The EHIC Card and Private Medicine in Europe

Some people head off overseas on holiday or business trips clutching their EHIC card confident in the belief that it will cover them for any medical costs they might incur.

In fact, it’s a little more complicated than that.

Keep in mind

At the outset, there are three critically important points to keep in mind when reading this article:

1. The EHIC card (European Health Insurance Card) is only valid for European Union countries plus one or two others associated with it. Nothing in what follows applies to medical treatment outside of the EU.

2. The position with the use of this card may vary considerably depending upon which of the EU member states you are in. That’s because their health systems are different and therefore just what the card will do for you will vary.

3. The subject area of this article has been subject to inter-governmental squabbling for some years and that looks likely to continue. So, what is accurate today might not be totally accurate tomorrow.

Public versus private health

In general terms, the system is intended to give European Union citizens travelling in another EU country the right to access any freely-provided emergency medical services made available by the country concerned to their own citizens. That access should be free if it is also free to local citizens.

Now although it isn’t entirely explicitly stated, there is an inbuilt assumption that such services are provided by the state. For example, in the United Kingdom, accident and emergency services are almost exclusively provided by the NHS, as opposed to private hospitals. Private hospitals in the UK tend to be aimed exclusively at non-critical treatment or that which is elective in nature.

So, in the UK a visitor from another EU country who was in urgent need of medical attention would almost certainly obtain it from a public health service GP or perhaps an accident and emergency unit. As publically provided services, these are largely entirely free of charge to a UK citizen, so they would also be covered by the visiting EU citizen’s EHIC card.

Things aren’t the same everywhere

Unfortunately, in some other European countries, the distinction between public and private treatment can be rather more blurred. In some countries, private hospitals may provide certain components of treatment that might normally be offered by the NHS in the UK. The citizens may be able to choose between going to a public hospital or GP, and therefore pay nothing all, or going to a private hospital or GP and paying for their treatment or making a substantial contribution to it.

What this means for you

The position is exceptionally complicated but broadly speaking, if you accidentally choose to use a private hospital or private doctor when travelling in the European Union, you may find that they won’t accept your EHIC card. You also typically will not be able to reclaim your expenditure upon your return to the UK.

There is no universal answer to this potential problem other than to be aware of it and to make sure that you take advice abroad when seeking urgent treatment. Make sure you ask the doctor or institution concerned (in advance where practical and safe) whether they are a public or private operation and whether they will take an EHIC card.