EHIC & Travel Insurance

So are you really covered?

This is the question you should be asking yourself before you set off on your holiday to that long awaited Pina Colada.

Have you got your EHIC yet? Well considering how long the EHIC card has been around for, there are still a lot of people out there that don't really understand the pro's and con's of having one when travelling within the EU.

Let us try and help clear things up for you...


Private Insurance Vs EHIC?

Often the primary confusion when it comes to EHIC is the difference between private and state care. Unlike the UK where state medical care is the norm and the private medical sector is relatively small, other countries have a much larger private sector and may even have private and state GPs working side by side in the same medical centre. EHIC never covers treatment by private medical staff or in a private hospital. This applies even if you have a private hospital next door with the state facility several hours drive away. If you have your own travel insurance policy, you can access most private medical facilities. Private facilities might be more modern, have the latest equipment and offer single occupancy rooms and better food than state facilities, but not always. If you choose to use your private travel insurance to fund your healthcare, the medical staff will liaise directly with your insurer, and all you’ll have to pay is the policy excess.



If the very worst happens and you or someone you’re travelling with falls seriously ill overseas, you may have to completely rethink your travel plans for getting home. The EHIC system only covers your state treatment in the country where you fall ill; it won’t cover the cost of missing your flight home and having to buy new tickets, accommodation for family members or transfer back to the UK in a specialist air ambulance in the case of serious illness or injury. These costs can easily run into tens of thousands of pounds, and are usually covered as standard by good travel insurance policies.


Geographical Issues

Most of us are well aware of the EU, especially since all of the discussion about the UK and Brexit started. The EEA is not as well known, and surveys among travel insurers indicate that a high percentage of travellers are unsure whether their destination is part of the EEA or not. Popular tourist destinations such as Turkey are not part of the EEA or the EHIC scheme, and countries of the former Yugoslavia aren’t in the EEA either. It’s important to remember also that the countries your travel insurance company defines as “Europe” are probably not just EU or EEA countries either. One issue which often catches people out concerns cruise ship passengers who are classed as being resident on their ship, and therefore unable to use EHIC cover even if their illness or accident occurs on a shore visit. Always compare the cover being offered by the various travel insurance companies – not all policies are the same, and the cheapest ones may only provide a very basic level of cover.


Ambulances, Physiotherapy and other “Extras”?

Every EEA country has its own medical system, and not all cover the same things. In the UK, we take it for granted that an ambulance will be sent out without cost to us if we need one. In other countries, ambulances are only covered under the state system if you see a GP first and they decide that you need to go to hospitals. Other countries have no state ambulance system at all. Similarly, the NHS in the UK provides physiotherapy if required, and some prescription medicines depending on age and income. Often, you will be expected to pay for these elsewhere in Europe. Several countries have a co-pay arrangement whereby most of the cost of a GP appointment is covered by state insurance, but the patient is expected to make a contribution to the costs. Under EHIC rules, you will also be expected to make the same contributions and won’t be able to claim these costs back. If you have travel insurance, your insurer will take care of all the costs, with you just being asked to pay the policy excess. Depending on the level of costs involved, you can still choose to claim these back from a travel insurance company even when you have used your EHIC to meet the majority of the costs.


How Quickly Do You Need Cover?

Although the EHIC might be a lower cost if any at all than buying insurance policies, it could take longer to organise. EHIC can be applied for online, but applications are processed centrally by the NHS and it usually takes a couple of weeks for the cards to be sent out in the post, however cover may be active before you receive the cards. There is a process for arranging state treatment for people who have sent in their application but have not received their card, but this is time-consuming and involves making costly international phone calls to the NHS call centre. Now that most travel insurers and brokers are online, you can complete your application at any time of the day or night and then be covered instantly – perfect for those last minute trips away.


Rapid Treatment?

It’s not just the UK’s health sector which is struggling under increased workloads and patient numbers. Other state healthcare systems across Europe are under similar pressures, and although if you’re admitted as an emergency you’ll be seen as quickly as possible, the same cannot be said for less serious conditions. There may be a lengthy wait for diagnostic tests or scans and then a further wait for surgery if necessary. Private sector hospitals often have shorter waiting times, and your travel insurance company will usually arrange to have you treated privately and more quickly.


What is an EHIC?

In 2006 the E111 was replaced with the new EHIC (European Health Insurance Card). This entitles card holders to free or reduced cost healthcare throughout Europe. You will need to renew your E111 card in place for a valid up-to-date EHIC but please make sure you check which EHIC rules apply in the European Countries you plan to visit. EHIC – the European Heath Insurance Card – replaced the E111 in 2005 and is a reciprocal health agreement between the various countries which make up the European Economic Area. The EHIC allows a holder to renew and access government-provided healthcare across Europe on the same basis as residents of the country concerned. That doesn’t mean UK residents get free healthcare in Europe as the system varies by country, and you can check online to see how healthcare works in the country you are thinking about visiting.


Who needs to apply for an EHIC?

In order to apply to have an EHIC card issued in the UK, you have to be a UK, European Economic Area or Swiss citizen. You also have to be resident in the UK, with a permanent UK address. If you were, for example, a French student working for the summer in the UK, you would have to apply or renew your EHIC with the French authorities. Citizens of countries outwith the EEA, even if they are resident in the UK, are not eligible for EHIC cover and will have to make alternative arrangements for their health cover while overseas. If you move overseas, your resident status changes, or start to work abroad, you may lose your entitlement to EHIC. There are also different rules which apply to students studying at Universities overseas, workers sent overseas by their employers and pensioners who have emigrated from the UK to the sun. If you fall into one of these categories, seek further advice for renewal information.


Whats the difference between the E111 Form and the EHIC?

Unlike the old E111 form which covered the whole family, each member of the family needs a separate EHIC card. This gets around the problem of having one document, a parent needing it to take on a business trip at the same time as one of the children are going on a school trip. Adults can apply and renew their own EHIC cover, but parents or guardians have to apply on behalf of any children under the age of 16. There is a short turnaround time for processing EHIC applications, so make sure you get online and fill the forms in well before travelling.


The EHIC is valid in the following countries:

Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech, Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Madeira, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland.


How to apply for an EHIC.

Online - You can apply online for free by visiting the NHS website and completing an online application. It can take up to a couple of weeks to receive your card, so make sure you give yourself plenty of time to get one in time before you travel.
By Telephone - You can telephone the NHS Business Services Authority EHIC Application Line on 0300 330 1350. Making an application by phone is free of charge. Your application should be processed within 7-10 working days.
By Form - You can download an application form from the NHS website, which will need to be completed and sent in to the NHS Business Services Authority, which processes all applications.
The address for this department is :-
NHS Business Services Authority,
European Health Insurance Card,
EHIC Applications,
Sandyford House,
Archbold Terrace,
Newcastle upon Tyne,
NE2 1BF.
The following details will be necessary in order to complete your application:
• full name• date of birth• National Insurance or NHS number (CHI number in Scotland or Health and Care Number in Northern Ireland).
Please note that temporary National Insurance numbers aren’t valid. Temporary National Insurance numbers uses the prefix 'TN', the date of birth and M or F to denote gender (for example TN131160M). These numbers are no longer accepted and cannot be used to apply for your card.