Does the GHIC Replace Travel Insurance?

Key things to know

1. The GHIC lets UK residents use state healthcare in the EU and a few other countries, with treatment given much as it would be to someone living there.
2. It does not cover repatriation, private treatment, planned treatment abroad or trip problems such as cancellation, so travel insurance is still advised.
3. The card is free, lasts up to five years and should be applied for through the NHS website, because unofficial sites charge fees.
4. Local medical staff, not the card, decide whether treatment counts as medically necessary, and charges that apply to residents may still be payable.
5. Check FCDO travel advice and buy insurance soon after booking, because travelling against FCDO advice can invalidate a policy.

No. The Global Health Insurance Card, or GHIC, gives UK residents a right to state-run healthcare in the EU and a short list of other countries, with treatment delivered much as it would be for someone who lives there. What it never does is fly you home, cover private treatment or pay for anything that could safely wait until you were back in Britain. The NHS says plainly that the card is not a replacement for travel insurance, and this article explains what each one covers so you can see why most travellers need both.

What the GHIC Is and Who Can Get One

The UK Global Health Insurance Card replaced the European Health Insurance Card (EHIC) for most UK residents. An existing EHIC stays valid until the expiry date printed on it, and once it expires you apply for a GHIC to replace it. Some people with rights under the Withdrawal Agreement can instead apply for a new UK EHIC, which works in EU countries, Switzerland, Norway, Iceland and Liechtenstein.

The card is free and lasts up to five years. Applications go through the NHS website, and it is worth being careful here, because unofficial websites charge a fee for something you can do yourself at no cost. You can apply up to nine months before your current card expires, and GOV.UK suggests applying at least two weeks before you travel so the card arrives in time.

Eligibility is residency-based, so for most applicants you need to make your ordinary home in the UK. Every family member needs their own card, although a husband or wife, civil partner and children can be included on the same application. If the NHS asks for evidence to support your application, you have eight weeks to provide it before the application is withdrawn.

What the Card Covers: Medically Necessary State Healthcare

The GHIC pays for state-run treatment that cannot be safely put off until you get home. It is the medical staff treating you, not you and not the card, who decide whether that threshold is met. In practice, that covers the sort of care a person needs during a temporary stay:

• emergency treatment after an accident or sudden illness
• routine care for a condition you already have where ongoing monitoring is needed
• routine maternity care, as long as you are not travelling abroad specifically to give birth

Some treatments have to be arranged in advance with the medical services where you are heading, such as kidney dialysis or chemotherapy. In Spain, for example, oxygen therapy is available under the card, but a written request has to reach the Spanish health authority for the region you are visiting at least a month ahead.

Two limits matter. First, the card covers state healthcare only, so you cannot use it at a private clinic or hospital. Second, state healthcare is not always free. You may have to pay the same statutory charges a local resident would pay, such as prescription costs, and these cannot be refunded. In Spain, prescriptions are charged at a reduced rate with the card, and UK State Pension holders pay 10 percent of the prescription price.

What the GHIC Does Not Cover at All

The gaps are where people get caught out. The card does not cover:

• transport back to the UK because of illness, injury or death, known as medical repatriation
• planned medical treatment, where you travel deliberately for care
• any private healthcare
• things such as mountain rescue, which the Spain guidance names specifically
• changes to travel and accommodation bookings, cancellation, lost baggage or any other disruption to the trip itself

Planned treatment deserves its own note. The GHIC is for healthcare that becomes necessary during your stay. If you want to go abroad for treatment you have already arranged, there are separate NHS routes, such as the S2 route, which needs prior authorisation from NHS England before you receive treatment. Most travel insurance policies will not cover planned treatment abroad either, so specialist cover may be needed, and it makes sense to discuss the plan with a GP first.

Where the Card Works and Where It Does Not

A UK GHIC works in EU countries and Switzerland. It also works in Montenegro, Saint Helena, Ascension Island and Tristan da Cunha, though the UK EHIC does not cover those countries. Some French overseas territories accept both cards. Arrangements can vary and the list may change, so check the latest NHS guidance for your destination rather than assuming the card will work.

The Republic of Ireland sits outside the card system in a useful way. As a UK resident you are automatically entitled to state healthcare there on the same basis as an Irish citizen, and you can show proof of residency, such as a driving licence or passport, at the treatment facility.

The Crown dependencies are a different case. Jersey, Guernsey and the Isle of Man are not part of the UK, so people who ordinarily live there are not entitled to a UK GHIC, although visitors can use one if they need medically necessary treatment.

Outside the EU and the countries listed above, the UK has reciprocal healthcare agreements with some non-EU countries. These vary in what they provide, and generally only immediate medical treatment is free, to allow visitors to return home for other needs. Some agreements ask for specific documents, such as proof of National Insurance enrolment or a letter showing your name and NHS number, and some accept the GHIC as evidence. If a country is not listed, there is no agreement, which makes travel insurance the only safety net.

Why Repatriation and Private Care Need Insurance

The government’s guidance is blunt about what can go wrong uninsured. Fall and break your leg in Spain and you may need hospital treatment and possibly medical evacuation home. A quad bike accident in Greece might require surgery and a medical flight. A stomach bug treated in a hospital in the USA could also end with repatriation. Without appropriate insurance, those emergency expenses are yours to pay, and they can cost thousands of pounds.

Repatriation is the clearest gap. The card explicitly does not pay to bring someone home to Britain after they fall ill, are injured or die abroad. Emergency transport, such as an ambulance, is often billed separately from other medical expenses, and a medical flight home can run to a very large sum.

Travel insurance also picks up the human logistics around a medical emergency: the sensible costs of a relative or friend staying by your bedside, or flying out to escort you home. If a family member dies abroad, the policy should cover repatriation costs. None of that comes with the card.

A Worked Example, for Illustration

Take a hypothetical trip to Spain. A traveller falls ill and needs a stay in a state hospital, followed by prescription medicines. With a GHIC, the state hospital treats them as it would a Spanish patient, so the care is free or at a reduced local rate, and the prescriptions are charged at the reduced Spanish rate. What the card does not touch is the medically supervised flight home, the extra nights a partner needs in a hotel while the traveller recovers, or the cost of rearranging the return journey. A travel policy that covers those items, with the traveller’s health conditions declared, is what stops the trip turning into a bill running into thousands of pounds. This is an illustration of how the two fit together, not a description of any specific policy.

Using the Two Together on a Trip

The two are designed to work as a pair. The card reduces the cost of state treatment on the ground, and the policy handles everything the card was never designed to touch. A few practical points make the combination work properly.

Buy the policy as soon as your trip is booked, and read the small print, particularly the exclusion clauses. Declare any existing physical or mental health conditions, including any currently under investigation, and any pending treatment or tests, because failing to declare something may invalidate the policy. Our guide to travel insurance and pre-existing conditions explains how screening works and what to expect.

Check the Foreign, Commonwealth and Development Office (FCDO) travel advice for your destination, because travelling somewhere the FCDO advises against can invalidate your insurance. When you travel, carry your policy details, including the policy number and the insurer’s emergency assistance telephone number, and share them with your travel companions and family at home. Our guide to getting started with travel insurance sets out the full checks worth making before you buy.

Worth doing: If your card is lost, stolen or does not arrive before you travel, you can request a Provisional Replacement Certificate (PRC), which provides short-term cover. If you need medical care and the card is not to hand, contact NHS Overseas Healthcare Services.

The simplest next step is to check the expiry date on your card today, and if it is out of date or close to expiring, apply through the NHS website before you book anything else.

Questions answered

Is the GHIC free to apply for?
Yes. The card is free and usually lasts up to five years. Apply through the NHS website, because unofficial websites charge a fee for the same service.

Does the GHIC work outside Europe?
It works in EU countries, Switzerland and a small number of other countries, including Montenegro. The UK also has reciprocal healthcare agreements with some non-EU countries, but if a country is not listed there is no agreement, which leaves travel insurance as your only cover.

What if I need treatment but my card has not arrived or is lost?
You can ask for a Provisional Replacement Certificate (PRC), which gives you short-term cover. NHS Overseas Healthcare Services can help if you need care and the card is not with you.

Does the GHIC cover pre-existing conditions?
It covers routine care for conditions you already have where monitoring is needed, although some treatments such as dialysis must be pre-arranged. You should still declare any conditions to your travel insurer.