claim back up to 75% of the charge out there, and the remaining 25% in the UK. See NHS Belgium healthcare.
- Bulgaria. Check before making an appointment whether the doctor is registered with the National Insurance Fund. There's a small charge to see a doctor but you may be able to get this back in the UK. See NHS Bulgaria healthcare.
- Cyprus. Treatment is available from doctors in state healthcare centres. It'll cost €2 for each visit, but you may be able to claim this back in the UK. See NHS Cyprus healthcare.
- Czech Republic. Make sure the doctor's registered with the CMU. You'll need to pay a small patient contribution, though watch out as you'll have to pay the full cost if the doctor isn't registered. See NHS Czech Republic healthcare.
- Denmark. Doctor consultations are covered, though check whether the doctor's registered with the Danish public health service. If you're charged, you can claim back the full amount. See NHS Denmark healthcare.
- Estonia. You'll need to pay some of the fee for any medical treatment, and this includes home visits. You might be able to claim for this when you arrive back in the UK. See NHS Estonia healthcare.
- Finland. Visit a municipal health centre for assessment; under-18s get free treatment. Some medical services are free, though health centres may charge for others. See NHS Finland healthcare.
- France. Make sure the doctor or dentist is registered with France's state healthcare provider before making an appointment. You should be able to claim back approximately 70% of the treatment fees. See NHS France healthcare.
- Germany. Check the doctor provides treatment under the state scheme. There's a standard charge of €10 for nearly all services, though this may be refundable back in the UK. See NHS Germany healthcare.
- Greece. See an IKA-ETAM doctor or dentist to get reduced-price or free treatment. If you need medicine there's a 25% patient charge (can vary), which
may be refundable in the UK. See NHS Greece
Warning: Some people have had problems with EHICs being refused in Greece.
- Hungary. You'll need to go to surgeries contracted with the OEP, though there's a fee of 600 forint (about £1.80) for each visit, or 1,000 forint (about £3) if it's out of normal treatment hours. These may be refundable in the UK. See NHS Hungary healthcare.
- Iceland. Its health centres provide treatment from 8am to 4pm, and are in all districts of Iceland. There's a charge of 1,000 krónur (about £5.50) - halved if you're on a state pension - which may be refundable in the UK. See NHS Iceland healthcare.
- Ireland. Visit doctors working under the Primary Care Reimbursement Service scheme to get free treatment. To find your nearest, go to your local Health Service Executive office. See NHS Ireland healthcare.
- Italy. Make sure the doctor's registered with the Italian national health service, the SSN, and treatment should usually be free. Surgeries are generally open Monday - Friday, though opening times vary. See NHS Italy healthcare.
- Latvia. Charges apply to see a doctor, though pregnant women receiving treatment to do with their pregnancy won't be charged. Under-18s also avoid the fees, which may be refundable in the UK. See NHS Latvia healthcare.
- Liechtenstein. Visit a doctor covered by the public health scheme and you'll pay 67 francs (about £47), half-price for pensioners and children. See NHS Liechtenstein healthcare.
- Lithunania. Visit a doctor who works with one of the territorial patient funds to get free treatment. Any private healthcare fees are sadly non-refundable. See NHS Lithuania healthcare.
- Luxembourg. You'll need to pay and then claim the cash back from the CMO, the Sickness Insurance Fund for Manual Workers. Hospital stays and medicines are fully funded by the CMO. See NHS Luxembourg healthcare.
- Malta. Go to public health centres to see a doctor. State-provided emergency dental treatment is free, though isn't widely available as most dentists have private practices. See NHS Malta healthcare.
- Netherlands. See a doctor covered by the AGIS Zorgverzekeringen scheme and treatment will normally be free. Children can also receive state-provided dental care, though others will have to pay. See NHS Netherlands healthcare.
- Norway. You'll have to pay a fee. Make sure you see a doctor with a reimbursement arrangment with the NAV. Though the cost is non-refundable in Norway, you may be able to get it back in the UK. See NHS Norway healthcare.
- Poland. The NFZ logo indicates those working under the state healthcare scheme. You'll be able to visit doctors' surgeries from Mon-Fri, 8am-6pm; outside these hours a 24-hour medical service is provided by NFZ-contracted health units. See NHS Poland healthcare.
- Portugal. There's no charge for state doctors, dentists or hospitals. If you need a pharmacy, you'll find them across Portugal, open Monday to Friday, with shorter opening hours on weekends. These can also provide lists of pharmacies with 24-hour service. See NHS Portugal healthcare.
- Romania. Check the doctor, dentist, pharmacist or hospital is working with the Casa Nationala de Asiguarari de Sanatate. There's normally no charge for a medical consultation, though you'll be charged part of the cost for any tests. See NHS Romania healthcare.
- Slovakia. Make sure the doctor or dentist is covered by the Slovakian health insurance system. You'll need to pay a contribution if you see a doctor, but emergency dental treatment is free. See NHS Slovakia healthcare.
- Slovenia. Check the doctor's registered with the Health Insurance Institute. You may need to pay a standard contribution, though this may be refundable in the UK. See NHS Slovenia healthcare.
- Spain. State healthcare is free, but check they accept your EHIC first as some hospitals and health centres also offer private healthcare. See NHS Spain healthcare.
- Sweden. Under-20s receive free treatment, though others will be charged between £8-£12 per treatment. Make sure you see a doctor working under the public insurance scheme. See NHS Sweden healthcare.
- Switzerland. Check the doctor's registered with the Swiss public health service. Usually, you'll need to pay in full for treatment and claim a refund later. See NHS Switzerland healthcare.
How do I get a free EHIC?
There are several ways to register for a card:
Generally, it'll take about seven to 10 days for it to come through, though it's worth applying early so you get it in good time for your holiday. If you’ve lost your card, or it’s been stolen, call 0300 330 1350, or from abroad call 0044 191 218 1999.
BEWARE UNOFFICIAL EHIC WEBSITES
Watch out for websites demanding a fee for the EHIC. Search on the internet for "EHIC" and you’ll find sites that describe themselves as "reviewing" or "forwarding" services, charging about £15-£20 (sometimes more) to process your application. They often look official, but scroll to the bottom and you’ll find a tick box asking for cash.
ITS A CON. DO NOT PAY A PENNY FOR
YOUR EHIC CARD
One unofficial site takes a "processing fee of just £14.99", and another states "EHIC fee only £19.99". Some even claim to provide a "fast-track" service for an extra fee. Yet there's no such thing as an EHIC fast-track application, so don't get caught out.
ALWAYS use the official site, www.ehic.org.uk, to get yours for free. A Department of Health spokesperson told us.
In 2010, the Office of Fair Trading (OFT) took action against several sites which deceptively sold EHICs, see the OFT website for more. In July 2011 it also announced investigations into online websites deceptively selling Government services, including the EHIC.
MONEY BACK IF YOU HAVE PAID?
Sadly, far too many are caught out through Googling "EHIC" and end up paying through an unofficial site. If this has happened to you, it's unlikely you'll be able to get your money back. However, it's worth contacting the site straight away and asking for a full refund, just in case.
This won't always work, but it's worth a shot - one person who paid for his EHIC via an unofficial website found its terms allowed refunds within 30 days, so used this to get his money back, this won't be in all sites' terms & conditions, but if it's happened to you, do give it a go.
The OFT have said that while it isn't unlawful to charge for a reviewing and forwarding service, tricking consumers into spending on unwanted services is. If you're concerned about an unofficial EHIC website, contact the Citizens Advice consumer helpline on 08454 04 05 06. See the OFT website for more info.
BEWARE UNLWAFUL EHIC REFUSALS
Worryingly, reports of holidaymakers having had their EHICs refused for public healthcare in some countries have been coming to light. It only affects a minority of travellers, and you should always take an EHIC nevertheless. But it's worth ensuring you've decent travel insurance too, just in case.
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.
BE CAREFUL WHAT YOU SIGN
The European Commission's have said that if your EHIC's refused for public
healthcare, it's likely to be a breach of EU law. To ensure you don't get caught out, ALWAYS check you're being treated under the public (rather than private) healthcare system when you show your
Be very careful what you sign, particularly if you don't understand it, and be prepared to go elsewhere if you're refused public treatment. If it's a medical emergency and this means you're forced to pay for private treatment, gather as much as evidence as possible.
Will I get medical costs refunded if my EHIC's refused?
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.If you don't have insurance, or you're not covered for the condition, it's highly unlikely you'll be reimbursed.
We are pleased to have been awarded the RiDE Magazine Recommended triangle on our recent tour to Northern Spain.
So what does that mean for you?
Well we don't do anything differently on all our other tours, so you can have peace of mind that we will look after you just as much.