EHIC, the European Health Insurance Card, isn’t quite as straightforward as many people assume. This is a pan-European scheme which as well as including the EU countries also includes nations such as Norway and Switzerland, and the concept is to allow European card holders access to state healthcare when they travel overseas. The problem is that Europe doesn’t have one continent-wide healthcare system, so what you are covered for will depend on where you are, and the purpose of your visit.
What EHIC doesn’t cover
Before discussing what EHIC may or may not cover, there are some very clear cases where you can never rely on EHIC. You can never use EHIC cover to pay for stays in private hospitals. EHIC can never be used when the prime reason for your travel is to access medical treatment, and this also covers “medical tourism” to access cheaper cosmetic procedures abroad. EHIC will not cover any of the extra items covered by travel insurance such as repatriation to the UK in an air ambulance, cancellation cover if you or someone else falls ill before you leave the UK, or costs of rearranging flights after a hospital stay.
“Free” Medical Treatment Overseas
The most common misconception about EHIC is that because we do not pay to see our GP or go to A&E in the UK, that we can get treatment in Austria or Greece on exactly the same basis as at home. This is not the case. EHIC provides you with medical treatment on the same basis as someone permanently resident in the country you are visiting. Sometimes that means you get free emergency healthcare and GP visits. Often you will be asked to make a co-pay contribution. The sums of these contributions vary from less than £1 in parts of Eastern Europe to upwards of £100 in pricey Scandinavian countries. You will not be able to claim back these charges either while overseas or when you get home from the NHS, but may be covered if you have taken out additional travel insurance. Always do your homework before heading off on holiday to make sure you know how the system works in the country you are visiting, and know what charges if any you will be expected to pay.
Dental treatment, physiotherapy, prescriptions and ambulances
In the UK, we can access physiotherapy on the NHS, whether we pay for dental treatment and prescriptions depends on our income, and ambulances are part of the NHS service. This is not the case across Europe. Many countries will only provide free ambulance transfers if arranged by a doctor, others do not have an ambulance service. In many countries, physiotherapy has to be arranged privately. Even if you qualify for free prescriptions in the UK, you may have to pay if a doctor prescribes you medication from a foreign pharmacy. Dental treatment varies enormously – EHIC in some countries covers emergency dental work such as extractions and treatment of abscesses, others cover no dental treatment at all. The golden rule is therefore always to check what treatment is being recommended and always to ask whether it is covered under EHIC. And never assume that because something is free on the NHS, that it is free everywhere else.