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 3.5m 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 gives.
In this guide
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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, youíll be entitled to the same treatment that local citizens are entitled to - extremely useful in emergencies. Itís completely free and valid for 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.
Itís also worth noting that the EHIC doesnít 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 friendís wedding. I was due to make a speech and lost my voice, so I nipped to the local GP at no cost.
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 (see How to apply).
As you can apply for a new card up to six months before the current one ends, itís worth doing this in advance so you donít 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 havenít got it on you, so donít leave it behind at the hotel if youíre 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 a proportion of your costs and may be entitled to 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, itís 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 doesnít 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, donít assume this type of coverage will always be available. You may be taken to a private hospital.
Cancellation, delay, repatriation, baggage loss and theft arenít 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.
Country-by-country EHIC guide
The EHIC's usable in the EUís 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 whatís covered in each. See below for a quick summary:
- Austria. Treatment's 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% back there, and may be able to claim the remaining 20% in the UK. See NHS Austria healthcare info.
- 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 info.
- 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 info.
- Croatia. 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). See NHS Croatia healthcare info.
- Cyprus. Treatment is available from doctors in state healthcare centres. It'll cost Ä2 for each visit, but you may be able to claim this back in the UK. See NHS Cyprus healthcare info.
- 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 info.
- 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 info.
- 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 info.
- 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, as this varies by area. See NHS Finland healthcare info.
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 info.
The UK 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.
- Germany. Check the doctor provides treatment under the state scheme. There's a standard charge of Ä10 for nearly all services, though this may be refundable back in the UK. See NHS Germany healthcare info.
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 healthcare info.
Warning: Some people have had problems with EHICs being refused in Greece, so ensure you read EHIC refusal help before you go.
- 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 info.
- Iceland. Its health centres provide treatment from 8am to 4pm, and are in all districts of Iceland. There's a charge of 1,000 krůnur (about £5) - halved if you're on a state pension - which may be refundable in the UK. See NHS Iceland healthcare info.
- 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 info.
- Italy. Make sure the doctor's registered with the Italian national health service, the SSN, and treatment should usually be free. Most dentists operate privately, but you can find state-provided care at SSN-operated hospitals and ASL-managed health centres. See NHS Italy healthcare info.
- 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 info.
- 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 info.
- Lithunania. Visit a doctor who works with one of the territorial patient funds to get free treatment. Private healthcare fees are non-refundable. See NHS Lithuania healthcare info.
- 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 info.
- 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. Check it's a state-funded healthcare provider, as some offer both public and private care. To see a doctor or dentist, you'll need to make an appointment first if it isn't an emergency, and you'll need to be referred by a doctor for non-emergency treatment in hospital. See NHS Netherlands healthcare info.
- 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 info.
- Poland. The NFZ logo shows those working under the state healthcare scheme. You can 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 info.
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 info.
The UK Department of Health confirms Portugal's EHIC cover also includes the Azores and Madeira, so you're covered here too.
- Romania. Check the doctor, dentist, hospital or pharmacist 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 info.
- 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 info.
- 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 info.
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 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, so you're covered here too.
- 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 info.
- Switzerland. Check it's a state-funded healthcare provider, as some offer both state-funded and private treatment. It's worth noting dental treatment isn't covered unless it's caused by an accident or serious illness. 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.
It says that in a few countries, the state sometimes contributes to private as well as public healthcare costs. So 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.
How do I get a free EHIC?
There are several ways to register for a card:
- Apply on the EHIC website, or find more info on the NHS website.
- 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.
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't get an EHIC from your doctor, nor can you get one from a post office.
If youíve lost your card, or itís been stolen, call 0300 330 1350, or from abroad call 0044 191 218 1999. For more emergency info, itís also worth taking the free, printable Little Lifesaver travel guide with you when youíre 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 unofficial EHIC websites
Watch out for websites demanding a fee for the EHIC. Search on the internet for "EHIC" and youíll find sites that describe themselves as "reviewing" or "forwarding" services, charging about £20 or more to process your application. They often look official, but scroll to the bottom and youíll find a tick box asking for cash.
One unofficial site describes "a small service charge of £23.50", and another charges "a cost of £24.50 per application". 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 says:
We're trying to do something about these websites - they are not endorsed by the Department of Health. EHICs are free through the NHS - there's no need to pay.
In 2010, the Office of Fair Trading 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'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 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 08454 04 05 06. See the OFT website for more info.
Beware unlawful EHIC refusals
Worryingly, we've heard reports holidaymakers have had 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?
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.
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.
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.
If it's happened to you, please let us know how you get on in the Free EHIC discussion.