The EHIC, or European Health Insurance Card, is free and gets free or discounted medical care in all 28 EU countries, plus others. But over half of people in the UK don't have one, and around 5.2m are due to expire in 2015, so check yours urgently.
This guide tells you how to check yours, who can use it and when you can use it, plus crucially how to get or renew one free (see how to). DON'T GOOGLE or you'll end up at imposter sites that charge or pretend they fast track.
In this guide...
How does the EHIC work?
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. It replaced the old E111 form in 2005.
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 up to five years. All UK residents are eligible, residents of the Channel Islands and Isle of Man aren't.
It's also worth noting it covers some (not all) overseas territories too – for example, Portugal's cover includes the Azores and Madeira. We've included these in the country-by-country listings.
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.
Martin's quick tale:
My own EHIC was a godsend at an Italian friend's wedding. I was due to make a speech and lost my voice, so I nipped to the local GP at no cost.
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:
EHIC doesn't always mean free treatment - where it doesn't, travel insurance usually covers it.
Even in a state hospital using EHIC, you may still have to pay a substantial amount in some countries. 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. It's possible to cover a year's holidays for less than £20. See Cheap Travel Insurance for more information.
Check and ensure your EHIC is valid
Everybody who is travelling in Europe needs an EHIC but with around 5.2 million EHICs due to expire this year, ensure yours is valid before you go away. 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 the date on yours.
The expiry date is on the bottom right. If it's already expired, or is about to, renew it now (see How to apply).
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.
You could be asked to pay up front 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 faxed to where you're being treated to prove your entitlement. For this, call the NHS Overseas Healthcare Team on 00 44 191 218 1999. You can also get them at short notice just before you go. See the NHS website for more. 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 a proportion of your costs, known as patient contributions. Rule changes, which came into force in July 2014, mean you can no longer be reimbursed for these contributions, but you could still be able to claim for payments made before this date. See NHS website for more information.
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 (longer for posted applications), though it's worth applying early so you get your EHIC in good time for your holiday.
You can get an EHIC the following ways:
Call 0300 330 1350.
Print the application form from the NHS website, fill it in and post it to: NHS Business Services Authority, European Health Insurance Card, EHIC Applications, Bridge House, 152 Pilgrim Street, Newcastle Upon Tyne, NE1 6SN.
You can't get an EHIC from your doctor, nor can you get one from a post office.
If you've lost your card, or it's been stolen, call 0300 330 1350, or from abroad call 0044 191 218 1999. For more emergency info, it's also worth taking the free, printable Little Lifesaver travel guide with you when you're away.
If you've any questions about the application process, there's also now an official EHIC Facebook page where you can get help from the NHS's EHIC team.
Beware shyster 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 £20 or more to process your application. They often look official, but scroll to the bottom and you’ll find a tick box asking for cash.
One unofficial site describes "a small service charge of £23.50". It also charges £24.99 for a "fast-track" service. Yet there's no such thing as an EHIC fast-track application, so don't get caught out.
These copycat websites also try to trick people into overpaying for driving licences, passports and others – see the full Shyster Sites guide for more.
ALWAYS use the official site, www.ehic.org.uk, to get yours for free. A Department of Health spokesperson says:
These websites are not endorsed by the Department of Health. The Government is working with the Advertising Standards Authority, Trading Standards and search engines such as Google, to raise awareness and ensure enforcement action is taken where appropriate.
Can you get your money back from a shyster site if you've 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 MoneySaver 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 (see the Paid-for EHIC applicants could get refund MSE news story). This won't be in all sites' terms, but if it's happened to you, do give it a go and let us know how you get on in the Free EHIC discussion.
The OFT tells us 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 03454 04 05 06. See the National Trading Standards website for more info.
Beware unlawful EHIC refusals
Worryingly, we've heard reports of holidaymakers having their EHICs refused for public healthcare in some countries. This has only affected a very small 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.
Which countries have been affected?
In 2013, the European Commission confirmed that EHICs had been refused in some tourist areas of Spain.
At the time, hospitals were reportedly insisting people be treated privately, which costs money. In some cases individuals were asked to sign a 'medical consent form' which was actually a consent form for private treatment.
This case has now been closed, after the Spanish authorities issued extra guidance, reiterating that Spanish public health services shouldn't ask for additional insurance if EU citizens present an EHIC.
The UK's Department of Health said it had seen reports of similar EHIC refusal problems in Greece, though there were fewer complaints than from visitors to Spain.
Be careful what you sign
The European Commission's told us 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 EHIC.
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.
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.
If it's happened to you, please let us know how you get on in the Free EHIC discussion.
Country-by-country EHIC guide
The EHIC's usable in the EU's 28 member states, plus a few others. Show your card before treatment, and keep any receipts. The NHS England site also has detailed country-by-country information on what's covered in each.
Free app gives country-by-country emergency EHIC info on holiday
Once it's downloaded, it keeps the info on your phone, so you can access it offline for nowt. Hopefully you won't need it, but it could be handy in a holiday emergency.
How it works
To use it, select the country you're visiting and it shows you its emergency services number, contact details for that country's EHIC healthcare system, plus key info on what to expect if you're being treated, how much it costs, and how to apply for reimbursement.
Download it before you go to avoid data charges abroad – it's about 13MB in total. We don't have feedback on it yet, so if you try it, please do let us know how you get on.
Only get the official app via the links above though – we've come across another free EHIC app before that linked you to a site which charged, so keep your wits about you.
In each of the countries which allow you to use your EHIC, listed below, it's worth checking that your treatment provider is registered with the state-run health scheme. Here's a quick summary:
Treatment's free if the doctor's contracted with one of Austria's regional health insurance offices. If you use a private doctor you will be charged but may be able to claim a partial refund. There is also a non-refundable daily charge for the first 28 days of a hospital stay. See NHS Austria healthcare info.
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. You will also have to pay for some hospital costs and ambulance journeys are not covered. See NHS Belgium healthcare info.
Check before making an appointment whether the doctor is registered with the National Health Insurance Fund. There's a small charge to see a doctor or a dentist. See NHS Bulgaria healthcare info.
Now Croatia's joined the EU, the Department of Health confirms EHIC cards are now accepted there too. Make sure the healthcare provider's with the CHIF (Croatian Health Insurance Fund). All Croatians have to pay a healthcare contribution, and you might have to too, even with your EHIC card. See NHS Croatia healthcare info.
Treatment is available from doctors in state healthcare centres, and it'll cost €3 (about £2) for each visit to a general practioner. The cost is higher if you need to see a specialist. The NHS warns that the EHIC cards are not valid in some northern parts of Cyprus. See NHS Cyprus healthcare info.
Treatments given by a doctor or dentist should be free of charge, but there's a standard consultation charge of 30 koruna (80p) that everyone needs to pay. You'll also be charged fee if you go to the hospital or if you're given a prescription. Make sure the doctor's registered with the CMU, otherwise you're basically a private patient and you won't be covered. See NHS Czech Republic healthcare info.
Doctor consultations are covered, but you'll need to make an appointment first. Check whether the doctor's registered with the Danish public health service. Hospital treatment is also free. You'll need to contribute to dentist treatment, as everyone in Denmark has to pay for a private dentist when they're over 18. See NHS Denmark healthcare info.
You'll need to pay some of the fee for any medical treatment, and this includes home visits. There is also a non-refundable €2.50 per day fee for up to 10 days in hospital, this is waived for children, pregnant women and anyone in intensive care. See NHS Estonia healthcare info.
Visit a municipal health centre for assessment – under-18s get free treatment. Some medical services are free, though health centres may charge for others, as this varies by area and some are based on contributions. Doctors can charge between €13.80 (about £10) and €18.90 (about £14) for on-call visits. If you are charged ask for a receipt. See NHS Finland healthcare info.
Make sure the doctor or dentist is registered with France's state healthcare provider before making an appointment. You need to pay the practitioner directly but should be able to claim back approximately 70% of the treatment fees while in France so long as you have a signed statement of the treatment given. Make sure you keep your recipts and any paperwork. See NHS France healthcare info.
The UK's Department of Health confirms France's EHIC cover also includes the territories of Guadeloupe, Martinique, Guyane (French Guiana) and Reunion, so you're covered there too.
Check the doctor provides treatment under the state scheme. There's a standard charge for nearly all services, including a daily charge of €10 a day for hospital stays. The EHIC only covers ambulance trips in emergencies or if a doctor says it is necessary. See NHS Germany healthcare info
See an EOPYY doctor or dentist to get reduced-price or free treatment, or you can now also use the National Primary Healthcare Network scheme. If you need medicine there's a 25% patient charge (can vary). See NHS Greece healthcare info.
Warning: Some people have had problems with EHICs being refused in Greece, so ensure you read EHIC refusal help before you go.
You'll need to go to surgeries contracted with the OEP (National Health Insurance Fund). Doctors' consultations are free but any charges you pay, such as for meals in hospital, will not be refunded. See NHS Hungary healthcare info.
Its health centres provide treatment from 8am to 4pm, and are in all districts of Iceland. There's a charge of 1,000 krónur. Generally, there's no charge for hospital inpatient treatment. There's a 5,400 krónur charge for outpatient treatment. See NHS Iceland healthcare info.
Contact the Primary Care Reimbursement Services (PCRS) scheme, which will arrange a public health service doctor or dentist, and make it clear that you wish to be treated for free under the EU's social security arrangements. See NHS Ireland healthcare info.
Make sure the doctor's registered with the Italian national health service, the SNN, and treatment should usually be free or low cost. Most dentists operate privately, but you can find state-provided care at SNN-operated hospitals and ASL-managed health centres. You may be charged part of the fee for a dentist or hospital visit. See NHS Italy healthcare info.
Charges apply to see a doctor, although in most cases it's under €10. Pregnant women receiving treatment to do with their pregnancy won't be charged. Under-18s also avoid the fees. See NHS Latvia healthcare info.
Visit a doctor covered by the public health scheme and you'll pay 67 francs, half-price for pensioners and free for under-20s. There's no state-run dentists so you'll have to pay the full amount if you need treatment. See NHS Liechtenstein healthcare info.
Visit a doctor who works with one of the Territorial Health Insurance Patient Fund and present your EHIC card to get free treatment. Private healthcare fees are non-refundable. See NHS Lithuania healthcare info.
You'll need to pay for treatment but you can claim some of it back from the CNS, the National Health Fund. Fees vary and you might not be reimbursed for the full amount because some healthcare requires a patient contribution. Hospital stays are funded by the CNS but you may have to pay and then claim back medication costs. See NHS Luxembourg healthcare info.
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.
Healthcare providers in the Netherlands are all private entities, and your EHIC doesn't cover private treatment. Even with the EHIC you may have to pay for treatment in advance or make patient contributions. See NHS Netherlands healthcare info.
You'll have to pay a fee and make sure you have the EHIC with you or you could face paying the full bill. You will also usually have to pay for dental treatment in full – children under the age of 18 get free treatment and those aged 18 and 19 are entitled to have 75% of the fee covered. See NHS Norway healthcare info.
Make sure you see a doctor or a dentist Polish National Health Fund (NFZ). Dentists can offer private and NFZ treatment, which may not be available everyday – make sure you check. Hospital stays are also free but you may have to pay for prescriptions. See NHS Poland healthcare info.
You will have to pay a fee towards treatment but make sure you ask to be treated under the Portuguese health service – if you're asked to pay upfront, it's likely you've ended up in private care. See NHS Portugal healthcare info.
The UK's Department of Health confirms Portugal's EHIC cover also includes the Azores and Madeira.
Check the doctor, dentist, hospital or pharmacist is working with the Casa Nationala de Asiguarari de Sanatate (CNAS). 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 info.
Make sure the doctor or dentist is covered by the Slovakian health insurance system (ZZZS). You'll need to pay a contribution if you see a doctor, but emergency dental treatment is free. You will have to pay a daily charge if admitted to hospital. See NHS Slovakia healthcare info.
You can get free treatment in an emergency but you may have to pay towards some other health services. There may also be some extra costs for prescriptions or ambulance journeys. See NHS Slovenia healthcare info
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 info.
Warning: Some people have had problems with EHICs being refused in Spain, so ensure you read EHIC refusal help before you go.
The UK Department of Health confirms Spain's EHIC cover also includes the Balearic Islands, Canary Islands, Ceuta and Melilla.
Make sure you see a doctor working under the public insurance scheme, but you will still be expected to pay part of the costs which could vary depending on which part of the country you are in. It's usually between 100-300 krona. Dental care is free for under 20s and subsidised after that. See NHS Sweden healthcare info.
You may be asked to pay upfront and then claim a refund and you will also be expected to pay a non-refundable standing charge. There are also daily hospital charges and ambulances (including air ambulances) are not covered so health insurance is highly recommended. Dental treatment is not covered unless it is caused by a serious illness or accident. See NHS Switzerland healthcare info
The European Commission tells us that in some countries, public and private healthcare happen in separate hospitals, but in others, hospitals may provide both.
In a few countries, the state sometimes contributes to private as well as public healthcare costs. In some cases, even treatment at a private hospital may be partly reimbursable under an EHIC, if this is what the locals get. For example, in Belgium reimbursement's given for both public and private care. So always check.