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What does the EHIC card cover?

When planning to travel between countries in the European Economic Area (EEA), it is essential that you take out adequate travel cover. This includes a standard travel insurance policy, and also a European Health Insurance Card (EHIC). The EHIC is proof of eligibility for treatment in state-funded hospitals and medical centres, throughout any qualifying European nation. Without this card, you could find yourself paying a high rate for treatment.

Read on to learn exactly what parts of your medical care your EHIC will cover you for, and what grounds could prevent you from claiming against the policy. You can also find out which treatments and procedures will always be included under EHIC provision, and which aspects of medical care might be excluded.

Applying for your EHIC

Every resident of a qualifying EEA/EU country (and Switzerland) is eligible to hold an EHIC. You need to contact the state health authority or government in order to apply. Every person travelling in your group requires their own EHIC. This includes any infants and children. As a parent, you can apply on behalf of your whole family, including your partner. You can also apply as a teacher travelling with boarding pupils, and as a carer for dependent adults.

The card is completely free, and will usually be sent to you within seven working days of your application. Once you have received your card, it is valid for five years. You should take it with you whenever you travel within Europe, and present it whenever you need healthcare services. With this card, patients can obtain medical treatment at European hospitals under the same terms as a resident of that country. This could mean free care in many cases, and greatly subsidised treatment in others.

What is covered by the EHIC?

In the event that you become ill or get injured while you are in a foreign European country, you may need to attend a hospital or medical centre. As long as you visit a state-funded hospital, you can be treated for free (or at a reduced cost) just as any resident of that country would be. The card should cover you for your time in the hospital, for any medical or surgical procedures, and for any follow-up treatment such as return visits.

This will always include basic life-saving care. It should also cover you for ongoing treatment in order to facilitate a complete recovery. Along with major and minor illness and injury that occurs during your travels, the EHIC does cover you for pre-existing conditions. If you have an ongoing condition and you need treatment while you are away, you can usually get this through the EHIC scheme too. This might include dialysis for kidney problems, issuing of medication for diabetes, or routine maternity care such as check-ups and ultrasounds.

What is not covered by your European health card?

It is important to remember that the EHIC does not cover you for every eventuality. For example, you might find yourself being treated at a local private hospital, instead of a state-funded one. In this case, you would need to pay the full cost of treatment. You may also be charged for the transport to and from that hospital unless ambulance travel is included in that nation’s state healthcare provision.

Not all medical services are part of the state-funded service. In the UK, for example, routine eye care and all aspects of dental care fall outside of the National Health Service provision. There is also a charge for prescriptions that are given outside of a hospital setting. Just like a resident patient, a visitor with an EHIC should expect to pay these charges. There may be some exceptions, for example when the patient is a child, a pensioner, or a pregnant woman. The hospital you attend can provide more information.

You should also bear in mind that travel tourism is strictly prohibited under the terms of the EHIC. In other words, you may not travel abroad purely to seek treatment from a state with free or low-cost healthcare. This includes travelling overseas in order to give birth, or to access treatment that is not available in your home country. Only care that is necessary during a trip overseas will be covered by the health insurance scheme.

In some cases, you may have to pay for treatment upfront, even with your EHIC. However, you may well be able to claim the cost back once you return home. This could be the case if your EHIC is not available when you attend the hospital, or when visiting a country which charges for healthcare as a resident of a country with free medical care.

Why travel insurance is important

In the event that your treatment is not wholly or partially covered by your EHIC, your travel insurance policy should be a solid back up for you. Travel insurance does not replace the EHIC, and the EHIC is not a substitute for insurance. You need to have both. Many insurers will not issue a travel insurance policy unless there is a valid EHIC in place. The EHIC keeps costs for treatment to a minimum. You can obtain an EHIC without holding valid travel insurance, but you are putting yourself at risk of incurring costs if something happens to you.

Where insurance can help is in the event of costs incurred through hospital transport, or returning to your home country. It might also cover you for prescription medication, or for additional treatments that are not in the EHIC terms and conditions. Additionally, travel insurance covers you for other issues that might arise as a result of injury or illness: such as missed flights back home, or towards compensation for missing your holiday. Insurance can cover loss or theft of personal property, which the EHIC cannot. If your belongings were damaged or lost in an accident, for example, travel insurance allows you to make a claim. You cannot claim for property through the EHIC.