The EHIC, European Health Insurance Card allows anyone who is insured by or covered by a statutory social security scheme of EEA countries and Switzerland, to receive medical treatment in another member state free or at a reduced cost, when treatment becomes necessary during their visit, for example, due to illness or an accident. The term of validity of the EHIC varies depending on the issuing country.
The intention of the scheme is to allow people to continue their stay in a country without having to return home for medical care. Therefore, it does not cover people who have visited a country for the purpose of obtaining medical care, nor does it non essential care, which can be delayed until the individual returns to his or her home country. The costs not covered by self-liability fees are paid by the issuing country, which is usually the country of residence. It only covers healthcare which is normally covered by a statutory health care system in the visited country, so it is not a replacement for travel insurance.
Entitlement to EHIC
Entitlement to an EHIC is based on insurability under EU law, and not on a person’s nationality. This applies to all EEA countries. The UK operates a residency-based healthcare system, which means that insurability is generally determined by residency and not by the past or present payment of National Insurance contributions or UK taxes.
If you are ordinarily resident in the UK and not insured by another EEA country, then you are likely to be considered to be insured by the UK under EU law and, therefore, will be entitled to a UK-issued EHIC. You will need to provide the necessary evidence when applying. There are certain circumstances where you may be entitled to a UK-issued EHIC despite living in another EEA country.
If you are insured by another EEA country but live in the United Kingdom, you are not entitled to a UK-issued EHIC. You should contact the relevant authority in the country you are insured by and request an EHIC.
What does EHIC cover you for?
If you have an EHIC issued by an EU-member state and you are in Spain on a holiday or other temporary visit – that is, you are not yet a resident in Spain – you can use your EHIC to access state healthcare in Spain. You can also use it if you are studying in Spain as part of a course based in your home country.
You can use the EHIC to get any medically necessary treatment (as determined by the doctor you see) through the state system either at a reduced cost or free. This could be routine or specialist treatment – for a new or an ongoing condition – which cannot wait until you return home. It does not give access to private healthcare.
You cannot use the EHIC if you are coming to Spain specifically to get medical treatment or to give birth. If this is the case, you should seek advice from the health authorities in your home country before coming to Spain.
It is advisable not to totally rely on the EHIC and to take out medical insurance. There have been cases where an EHIC has been refused in some parts of Spain. This is being investigated by the European Commission but if it happens to you, try to get proof that you presented it at the time as it may persuade an insurer to waive their excess.
Once you are Resident in Spain you cannot use a European Health Insurance Card unless you are a student.
Please note, that with the UK leaving the EU, the above is all likely to change and the European Health Insurance Card may no longer be valid for UK citizens.