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Europe and the European Health Insurance Card (EHIC)

3rd August 2017

After it was recently announced in June 2017 by Brexit Minister David Davies that the UK will seek to negotiate the continued validity of the Europe and the European Health Insurance Card (EHIC) when the UK leaves the EU, it is worth reminding ourselves of some of the terms of the EHIC.  There are often considerable misapprehensions as to what cover an EHIC will provide for UK residents travelling in the EU.

 

What Does It Cover?

 

The basic premise of the EHIC is that citizens of the European Economic Area and Switzerland carrying the card can expect to be eligible for free or lower cost necessary medical treatment by state provided medical services when visiting other countries within the zone. (The European Economic Area includes all EU countries plus Norway, Liechtenstein and Iceland.)

The difficulty with this is that there is no commonality between different European countries as to how health services are provided.  Very few, if any, other countries in the EU provide health care free at the point of delivery to all its citizens as the UK does.   Frequently, health care provision in Europe is provided by a combination of insurance and state funding and visitors from other European states can only expect to be treated free to the same level as a local citizen.   In some circumstances, travellers must make patient contributions and since 2014 it has not been possible to claim these charges back from the NHS on returning to the UK.

 

It is vital to understand that UK travellers cannot expect that the treatment they will receive in other European countries will replicate the entitlement they have under the NHS in the UK.   The key term here is “necessary medical  treatment “.  In some countries within the EHIC card scheme this will effectively mean emergency care only. Travellers are expected to return home for longer term in-patient or out-patient care.  And when they do, they need to be aware that the EHIC card will not cover re-patriation costs which can be considerable.

 

Does a Traveller Need Private Travel Insurance as well? Yes - All UK Travellers Need Both an EHIC and travel insurance.

 

This is for two main reasons.  Firstly, you need travel insurance to cover the costs of other items that may be recommended by health professionals such as X-rays or physiotherapy and the re-patriation costs that are not covered by the EHIC.   

 

Secondly you need an EHIC because most UK issued travel insurance policies urge you to have one and in many cases actually insist you carry an EHIC with you and make use of any entitlement to state health care before making any claim on their travel policy.   We have heard of cases where patients have had to be ferried by ambulance from a private hospital to a public one because the UK insurer refused to authorise treatment.   Insurance companies do not cover themselves in glory in their policy wording on this issue.

 

In policy documents issued by many well-known insurance brands in the UK, we found the following wording.

 

The somewhat ambiguous: “..we strongly recommend that you take a …(EHIC) card with you.  This should allow you to benefit from reciprocal health arrangements which exist with these countries.  You should take reasonable steps to use these arrangements where possible”

 

The categorical:  “You must therefore obtain an EHIC… If you are admitted to a public hospital, you should present your EHIC to the hospital; if you are unable to do so, you must cooperate with the medical assistance department in order to obtain one.”

 

Both types of policy are really indicating that companies only want to cover the costs over and above what the EHIC provides.  Therefore, having both an EHIC and travel insurance as well is strongly advised and employers are warned not to rely solely on local state health services in the EU for their travelling staff in the light of their employment duty of care liabilities.