UK residents are blessed with one of the world’s most comprehensive free-at-the-point-of-delivery healthcare systems. The NHS (no one needs to use its full title) is a national institution, a source of enormous pride and a bastion of all that is great about being British.
It also lulls many Brits into what we might call a sweet naivety about the realities of how healthcare works. Pay to see a doctor or to be treated in hospital? Of course you don’t have to!
But that’s the reality in many parts of the world. It’s also the reality if you are British and happen to fall ill or have an accident while visiting another country.
Or at least, it is if you’re travelling outside Europe. Because as well as the NHS, us sheltered Brits have long been protected from the stark capital realities of healthcare costs in other countries by another institution. The European Health Insurance Card, or EHIC.
From the EHIC to the GHIC
The EHIC is an EU-wide initiative that gives all citizens of member states the right to state-subsidised healthcare in any EU country. It means that, as a foreign tourist, if you fall ill and get admitted to hospital in Spain, France, Italy, Poland or any other member state, you don’t have to pay for your treatment at private rates.
The UK’s relationship with the EHIC has become complicated, however. The country is no longer, of course, part of the EU. That means the EHIC is no longer available to Brits travelling to mainland Europe on holiday.
But that’s not actually such a big deal. Because the UK government was quick to agree a reciprocal healthcare deal with its EU neighbours to allow its citizens to continue to enjoy the benefits of the EHIC. It just has another name now, the Global Health Insurance Card or GHIC.
The real problem with the EHIC – and now the GHIC – is that it reinforces some of that ingrained naivety about paying for healthcare that Brits carry around with them. You can hardly blame us – growing up with the NHS, we’ve never known any different.
There is a widespread misconception, for example, that the EHIC/GHIC entitles you to FREE healthcare all over Europe. It doesn’t. It entitles you to state subsidised healthcare on the same basis that citizens of whatever country you are in enjoy. But healthcare isn’t free in every EU country. Cheap in most places, yes. But not free.
Why the GHIC is no substitute for travel insurance
This leads to other misconceptions, the most risky of which is this one – that you don’t need travel insurance when going on holiday to Europe. Because, if you have an EHIC/GHIC card, you’re covered for medical expenses.
Let’s put aside the fact that travel insurance covers you for plenty besides potential medical costs. It gives you financial protection in case, say, your trip is cancelled last minute and you can’t claim your money back from your travel agent or airline. Or if you miss a flight through no fault of your own and have to pay for a new one. Or if you lose all your luggage en route.
Travel insurance covers you for all of these things. But its most valuable protection is for medical expenses. That’s because medical care is in reality expensive. Very, very expensive, in some cases. Including in Europe.
Out of the top 10 most expensive countries in the world for a single night’s hospital stay, four are EU member states (Netherlands, Ireland, Denmark and Luxembourg). Two more are part of the wider European Economic Community (Switzerland and Norway), and two more are European microstates (Monaco and San Marino).
Aha, you say. But that doesn’t affect me if I apply for my GHIC before I travel (or if your old EHIC has yet to expire). And true enough, you probably won’t have to pay the full rate for a hospital bed if you can present a GHIC in any of these countries.
But that doesn’t mean you’re fully protected. Different countries subsidise different medical interventions in different ways. Things you are used to getting free on the NHS might not be subsidised at all in the country you are travelling to. Even with a GHIC, if the citizens of that country have to pay for it, so will you.
There are also some things the GHIC definitely does not cover. If you fall seriously ill or are badly injured and need assisted repatriation, for example (i.e. being flown home with medical assistance). GHIC or not, without travel insurance, your options would be to pay for it yourself, or wait things out in a foreign hospital until you are well enough to travel alone.
So in summary, assuming that healthcare is free if you travel to Europe can be a dangerous assumption. Depending on where you travel to and what you need medical attention for, you could be in for a nasty surprise. Even with an EHIC/GHIC card, it’s common to have to pay at least something towards medical costs across Europe. And there are major gaps in the cover those schemes provide, such as for medical repatriation.
The only way to protect yourself completely for all medical eventualities when you go on holiday is to take out travel insurance.
