Friday, 7th August 2020

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Your NHS service abroad

Your NHS service abroad

The European Health Insurance Card

Most people will know by now that the old E111 form has been done away with since January 2006, but what many do not know is that it has been replaced with the EHIC that needs to be applied for and what this means.
The British card is only available free of charge to UK residents, which means that if you are a Spanish resident you must look at the Spanish NHS for the equivalent.

If a British resident decides to work or live abroad, then the authorities should be informed accordingly and the card returned.
The main advantage of the card is that it will entitle you to medical treatment that becomes necessary, at reduced cost or sometimes free, when temporarily visiting a European Union (EU) country, Iceland, Liechtenstein, Norway or Switzerland.

Applicants must be over 16 and the quickest way to apply for the free card is probably to go to  and find the page to apply. Applications for under 16¬ís are accepted when presented by a responsible adult.

The EHIC is normally valid for three to five years and covers any medical treatment that becomes necessary during your trip, because of either illness or an accident. The card gives access to state-provided medical treatment only, and you'll be treated on the same basis as an 'insured' person living in the country you're visiting. Remember, this might not cover all the things you'd expect to get free of charge from the NHS in the UK. You may have to make a contribution to the cost of your care.

The EHIC also covers any treatment you need for a chronic disease or pre-existing illness. You need to make arrangements in advance for kidney dialysis and oxygen therapy. To arrange for kidney dialysis while you're away, contact your NHS renal unit in the UK before you travel. For limited information on oxygen supply services in the EEA countries and Switzerland, call the Department of Health's Customer Service Centre on 020 7210 4850.


What treatment is covered and what will I be charged for in Spain (including the Canary and Balearic Islands)?

  • Doctors and dentists: make sure the practitioner you see works within the Spanish state health service. In some parts of the country, particularly the outlying islands, you may have to travel some distance to attend a state surgery ('consultorio'), health centre ('centro sanitario') or hospital clinic ('ambulatorio'). If you need to call out a doctor in an emergency, make it clear that you have a European Health Insurance Card (EHIC) and that you want to be treated under the EU arrangements. Whenever you need treatment, show your EHIC. Dental treatment is not generally provided under the state system, and the costs will not be reimbursed. In Spain, doctors, health centres and hospitals have separate surgery times for private patients and those treated under the state health service. If you are asked to pay, you are not being treated under the Spanish health service and your EHIC will not be accepted. 
  • Prescriptions: medicines prescribed by health service practitioners can be obtained from any pharmacy ('farmacia'). You will have to pay up to 40 per cent of the cost unless you are a UK or other European Economic Area (EEA) pensioner, in which case the medicines will be free of charge. You must show proof that you are a state pensioner; otherwise you will be charged 40 per cent of the cost, which you can claim back on your return to the UK. If a hospital says you need medicines after you are discharged, you must take the medical report to a GP, who will give you a prescription.
  • Hospital treatment: a doctor will usually arrange any hospital treatment you may need. In an emergency, you can only get free treatment in a public ward at a public hospital. You must show your EHIC; if not, you will be charged as a private patient and will not get your money back. Under the strict terms of the Spanish health service, there are no refunds for private healthcare charges. Make sure you have private medical insurance in case you are treated in an emergency in a private hospital. Doctors in the emergency departments of state health service hospitals will prescribe medicines on the appropriate medical report, but do not issue official prescriptions. You must take the report to a primary care doctor who will issue the official prescription.

Remember that the EHIC won't cover you if getting medical treatment is the main purpose of your trip.

Who handles reimbursements?
There are none. However, if you are a state pensioner and are charged for your prescriptions, you can apply for a refund when you get back to the UK. Contact the Department for Work and Pensions (DWP) for more information. You will need the original receipts to claim money back.

For further information in Spain you should contact Servicio Regional de Salud (Regional Health Service Offices).

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