Dr Sarah Jarvis, MBE
Author: Dr Sarah Jarvis, MBE, General Practitioner (GP)

Dr Sarah Jarvis is the Clinical Director of the Patient Platform, an active medical writer, broadcaster, and the resident doctor for BBC Radio 2.

Originally posted: 15th Mar 2024

If you’re heading off on holiday, the last thing you want is to get ill while you’re away. But accidents and medical emergencies do happen, and they can cause long-term financial disaster as well as short-term stress. By taking precautions in advance, you can relax and enjoy your well-earned rest – or set off with confidence on a new adventure.

In this guide, we'll explore the safety nets available to travellers, namely the Global Health Insurance Card (GHIC), the European Health Insurance Card (EHIC), and comprehensive travel insurance. These tools are your best allies in mitigating the financial strain of unexpected illnesses or Understanding the protection each of these options offers is key to ensuring peace of mind during your travels.

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What is the difference between GHIC and EHIC?

On 11th January 2021, the government announced that UK citizens would be able to apply for a Global Health Insurance Card, launched as part of a UK/EU deal.

Before the UK left the EU, you could apply for a European Health Insurance Card (EHIC). The UK Global Health Insurance Card (GHIC) has now replaced the EHIC. However, if you have an existing EHIC that hasn’t expired, you can keep using it until the expiry date. Once it reaches that date, you’ll need a GHIC instead – like the old EHIC, these are valid for 5 years. You can apply for your new card up to 9 months before your current card expires.

Confusingly, the list of countries you can use a GHIC in is slightly different from the countries you’re eligible under an EHIC. So if you’re travelling outside the EU, it’s worth checking if you need to apply for a GHIC even if you have an EHIC.

More confusingly still, the rules are slightly different in some countries if you’re not both a UK national and a UK resident. So the rest of this article assumes that you’re both. If you aren’t, you can find out more from the NHS website.

If you have a GHIC, you can use it in:

  • Any EU country
  • Montenegro (emergency treatment is free but you’ll need to pay for other treatment)
  • Australia
  • Jersey, Guernsey and the Isle of Man
  • St Helena, Tristan and Ascension
  • Switzerland

If you’re visiting Norway, you can get medically necessary treatment by showing your UK passport, as long as you’re living in the UK.

If you have a UK EHIC, you can use it in:

  • An EU country
  • Montenegro
  • Norway
  • Iceland
  • Liechtenstein
  • Switzerland

Do I always need travel insurance?

The short answer is yes, absolutely.

As a UK national and resident, some costs may be covered in some countries if you have a European Health Insurance Card (EHIC) or UK Global Health Insurance Card (GHIC). But the important word here is ‘some’. Government websites advise that even if you’re eligible for EHIC/GHIC cover:

  • You should also have travel insurance with healthcare cover.
  • An EHIC or GHIC is not a replacement for travel insurance. Make sure you have both before you travel.
  • If you have a health condition, you should buy travel insurance with cover for your pre-existing medical condition.
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Why do I need travel insurance if I have a GHIC or EHIC?

Even if you’re able to use a GHIC or EHIC, the care you get may not be free as it is on the NHS. For instance, it only covers “medically necessary healthcare” – that’s emergency treatment, or treatment that can’t wait until you get back to the UK. Even then, you can only get the treatment in a limited number of healthcare facilities which provide state-run services.

The country you’re in will decide whether the treatment you need is “medically necessary”. For instance, if you want routine follow-up for a long-term health condition, they may decide that it could wait until you got back to the UK – in that case, it wouldn’t be classed as medically necessary while you’re abroad.

If you have conditions which require regular treatment – such as kidney dialysis, chemotherapy or routine maternity care – you may only be able to access them if you’ve made arrangements in advance. This can usually be done through your hospital team in the UK.

You can check the individual country you’re visiting on the government website to see what they do cover and how you can access them.

What does an EHIC or GHIC not cover?

Even if you’re visiting a country covered by your EHIC or GHIC, you’ll still have to pay for:

  • Medical repatriation to the UK.
    If you can’t get the care you need in the country you’re in, or if you need special arrangements because of your illness, you may require medical repatriation. This might include the cost of a specially equipped aircraft which can fly at higher altitude to reduce turbulence. You may need medical staff to accompany you. You could need ambulance transport to and from the airport. As you can imagine, the cost of all of these can be enormous.
  • Ski or mountain rescue.
    Specially trained teams can bring you back if you have an accident on the slopes or in the mountains – but all these services are private.
  • Treatment in a private medical facility.
    Your GHIC/EHIC only covers you for state-provided healthcare facilities – and the amenities here may be very different to what you’d expect in the UK.
  • Costs local residents would pay.
    In many countries, local patients are expected to cover some of the cost of treatment, or only some treatments are covered, or treatment is covered but medication is not. All these costs would need to be paid back by your insurance company – or you’d have to cover them yourself if you’re not insured.
  • Giving birth if you’ve gone abroad in order to give birth.

What about other countries?

The UK has ‘reciprocal healthcare agreements’ with several other countries. The type of treatment, and the proportion of the costs covered, vary from country to country.

You can find out more details by checking the list on the gov.uk website.

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How do you get a GHIC card?

You can find out more about the GHIC card requirements from the NHS website and apply for free through there too. You'll need to provide your:

  • Full Name

  • Address

  • Date of Birth

  • National Insurance or NHS number (England and Wales)

  • CHI number (Scotland)

  • Health and Care number (Northern Ireland)

You'll need to apply at least two weeks before you plan to travel to ensure your card arrives on time. It makes sense to check your EHIC card now and apply for a GHIC card as soon as possible if your EHIC has expired.

What if I don’t have a GHIC or EHIC?

If you’ve applied for a GHIC but haven’t received it – or if you have an EHIC/GHIC but don’t have it with you - you can apply for a Provisional Replacement Certificate (PRC).

If you don’t have any of these with you, you’ll need to pay for your treatment in full at the time. You may be able to claim some of your costs back by applying to the NHS Business Services Authority – so do make sure you keep all your original invoices, proof of all payments you’ve made and any other paperwork.

How long does it take to get a GHIC card?

It usually takes between 10 and 14 days for a GHIC application to be processed; once the application has been processed and approved, your card should be in the post within 2-3 working days. It is always worth applying for a GHIC card at least 3 weeks before travelling to allow for any complications or delays in your application.

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What do you need to look out for in a travel insurance policy now the UK has left the EU?

It will be more important than ever to make sure your travel insurance also provides medical cover, especially if you have any health conditions which you need to disclose. Healthcare costs can be eye-wateringly expensive in certain countries and having protection against these costs will be worth it in the long run.

You may also want to consider taking out a policy which includes Scheduled Airline Failure cover (sometimes known as SAFI) or Supplier Failure cover. These will help protect you should your airline, travel provider or accommodation provider get into difficulty and are no longer able to offer their services for your trip.

Will the rules change about which medicines you can and cannot bring into Europe?

The medicines you're allowed to bring into a given country depend on the laws of that individual country. This is unchanged by Brexit.

Each country makes its own rules about which medicines you can bring into the country and the maximum quantity you can carry. You can find out more about travelling with drugs to any country, including those in Europe, from our article and video on travelling with medication.

While the drugs most often prohibited are 'controlled drugs' such as powerful painkillers, there are some surprising exclusions. That's why it's always worth checking with the embassy of the country you're visiting before you travel if you're planning to take any medication with you.

How do state-run services abroad compare with the NHS?

That very much depends where in the world you’re going. In most parts of Europe, as well as in Australia, medical services and hospital facilities are of high quality. However, I’ve visited many hospitals further afield in my career as a doctor. I can confirm that in more far-flung countries, they vary enormously. I’ve seen facilities with water running down the walls, cockroaches on the floor and limited hygiene.

You may find yourself in an area where you’re expected to provide your own food, or your family is expected to carry out nursing and personal hygiene tasks. In some countries, access to single-use sterilised equipment can’t be taken for granted.

In these situations, it’s even more important to have an emergency insurance number to call to get advice on recommended facilities. But wherever you go, travel insurance with a specialist provider who can give guaranteed cover for your medical condition is a must for peace of mind.

Will I need to show physical proof of travel insurance?

Whether you will be denied treatment if you don't have proof of travel insurance will depend on the treatment and the country you're visiting. The last thing you need, if you’re unwell, is to be fretting about whether you can get treatment.

So, you should always take a copy of your travel insurance with you when you travel. If possible, we recommend keeping a paper copy and a backup online copy in case your belongings are lost. We also advise them to keep a note of the emergency number of their travel insurer and to leave a copy with someone who isn't travelling in case they lose their records.

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If you don't travel much then a single trip cover is perfect as you can cover specific dates suited to your trip. If you have cancellation cover, you'll also benefit from this as soon as you buy your policy.

If you travel 2 or more times a year, it may be cheaper for you to go for an annual multi-trip cover. It's best to start your annual trip cover as soon as possible, as if you have cancellation cover, you'll only benefit from this from your policy start date.

It is simple and quick to do! After you've told us about your trip details and answered some medical history questions you can add your pre-existing conditions, one by one, for each traveller. You'll only need to enter your details once, it's all online and there's no need to call, or provide details of your conditions in writing.

You will need to add each country that you are visiting. If you are on a flight stopover this will include any countries where you leave the airport. If you are on a cruise it includes any countries where your ship will be docking at.
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