Anyone taking a trip to the continent shouldn’t leave home without a European Health Insurance Card (Ehic), but some holidaymakers are in the dark about what it is and why it's useful.
The Ehic, which replaced the E11 in 2005, allows you to get medical treatment in EU countries either free of charge or at a discounted price, making it a holiday essential.
What is an Ehic?
An Ehic is a medical card – which can be used throughout the EU, as well as in Iceland, Liechtenstein, Norway and Switzerland – that entitles you to treatment in state hospitals at the same price as the residents of the country you are visiting. So if they get free treatment, you get free treatment.
The card is free and has to be renewed every five years. You can order a card via the EHIC website.
How do I use an Ehic?
Ehics are simple to use. All you have to do is present your Ehic before you have treatment and you shouldn’t have any problems. Remember to keep it on you at all times – if you are rushed to a medical centre and don’t have it with you, it can be more difficult to get treatment.
The important thing to remember is that you can only use the Ehic for state-run medical treatment. If you end up in a private health centre or hospital, then you will probably have to foot the entire bill yourself, unless you're covered for this by travel insurance.
You might be able to get a Provisional Replacement Certificate, a temporary Ehic replacement, if you don’t have your Ehic with you, but it's much easier to present your Ehic on arrival. Remember that Ehics can only be used in state-run hospitals, so if you go to a private clinic, you may have to foot the bill yourself.
If you need a Provisional Replacement Certificate, see the NHS guide for guidance on what to do.
Will the Ehic card work after Brexit?
While the government claims that existing Ehic arrangements will continue after the UK leaves the EU, no deal has yet been reached. You can continue to apply for an Ehic card (valid for five years) and it will work for at least long as the UK is in the EU.
I have an Ehic – do I need travel insurance?
Many travellers assume that having an Ehic means that they don't need travel insurance, but this couldn't be further from the truth. While, somewhat confusingly, Ehic has insurance in its name, it's not a suitable replacement for travel cover; it only helps you meet the cost of medical treatment.
Meanwhile, as well as covering medical expenses, travel insurance will cover you if you need to cancel your holiday or return early, and if your luggage goes missing or is stolen among, many other things. In addition, some insurers will waive the excess on a medical claim if you have an Ehic.
Find out more: Best and worst travel insurance
Will I be covered by Ehic if I have a pre-existing medical condition?
Ehic covers treatment of a chronic or pre-existing condition if the symptoms flare up during your holiday and a visit to a healthcare professional becomes necessary.
It also covers routine medical care for people with pre-existing conditions that need monitoring.
However, the Ehic does not provide cover if you are going abroad specifically to have treatment. Nor does it guarantee the kind of specialist treatment you might receive at home. Travel insurance for pre-existing conditions is therefore a necessity and has the added advantage of covering you for cancellation or curtailment if your condition worsens.
Unfortunately, mainstream travel insurers may charge a large premium to cover you for pre-existing conditions, and some may refuse cover entirely. However, there are specialists who can help.
Find out more: Travel insurance for pre-existing medical conditions
Could my Ehic be refused?
There have been problems in some countries where state-registered medical staff have refused to accept the Ehic, perhaps claiming that they don’t recognise the card or don’t have the technology to accept it. This is a breach of European rules and seems especially prevalent in regions of Spain, such as Catalonia.
Most medical facilities in Spain, often called ‘centros sanitarios’, are private, but even in some state hospitals, staff appear to be rejecting the Ehic if they know you already have travel insurance.
The UK government is aware of these problems and has sent officials to Valencia in an effort to improve the situation, and it has also raised the issue with the European Commission.
If your Ehic is refused in a state-run clinic, try to get proof that you presented it at the time, as this could be key to getting the excess waived by your insurer. And, if for some reason you think you’ve been incorrectly charged, you may still be entitled to reimbursement from the Department for Work and Pensions (DWP).
What if I'm made to pay upfront?
Even if the state-provided care is free, you may still have to pay upfront and claim the money back once you return home. In France, for example, you may have to pay upfront for certain services, although for others, a bill may be sent to your home address.
You could be told to apply for a reimbursement with the local authority where you had treatment; in other cases, you must apply for a refund through the UK’s DWP once you return home.