When you travel abroad, there are several items that you simply must take with you: your passports, your tickets, local currency… and your EHIC. Your EHIC is your European Health Insurance Card and it replaced the old E111 travel insurance in 2006.
Technically, your EHIC is not an insurance policy. It is actually proof that you are a citizen of a country within the European Economic Area (EEA). With this proof, you can access healthcare and medical help, including for pre-existing conditions and routine maternity care, in any country within the EEA.
In the UK, we pay for our NHS through our tax system and aside from prescriptions and dental care, we can receive all of our healthcare free at the point of use. This means that when you visit the doctor or go to hospital, you don’t pay any charges upfront except for a contribution to the cost of your prescriptions.
In other EEA countries they operate different systems – some are like our own, but others require their citizens to pay a contribution upfront for their care. This might be 20% of the actual cost, for example, and is called a co-payment. If you were to visit a country where the citizens had to pay a co-payment of 20% of the cost of their treatment, you would have to pay 20% upfront too, if you could produce your EHIC travel insurance card. If you could not produce your card, the hospital or doctor would have no choice but to charge you full price, which could amount to several thousands of pounds.
Do you need an EHIC if you already have travel insurance?
The short answer to this is yes. Many travel insurance providers make it a requirement within their terms and conditions that you use your EHIC when seeking medical treatment. The reason for this is that if you did have to have medical treatment abroad and had to pay a co-payment, your travel insurance policy will refund that (usually). It is important to note here that you cannot claim a refund from the NHS for any co-payment you’ve made while abroad – the only way you can get your money back is through a travel insurance policy.
If you have travelled abroad and received medical treatment without your EHIC card, you will have to pay the full cost of your treatment upfront – and your insurance company will probably refuse to reimburse you when you submit a claim. At best, they will refund the amount you should have paid by way of a co-payment (e.g. 20% of your actual cost).
Some insurance companies offer incentives to people who remember to take their EHIC with them on holiday by waiving the policy excess in the event of a claim being made where an EHIC was used.
Do you need travel insurance if you take your EHIC with you?
Again, the short answer to this is yes. Your EHIC travel insurance card will cover you for medical treatment that is given through the equivalent of that country’s NHS. Your EHIC will not pay for private healthcare and quite often, ambulance services in Europe are classed as ‘private’, so won’t be covered by your EHIC.
Your EHIC will also not cover you for medical treatment (including labour and birth) if you have purposefully travelled abroad for that treatment (or to give birth). The NHS might repay those costs, if arranged in advance with the relevant NHS department.
Travel insurance will usually pay for private medical treatment. It will also cover the costs of repatriating your body in the event of your death, which would not be recoverable through your EHIC. If you lose your luggage or suffer theft while abroad, or if your holiday has to be delayed, curtailed or cancelled, then only travel insurance will compensate you for these events – not your EHIC.
Don’t forget to take your EHIC
Your EHIC is your only proof that you are entitled to medical care in an EEA country – your passport is not sufficient. If you don’t have an EHIC and cannot produce it when treatment is required, you will be treated as a non-EEA resident and charged full price for all of your treatment. Your travel insurance will not usually compensate you for these additional costs, and if it is part of the terms and conditions of your policy that you take your EHIC card (and you do not), your policy might be deemed wholly invalid and will not pay out a penny. So take it with you and check that it is in date well before you travel (it will last for five years).