Most of us have heard of the European Health Insurance Card which allows European Economic Area citizens to access public healthcare across Europe. The process is relatively simple; you apply for a card for each member of the family before heading off on holiday, and if you break a leg in Greece or have an allergic reaction in Ibiza you can use the EHIC cover to get reduced-cost or free medical treatment. The system is long-established, works well in most cases and can save travellers a lot of money. There is however quite a bit of confusion about which countries are covered with EHIC and which aren’t.

EU Vs EEA

The first point of confusion is that it’s not just European Union countries which are signed up to EHIC agreements. The countries in which UK travellers can use EHIC cover extend to countries which are outwith the EU, but part of the larger European Economic Area. This includes Norway, Switzerland, Iceland and Liechtenstein. Countries which are geographically within Europe but which are not yet part of the EU or the EEA do not recognise EHIC. This includes Macedonia, Montenegro, Serbia and Turkey. There is another category of countries which are often classed as “European” but which aren’t in the EU, EEA and have no intentions of joining. These are nations such as Armenia, Belarus, Russia, Ukraine and Moldova. Additional travel insurance with a good level of medical cover is essential for these countries.

Smaller Nations

In addition to the larger countries which are not part of the EU or EEA, there are smaller states and countries which you may assume are firmly inside the EU, only to have your EHIC rejected by the doctor or A&E department. Monaco is assumed by many to be part of France, but although they speak French and spend Euros, your EHIC is not valid here. San Marino and the Vatican City are often assumed to be part of Italy, but neither is part of the EU or EEA. Closer to home, none of the Channel Islands (Jersey, Guernsey, Sark, Alderney) or the Isle of Man are in the EEA either. For UK travellers, there is a reciprocal agreement between the Channel Islands and Isle of Man to provide NHS cover, but this does not apply to visitors from other parts of the EU.

Other Exclusions

All countries differ in their state health care provision and what is provided free or with basic insurance. Don’t assume that just because you get free prescriptions or dental treatment in the UK that the same rules will apply in France, Italy or Germany. Often, dental treatment is not covered by public health insurance, and many countries have a system of charging when you are admitted to hospital. There is lots of information on the NHS website about what is included and excluded in different countries, so check before you travel. Remember to that EHIC only ever covers you for treatment in the country concerned and won’t pay to get you home if you miss your flight or need to be transported home in an air ambulance.