Healthcare for visitors in Europe: EHIC, GHIC and travel insurance

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Falling ill abroad is stressful enough without worrying about the bill. Many European visitors can use state healthcare at the local rate with a free card, but those cards have important limits. This guide explains how the EHIC and the UK's GHIC work, where they apply, and why you still need travel insurance. Rules change, so check the official guidance for your country before you travel.

The EHIC for EU, EEA and Swiss residents

The European Health Insurance Card (EHIC) is issued free by the national health insurer in each EU country, Iceland, Liechtenstein, Norway and Switzerland to people insured there.

It gives access to medically necessary state healthcare during a temporary stay in another of those countries, on the same terms as local people.
"On the same terms" means you pay what locals pay. Where treatment is free for residents it is free for you; where residents pay a share, so do you, and some countries expect you to pay upfront and claim back.
It is not insurance. It does not cover private clinics, mountain rescue or the cost of getting you home.

The GHIC for UK residents

After Brexit the UK introduced the UK Global Health Insurance Card (GHIC). Existing UK EHICs remain valid until the expiry date printed on them.

The GHIC is free. Apply through the official NHS website. Unofficial sites charge a fee for something that costs nothing.
It covers medically necessary state healthcare in EU countries and in the rest of the EEA, namely Norway, Iceland and Liechtenstein, according to the NHS's current list of countries.
In Switzerland, a GHIC can be used only if you are a British, Swiss or EU national, a refugee, a stateless person, or a family member of one of those. Other UK residents should check the guidance carefully.
The NHS and GOV.UK pages list the details country by country and are the place to confirm current coverage.

What counts as medically necessary

The cards cover treatment that cannot reasonably wait until you return home. This typically includes:

Emergency treatment and visits to A and E.
Treatment for a sudden illness or accident.
Ongoing care for an existing condition, such as routine dialysis or oxygen, though these usually need to be arranged in advance with the provider abroad.
Routine maternity care, as long as you are not travelling specifically to give birth.

They do not cover travelling abroad specifically to get treatment. That needs a separate planned treatment route.

Using your card abroad

Make sure you are treated by a state provider, not a private clinic. In tourist areas, private clinics are common and some may not mention that they are private. Ask before treatment starts.
Show your card and passport or identity document.
Keep all receipts and paperwork. If you have to pay a charge that should have been covered, you may be able to claim a refund afterwards.
If you lose your card while abroad, the issuing body can usually send a temporary certificate.

Why you still need travel insurance

Both the UK and other European governments advise travellers to take out travel insurance as well. A health card does not cover:

Private treatment.
Medical repatriation, which can be extremely expensive.
Mountain rescue and some ambulance costs.
The patient's share of costs in countries where residents pay part of the bill.
Non-medical problems such as lost luggage, theft or cancelled trips.

When choosing a policy, declare any pre-existing medical conditions, check cover for activities like skiing or diving, and make sure the medical limit is generous. Some insurers waive the excess if you use your EHIC or GHIC.

Pharmacies and minor problems

European pharmacies, usually marked with a green cross, can help with minor ailments and advise whether you need a doctor. Take a supply of any regular medicines in their original packaging, with a copy of your prescription. Some medicines that are ordinary at home are controlled elsewhere, so check before you travel.

In an emergency

Call 112, the free emergency number across the EU, for an ambulance. Contact your travel insurer as soon as you can for anything beyond minor treatment, as many policies require you to notify them before costs are incurred. This guide is general information. For questions about your own health or a specific condition, ask your doctor or pharmacist before travelling. Have you used an EHIC or GHIC abroad? Share how it went in the comments.