*Note: What you will find below is only applicable to people who live in any of the 27 EU countries, Iceland, Liechtenstein, Norway, Switzerland and the United Kingdom (we’ll see with Brexit). If you are visiting from the Americas, Asia, Africa, etc. you will need travel insurance with Schenghen coverage (my recommendation for this is Chapka which is based in de EU, but you can contact your local health insurance company for this too.)

The European Health Insurance Card is one of the most important free documents you should take with you when you travel. It is, to make it short, the document that entitles you to have the same free health coverage as the people of the European country you are visiting.

It is the equivalent of a health insurance that you can use when traveling for work, studies or tourism inside Europe, for European residents (not all, we’ll see below). And which grants equal health rights all around Europe (the European way, meaning that if you are visiting France you get the same as the french, not the same as the Spaniards, so if your country gives you free medical appointments but France charges 1€ per general appointment and 10€ per specialist appointment, that’s what you will have to pay when visiting France).

What the EHIC is not

• The European Health Insurance Card is not a travel insurance service. Meaning: it will not cover your drugs unless stated, the private doctors / private hospital appointments, taking you back home if you get really sick, cancelling the costs of your trip if you have to go back home before time… Plus it will not cover anything it doesn’t cover to the locals of the place you visit. So you still should get a travel insurance for all of these (they are usually cheaper inside Europe for this exact reason). On the good side it does cover your cronic and pre-existing medical conditions.
• It is not the tool to get surgery abroad. If your goal is to get surgery cheaper (allegedly Brits and German used to come to Spain to get their hip or cataract disease “fixed” at Spanish hospitals) and they can prove it, they can charge you for it or deny attendance.
• It is not a family card or a group insurance card. Each single person must have it’s own card, even children.
• Also, non-European nationals that are residents of the EU countries cannot use the card at Denmark, Iceland, Liechtenstein, Norway, Switzerland and the United Kingdom. Only EU nationals can use the card in these countries (unless they have an additional agreement between their country of nationality and these).

Who is entitled to an EHIC?

Every person that is entitled to use a national health system in an European Union is entitled to an European Health Insurance Card. Meaning, if you have local health insurance in Spain as a resident (whether you are national or not), you can have one, but if you are out of the national health system (a student, someone using an alternative allowed by the local law, an illegal immigrant, etc.), you cannot request it.

For example, in Spain you are entitled to the card it if you are a working person suscribed to the Social Security system (some are under other companies, for example many public servants), a beneficiary of one of them even if they don’t work (the husband/wife, children, parents), and unemployed during an unemployment coverage period, retired people (not all of them).

Also there are some restrictions or extra conditions applicable to those with temporary jobs, unemployed, bullfighters/artists, etc. And public servants under other companies have an alternative service that is quite similar in coverage as the EHIC.

Price of the European Health Insurance Card

It is free.

Repeat: it is free. In every country. So if someone is trying to sell it to you, they are selling the service of asking for it (which you can do online at most countries now).

And it usually is valid for 2 years (unless for unemployed, special category workers and similar) with some countries issuing it for 5 years (each country can set its own rules for this).

Do you still need travel insurance?

As I told you before, the EHIC will not cover the private doctors / private hospital appointments, taking you back home if you get really sick, cancelling the costs of your trip if you have to go back home before time…

Plus it will not cover anything it doesn’t cover to the locals of the place you visit. For example dental care in Spain only covers for free taking your tooth out and treating an infection. Which is not the best way to treat your teeth, in 99% of the cases. And you still go through the same timings as locals, so if fall and get your ankle twisted, you will go through Emergency fast, with free ambulance to go to the hospital, all the tests and cures done. BUT no ambulance back to your hotel/house and if you need surgery and they don’t consider it an emergency, you might get your surgery when you are back home (some appointments delay up to 18 months or more.)

Some other countries will cover your ambulance or other transport to your hotel but going to ER will be at a cost depending on the tests and procedures you have to go through.

So you still should get a travel insurance for all of these (they are usually cheaper inside Europe for this exact reason) so check your pricing at the different local companies. Also, check how much they cover when you are entitled to the EHIC, some will cut the coverage (you might not need it anyways.)

How/where do you get it

You need to request it at your local Social Security System. Meaning, you cannot request it once you have started to travel, they will not send it abroad (check the next point in case of emergency).

It takes from 7-15 days depending on the country and it’s automattic in most cases (you request it online or by phone and they send it to the address they have on the database.) So, if you are living in one city but you started working somewhere else, and never changed your address at the Social Security / Health system, do that before requesting the card.

If you are a resident of a country you are not a national of, they usually ask you to do it in person at the Social Security offices (check with your country of residence for this.) In Spain it is at Centros de Atención e Información de la Seguridad Social (CAISS) (they usually request an appointment).

what can I do if I forgot my EHIC card or didn’t have time enough to get it?

While you should plan in advance to get all your travel documents, weird things happen sometimes and you end up forgetting it or getting it stolen. Whatever the case is, the EU countries can provide you with a Certificate that proves you are entitled to the service.

At some countries, you can get it in advance at your local Social Security system in person, proving that you will be traveling in less than the time required to get your card (they can issue these certificates almost instantly). But most are only issued when you need them and they are delivered by email/fax.

In some countries, such as Spain, you can also request it online (with digital signature), which is the best option when you are already traveling.

On the other hand, these certificates are only valid for up to 90 days in most cases (check the date stamped on it) so you cannot rely in them forever.