European Health Insurance Card

The European Health Insurance Card in 2022

The Spanish healthcare system is one of the best in the world. Those visiting Spain can access the country’s national healthcare system and treatment via the European Health Insurance Card (EHIC). 

But with the current card being phased out and replaced by the Global Health Insurance Card (GHIC), there are some things you need to know.

In this article, we look at what you need to do if your card is one of them and what services are available for UK expats in Spain.


EHIC vs GHIC – what’s the difference?

Both the EHIC and GHIC are free and allow you to access public healthcare in European countries.

The main difference is that the EHIC covered more countries, including those outside the European Union (EU). Following the completion of Brexit, the new GHIC is now only valid in EU countries and Switzerland. The good news is you can still use both cards in Spain.

You should note that neither card is an insurance replacement. These cards are only there to cover necessary medical treatment.


What cover does the EHIC/GHIC provide?

Both cards provide access to medically necessary state healthcare only. Treatments or procedures at private hospitals will require you to have private health insurance.

The term ‘medically necessary’ means urgent treatments that cannot wait until you return to the UK.

Although a wide range of hospital treatments are covered, some are not. For example, dental treatment is not in most cases. Dental care will often require you to have medical insurance.

Some examples of medically necessary healthcare according to the NHS include:

  • Emergency treatments and visits to A&E
  • Treatment for long-term or pre-existing conditions
  • Routine medical care for a pre-existing health condition that needs monitoring
  • Routine maternity care – this does not include giving birth abroad
  • Oxygen therapy and kidney dialysis

For those needing medication, UK prescriptions are valid in Spain. Like the UK, Prescription medication is not free in Spain.

However, with a valid EHIC or GHIC, you pay a reduced rate as follows:

  • 50% of the prescription cost
  • 10% of the prescription cost for those who receive a UK State Pension

The UK government website has more information about healthcare for UK nationals visiting Spain.


How do you get a card or update an existing one?

Those with a European Health Insurance Card can continue to use it until it expires. Check the date on yours before you travel. You can apply for a new card up to six months before your current one expires.

However, according to NHS figures, an estimated 5.6 million EHICs are set to expire this year. So, whether you are applying for a new card or updating an old one, it’s essential you know the process.

Both cards are free of charge, but beware, unofficial scam sites exist that try to charge you a fee. The NHS provides EHICs and GHICs, so always make sure you use their official site when applying.


Healthcare in Spain for UK expats

EHICs and GHICs are intended more for temporary visits. They typically allow you to access healthcare in a country for up to 90 days.

Expats who plan on staying in the country for longer must register as Spanish residents or have an appropriate visa. Those working in the country are entitled to the same healthcare services as Spanish citizens.

You simply need to visit your nearest health centre and register with your social security number. To obtain a social security number, you will need to visit your local National Social Security Institute office.

However, if you are classed as a posted worker in Spain, you can continue to use your EHIC/GHIC to access local healthcare.

Also known as ‘detached workers,’ posted workers are those employed in the UK but temporarily sent to work in a European Economic Area (EAA) country.


Healthcare in Spain for UK expat retirees

If you are retired in Spain and receive a UK State Pension, you may be able to apply for the S1 form.

The S1 form shows that your healthcare costs are covered by the UK. As part of the Brexit Withdrawal Agreement, those visiting the UK can also access primary care services, emergency treatment and general medical care.

The NHS Overseas Healthcare Services handle S1 form applications. For more information, visit their page on planning your healthcare abroad.


Frequently asked questions about the European Health Insurance Card

Q: What countries accept EHICs?

A: The European Health Insurance Card (EHIC) and the Global Health Insurance Card (GHIC) are excepted by all EU countries and Switzerland.

Q: Are EHICs still valid?

A: EHICs are still valid. You can continue to use your card until it expires. At that point, you will need to apply for a new GHIC.

Q: Do British expats get free healthcare in Spain?

A: Expats living and working in Spain for an extended period must register as Spanish residents or have an appropriate visa. 

As a resident of Spain, you will have access to healthcare which is covered by social security contributions. This does not include private healthcare. For this, you will need a specific type of insurance coverage.

Q: What is the difference between EHIC and GHIC?

A: In general, both cards provide the same benefits should you need medical assistance or emergency medical treatment. Both grant access to free access to healthcare or at a reduced cost.

EU and non-EU countries such as Switzerland, Norway, Iceland and Liechtenstein accepted the older EHIC. Meanwhile, the new GHIC is only accepted in EU member states and Switzerland.

Q: What does the EHIC cover?

A: The EHIC grants access to different types of treatment at public hospitals and GPs. 

You are entitled to receive the same level of treatment as a permanent resident in the country and at the same cost. This could be free in some cases.

Q: What is the difference between the EHIC and travel insurance?

A: The EHIC provides the same level of treatment offered to Spanish citizens. However, it is not a replacement for travel insurance.

It does not provide dental cover in most cases, private treatment or repatriation – in other words, getting you back to the UK in case of a medical emergency.

Private travel insurance covers the cost of other medical services not offered by the EHIC. For this reason, having both is essential.


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