European Health Insurance Card (Formerly called E111)

GHIC Cards

Brexit was overshadowed by the Covic-19 pandemic in 2020, so it’s perhaps unsurprising that UK residents planning a trip to Europe in the near future are confused over their healthcare rights. Will their EHIC card still work? At the moment, the answer is that it will, but that there will be a gradual transition to a new scheme, the Global Health Insurance Card, or GHIC.

What is EHIC?

EHIC – the European Health Insurance Card – was launched in 2006 as a replacement for the previous reciprocal healthcare scheme which was E111. Since then the EHIC system has been used by people living across all of the countries of the EU, plus Iceland, Switzerland, Norway and Liechtenstein to access healthcare overseas.

If you already have a blue EHIC card then you don’t need to think about replacing it with the new card until it expires. EHIC cards are valid for five years, so don’t rush to replace just now. Different rules apply to the four EHIC member states which are part of the wider trading area but not the EU – so Switzerland, Norway, Iceland and Liechtenstein – and you will need additional private healthcare insurance if you are planning to visit these places.

State Medical Cover

The EHIC system grants the holder to access to the state healthcare system in the country which they are visiting, on the same basis as a resident of that country. State healthcare can often be accessed free or charge, or at reduced-cost. EHIC will also, unlike many travel insurance policies, cover existing medical conditions and routine ante-natal care.

EHIC was never seen as a substitute for comprehensive medical travel cover, as there are lots of exclusions to the EHIC scheme. EHIC won’t cover any treatment in a private hospital or clinic, and won’t cover air transportation back to the UK due to illness or accident.

Insurers have always advised a “belt and braces” approach to travel insurance, using the EHIC to cover routine GP visits or minor injuries, and having the back-up of a proper travel insurance policy to cover everything else. EHIC also won’t cover health tourism – or travelling overseas with the sole aim of getting medical treatment or to give birth.

Most countries in the EU have state healthcare services which are just as good as the NHS, or even better. Standards of care do vary across Europe though, and in some countries, patients are expected to pay for their own meals during a stay in hospital, or their bedding. If local residents have to pay these charges, so do UK nationals who are using their EHIC cover.

In many parts of Europe, the private healthcare system is used much more widely than in the UK. If you have a private travel insurance policy in addition to your EHIC, this should cover the costs of your treatment in any private or state healthcare provider, although it’s always recommended that you confirm eligibility with your insurer before agreeing to treatment plans.

Cost of Air Ambulances

The main exception to EHIC cover is an air ambulance, also known as a repatriation flight. Many people who fall seriously ill or have an accident overseas wish to return to the UK as soon as possible to continue their treatment. EHIC will not cover this cost, which can easily run into the tens of thousands of pounds for a flight home, accompanied by medical staff. Only private travel insurance will cover these repatriation flights.

Around 27 million of us here in the UK currently have a EHIC which was issued before the UK left the EU at the end of 2020. Press coverage at the end of 2020 regarding the deal done with the UK over Brexit was scant, being lost in the much higher profile coverage of the Covid-19 pandemic. So it’s perhaps not surprising that many of us are confused about what will be covered in 2021 and going forward. There was a rush of applications for EHIC towards the end of December 2020, probably due to confusion over the replacement for the scheme.

GHIC – The Replacement for EHIC

The government announced on 24th December 2020 that it will be launching a new Global Health Insurance Card to replace EHIC, with the official launch expected at some point in 2021. Details of the scheme are still to be ironed out. However, the key point from the announcement is that your current EHIC will remain valid until is expires, and you’ll only have to apply for a new GHIC at that point.

The Brexit agreement means that the GHIC will be a like-for-like replacement for the EHIC and will have the same limitations. It will probably be limited to state healthcare only, and patients looking to access treatment overseas for kidney dialysis or other chronic conditions should check in advance with local hospitals.

GHIC is also likely to have the same restrictions over payment for services as EHIC does. In many countries in the EU, patients are expected to make a financial contribution towards the cost of seeing a GP or having tests in hospital. Under the terms of EHIC, British patients accessing healthcare paid on the same terms, and this is likely to remain unchanged under the GHIC rules.

The other advice to British tourists planning a getaway to the EU or indeed elsewhere in the world is not to rely on EHIC or GHIC as their sole form of healthcare cover overseas. Having a good travel insurance policy is still absolutely essential.

EU Citizens in the UK, EHIC and GHIC

There are around 4 million EU nationals living in the UK, or around 5.5% of the country’s total population. Many of them rely on EHIC for their medical care on the NHS, especially if they are working in the UK for a short time only. The Brexit agreement protects the rights of EU citizens in the UK too, confirming that anyone who was living in the UK before the Brexit date of 31 December 2020 can still have access to healthcare on the NHS.

EU nationals living in the UK can also still access healthcare in other European nations, and will be entitled to apply for a new GHIC when the scheme is launched. EU nationals can get lots more information on their rights under EHIC and GHIC on the NHS Business Services Authority website.

Travel to non-EU Countries

The new name for the travel scheme – the Global Health Insurance Card – gives a clue as to the government’s aims for the system going forward. The UK already has a reciprocal health arrangement in place with Australia and New Zealand, allowing nationals of those three countries to access state healthcare while travelling. As with the EHIC scheme there are restrictions on what these reciprocal agreements cover. Reciprocal agreements with Australia and New Zealand cover emergency healthcare only and unlike EHIC don’t cover pre-existing medical conditions. As with other travel situations, anyone going to Australia or New Zealand require a good level of insurance cover not just for medical cover but for every other eventuality too.

Will Brexit Cause Other Issues for Travel to Europe?

Most of the coverage over the implications of travel to Europe at the beginning of 2021 was over quarantine or travel bans due to the Covid-19 pandemic. But as Europe starts to open up again to British visitors, there are other changes to travel rights which might affect your holiday plans. Prior to Brexit, UK nationals could remain in any other EU country for as long as they wished, but this has now changed.

British citizens can now visit any EU country for up to 90 days in any 180 period without the need for a visa. This should cover most holiday trips for a few weeks, but won’t cover people who wish to live in the EU for a longer period of work or study. Driving licences issued in the UK are also still valid in the EU, and you won’t need to get an international driving permit to hire a car overseas, or take your own car over the Channel for a driving holiday.

People planning a longer trip to Europe have the right to be overseas for up to six months in one year, although the stay is limited to 90 days at one time. Travellers are also advised to have at least six months left on their passport validity before leaving home.

For travel from 2022 onwards, it is likely that the UK will sign up to a Visa waiver programme similar to the ESTA scheme for travel to North America. British citizens will register online for their visa to travel into the EU, and the visa is likely to be granted for a three-year period. The exact fee for these visas, and the mechanism for applying, is still under consideration so keep your eyes on the press and television news towards the end of 2021 for further details about how to register for any visa waiver scheme.

A further implication could be for people who are considering buying a holiday home in an EU country. Exact details of the implications for property owners in the EU are still to be ironed out, but every indication is that buying a property in an EU country is going to be more complicated, more expensive and incur higher legal fees than previously.

Private Healthcare Insurance and GHIC or EHIC

Having a GHIC or EHIC card just isn’t enough cover if you are travelling out of the UK this summer or at any point in the future, and all experts advise buying a good quality health insurance policy in addition to free cover.

A good travel insurance policy will not only cover your healthcare overseas but many other eventualities too, such as cancellation or flight, theft or loss of travel documents. Travel insurance is widely available and easy to buy online. But that doesn’t mean that all travel insurance policies are equal. Levels of cover can vary enormously and although it may seem tedious, it’s important to at least read the summary of cover to understand what’s covered and more importantly, what’s excluded. Most travel insurance policies will exclude as standard so-called “risky” sports such as horse riding or even hiking in the mountains, for example. If you are planning to ski, scuba dive or go climbing, then you may need to pay extra for cover.

20% of British citizens travelling overseas don’t bother taking out travel insurance when going abroad on holiday, but industry statistics show that around 1 in every 8 travel gets ill or has an accident while overseas. Many of these will be minor, but we’ve all seen the newspaper appeals about someone travelling overseas uninsured and now stuck in a hospital with no funds to get home again.

The most common claims on travel insurance are for slips and trips causing broken arms or sprained ankles, and for minor ailments such as stomach complaints and infections. Most minor ailments can be resolved with a trip to a local GP, pharmacist, or visit to an A&E department. This will be covered under the EHIC scheme, although you may have to pay for any prescription medication. More serious conditions might require a flight home in an air ambulance, and as we mentioned before, these don’t come cheap.

FAQs about GHIC

Q: Can I still use my EHIC card for travel in the EU?

A: Yes, under the terms of the Brexit agreement, any EHIC which was issued in the UK before 31st December 2020 is still valid until the date of expiration printed on the card. However, the government continues to recommend taking out additional private medical insurance to provide a much deeper level of cover than is given by EHIC or GHIC alone.

Q: What will be covered by the new GHIC card?

A: The recently-announced new GHIC card is the government’s replacement for the EHIC card, announced at the end of December 2020. Although the name of the scheme has been announced, there are no hard details about what exactly this card will look like, how the system will operate, and what the card will look like. Speculation is rife about what the card will or will not cover, and which countries will be part of the scheme, but we will just have to wait until the firm details are confirmed by the government at some point in the future.

As the cover offered by the new GHIC scheme is still under wraps, the best advice is always to keep using your EHIC until this expires, and back this up with a good travel insurance which will cover what EHIC doesn’t, such as fees paid for GP consultations, medication prescribed or repatriation to the UK in a specially adapted aircraft.

Q: What does it mean for EU citizens in the UK?

A: The millions of EU citizens resident in the UK have their rights to accessing state healthcare protected under the terms of the Brexit withdrawal agreement. If people were living in the UK before the end of 2020, then they can still use the NHS for their routine or emergency medical needs. They can keep using their EHIC card until it expires for healthcare elsewhere in the EU, and have the right to apply for the new GHIC card when the scheme is launched. As with UK citizens, they are strongly advised to top up the basic level of EHIC cover with an additional private travel policy.

Q: How will the changes affect British pensioners who have retired overseas?

A: The situation regarding British pensioners who have retired to the EU is more complex, and people affected are advised to get advice on their specific circumstances. For most people however, pensioners living overseas and other expats should still be able to use EHIC for overseas healthcare.

Q: Do I really need to have private health insurance as well as my EHIC or GHIC cover?

A: GHIC and EHIC was never designed as a system to allow people to opt out of having proper travel insurance, and the limitations of the scheme mean it doesn’t cover every eventuality. All indications are that GHIC will continue to cover state healthcare in other EU countries in the same way as EHIC has currently, giving UK travellers cover in emergency situations. But there is a lot which GHIC won’t cover, and travelling uninsured is risky. If the worst happens and you suffer a serious accident or illness, the bill to get you back to the UK for treatment could run into tens of thousands of pounds. You don’t want to be one of those people setting up a Go Fund Me page and begging strangers to meet the cost of your treatment. A good travel insurance policy is a fraction of the cost of your holiday, so why would you scrimp on cover?