# Changes to EHIC Card rules



## barryd (May 9, 2008)

Found this link an another forum.

http://www.nhs.uk/NHSEngland/Healthcareabroad/EHIC/Pages/EHICchanges.aspx

Dont know if its been covered before but it looks like you wont be able to claim back any visits to clinics / Doctors etc if that service is normally paid for by locals.

I assume if you break a leg or need hospital treatment your still covered but I am unsure.

Anyone know?


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## fatbuddha (Aug 7, 2006)

you're still covered for any emergency treatment needed, but it's just that you can't claim for any services where a local would normally pay for them - the usual one is drug prescriptions following treatment which you've never been able to claim for and had to pay


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## Glandwr (Jun 12, 2006)

Germany do ask you to pay a one off 10 euro registration fee then everything free including scripts

Dick


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## barryd (May 9, 2008)

Oh thats ok then.

Just knowing my habit of ending up in Foreign hospitals, doctors and dentists when I break myself I thought it might end up totting up a bit.


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## pippin (Nov 15, 2007)

Given that WE have to PAY (at least something) when in EHIC land can we assume that THEY will have to PAY (at least something) when accessing OUR NHS services?

WE provide FREE emergency ambulances with highly trained paramedics.

Many other countries it is just a glorified taxi with funny lights and hee-haws, and you have to pay for it!


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## barryd (May 9, 2008)

Not so in Italy or France. Mrs D had 2 ambulance trips in the Alps in Trento in Italy which I assumed I would get a bill for. Never paid for anything including two hospitals, various specialists and treatments. (Kidney Stones). If you have never tried chasing an Italian Ambulance through the Alps in peak season in a motorhome I can fully recommend it to get your heart racing. 

I had to go in an ambulance in France when I cut my face off. No bill either but I had to pay to have the stitches out a week later which I did pay for but claimed back on the NHS. I assume its this kind of thing that you will now not be able to claim back.


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## fatbuddha (Aug 7, 2006)

it's also key to have good medical insurance in place as well as relying on the EHIC card. that will cover you for most things but if you need more specialist support it could cost a lot - especially if it involves helicopter rescue.

I broke my jaw in a ski accident many years ago which required being taken of the slopes by pisteurs in a "bloodwagon" (a specialist stretcher on skis) and then helicoptered off to a local hospital for treatment (surgery and 5 days in hospital). the pisteur and helicopter rescues aren't covered by EHIC and could have cost me thousands - I didn't have to pay a thing as my insurance covered me fully. 

always make sure you have adequate insurance to cover you for activities you might do on holiday - sadly, many holiday insurance policies are not good enough, especially if sold as part of a package.


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## Boff (May 10, 2005)

Neither so in Germany, Netherlands, Belgium, Denmark, Sweden, Finland ...

However, in some of those countries even the locals have to pay a certain lump sum, usually in the order of magnitude of about 10€, each time they visit a doctor. The EHIC prinicple is that visitors from other EU countries are treated in the same way as locals. Means if locals have to pay such a lump sum, so do visitors.

Best Regards,
Gerhard


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## alhod (Nov 1, 2010)

Reading that at "face value" the implications in France could be quite expensive for visiting Brits. Although the state system covers costs on most things the charges "reimbursed" are not the same as the amount charged by local hospitals, doctors etc. Residents of France have a top-up (private) insurance which covers that difference. If that was not in place you can often find that you are having to pay up to 30% of the total which is NOT covered by the state system. 
Reading the guidance on the NHS website ( http://www.nhs.uk/NHSEngland/Healthcareabroad/countryguide/Pages/healthcareinFrance.aspx ) it does emphasise that even with reimbursement you could face 30% of the bill being non-reclaimable so travel insurance seems to be a sensible precaution in any event.

Alan


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## bjandlin (Sep 15, 2009)

*Medical*

Yes that's the norm in France; maybe rightly so - if we have to buy ie
paracetomols in UK then surely thats no problem in Spain/France?
Sometimes its much better to buy over the counter, cheaper than 
all the hassle going to a gp. IE Diabetic Metformin about 3Euros in
Spain but costs a GP apt 23E plus a presc at cost price in France 
so you win some and lose some!
Mrs Barrie


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## Glandwr (Jun 12, 2006)

Just heard on the news that all EU citizens will be charged 125% of the cost of any NHS treatment they receive and that the government will fine hospitals that don't collect the money. Looks like that reciprocal arrangement is out of the window. Bloody thanks Nige!

Dick


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## Mike48 (May 1, 2005)

Any costs that are not recoverable from the EHIC are recoverable via your travel insurance. What troubles me is if there is no convenient State hospital in say Spain (Benidorm is an example) and you go into a private hospital then will your insurance pay? My feeling is that they will not as most travel insurance policies require you to use your EHIC as insurance companies say you have medical cover and not private health insurance.


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## Camdoon (Sep 21, 2012)

Glandwr said:


> Just heard on the news that all EU citizens will be charged 125% of the cost of any NHS treatment they receive and that the government will fine hospitals that don't collect the money. Looks like that reciprocal arrangement is out of the window. Bloody thanks Nige!
> 
> Dick


You really need to listen Dick.

http://www.bbc.co.uk/news/uk-politics-28291276


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## fatbuddha (Aug 7, 2006)

> Just heard on the news that all EU citizens will be charged 125% of the cost of any NHS treatment they receive and that the government will fine hospitals that don't collect the money. Looks like that reciprocal arrangement is out of the window. Bloody thanks Nige!


that's NON-EU citizens and it's 150%. but 100% of chargeable fees for EU citizens.

this procedure has been in place for some time but the money is either poorly or not collected so the Govt are tightening matters up.

it's not the end of the reciprocal agreement by any means, just a tightening up at the UK end.


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## Glandwr (Jun 12, 2006)

its going up to 125% next year apparently FB? Thanks both, just shows that you shouldn't try and listen to the news while driving through central London with a 6month old bawling in one year and the mother in the other saying hurry up :lol: 

Dick


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## barryd (May 9, 2008)

So are we covered or not? 

Ironically posted from X-ray, James cook hospital, Middlesbrough.


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## fatbuddha (Aug 7, 2006)

> its going up to 125% next year apparently FB? Thanks both, just shows that you shouldn't try and listen to the news while driving through central London with a 6month old bawling in one year and the mother in the other saying hurry up


yes - but that's 125% going to the trusts to ensure better collection processes, although EU patients will still get charged 100% centrally. in other words it's an incentive to get trusts recording better data on treatments given to EU nationals. central govt then reclaim this charge from other EU member states

non-EU patients are charged direct by trusts


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## Penquin (Oct 15, 2007)

Some information about costs in France, looking at their explanation page;

http://www.nhs.uk/NHSEngland/Healthcareabroad/countryguide/Pages/healthcareinFrance.aspx

they point out correctly that if you go to see a Doctor (Medecin traitante) you have to pay 23€ for the pleasure and are given a brown sheet to prove that.

When you get to the UK you can reclaim 70% of that 23€ (just over 16€) which is exactly the same as French citizens get back from Social Security.....

so you will be treated in the same way as the locals. That applies also for drugs and medication - you will have to pay a charge and will get a brown sheet telling you that you can reclaim on.

Hospital visits etc are more expensive - but, like anywhere in the EU you MUST ENSURE tat you are being treated in a "state" hospital and not a private one - you are ONLY covered for STATE treatment - there may be fees to pay and you can reclaim - hence why private health insurance is desirable IMO as that will give you wider cover and you will not have to pay before you leave......

NB Keep every piece of paper that you are given - you will need them.....

I hope that makes the muddy waters a little clearer.......

BUT as has been pointed out a lot of medication is MUCH cheaper in France (and Spain) than in the UK, so it is worth asking at the pharmacy whether a prescription (ordnance in France) is required - you might be pleasantly surprised how cheap some things are....

but the medication that you can buy over the counter is limited - don't expect to be able to top up your private morphine supply over the counter..... :lol:

Dave


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## wug (May 19, 2011)

Mike48 said:


> What troubles me is if there is no convenient State hospital in say Spain (Benidorm is an example) and you go into a private hospital then will your insurance pay? My feeling is that they will not as most travel insurance policies require you to use your EHIC as insurance companies say you have medical cover and not private health insurance.


I asked this of the company with whom I was insured and they replied that they expect you to use state facilities, but if no state facility is available then to phone them for approval. If you are not in a condition to contact them, e.g. if unconscious or otherwise not in control of your situation and you are taken to a private hospital then you will be covered.


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## bb46 (Oct 26, 2008)

We buy EHIC+ which combines use of EHIC with extra cover. Fortunately we haven't had to use it (yet), but for Europe travel it seems very good value. We have medical conditions which put a heavy premium loading on other health policies, but EHICplus accept cover for no additional cost.

http://www.ehicplus.com/

Barbara


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## Mike48 (May 1, 2005)

bb46 said:


> We buy EHIC+ which combines use of EHIC with extra cover. Fortunately we haven't had to use it (yet), but for Europe travel it seems very good value. We have medical conditions which put a heavy premium loading on other health policies, but EHICplus accept cover for no additional cost.
> 
> http://www.ehicplus.com/
> 
> Barbara


If the above post by wug is true and that insurance will pay for private treatment (which I remain sceptical about having spoken to a few people about this and read an earlier thread on here) I would question whether this EHIC plus policy is that good. EHIC plus appears to work alongside the State system. What happens if you are taken ill in an area where there are no State hospitals meaning you may have to be transported long distances which could be crucial, even terminal, in the event of a serious condition? In parts of the EU many people use private hospitals through their own private health insurance and the existence of State hospitals is relatively sparse.


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## fatbuddha (Aug 7, 2006)

from what I can see EHICPlus is a standard travel insurance policy that has a pre-requirement for a EHIC card - and no doubt most of us who have travel insurance have one of those anyway.

if it gives what you need - fine - but to me it seems to be a way of a company benefiting from the EHIC name and people thinking they are getting something that may in fact not be there.

various reviews seem to indicate there are issues with people understanding what they are buying with this policy - it seems not to cover for any private treatment which many travel insurance policies do.

EDIT: bit of a x-post with Mike48 - we're essentially saying the same thing - tread warily!


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## wug (May 19, 2011)

I didn't say insurance would pay for private treatment, unconditionally. The guidance I was given indicated that in a non-emergency situation you should first seek a state facility, if none was available then you should contact the helpline for advice. I think this is standard. In an emergency, where you are not in control, and if the ambulance takes you to a private facility then you would be covered. Of course you may be subsequently moved to a state hospital.

I also put the same question to EhicPlus and received no such assurance. It's probably something that should be clarified more generally in the documentation, but if concerned then ask your insurer. Graham


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## Mike48 (May 1, 2005)

The post below (not mine) illustrates the kind of difficulties, even the insured, might face when seeking treatment in Spain. Discussions with other campers who have had to claim from their insurance have left me with the impression that insurance companies have a default position and that is to avoid paying out where possible. For example they might agree to pay hospital costs and then, after examining your health records from your GP back home, find some reason not to pay out even if you think you are covered for declared health issues.

The above post from Wug illustrates the insurance line but, as stated earlier, things are not always as simple as they seem. While I continue to have insurance, it is best for everyone to understand from the outset that having insurance is not without potential problems.

Here is a post from this site which seems to illustrate the point:

"Last year I took ill in Spain. I visited a walk-in clinic, saw a doctor who referred me immediately to the 'Urgencies' (A&E)dept at the nearest hospital for tests and treatment. The walk-in clinic accepted my EHIC, the hospital did not - and it was a state hospital. I offered my EHIC at the hospital and they took it off me but then asked if I had insurance. I replied honestly that I had travel insurance. They then handed me back my EHIC and said they would not accept it and I must use my insurance.

Then ensued an argument between the hospital, me and my insurance company. We had a 3-way telephone conversation. I insisted that hospital and insurance must speak with each other to sort the ridiculous situation out. It didn't work! Hospital's position was that because I had insurance they would not accept the EHIC. Insurance company's position was that state hospitals in Spain MUST accept the EHIC. The insurance company told me my insurance was not for private treatement. I assured them I was not seeking private treatment but that I was in a state hospital. The insurance company told me I should have denied having insurance! Can you believe that? When I asked them what was I paying for - the cost of the annual multi-trip plus the extra costs for medical conditions I had declared, they said the the insurance was not for medical costs but for repatriation, accommodation costs for spouse etc. (Although on the policy it stated something in the region of £100,000 for hospital costs etc. I forget now the amount but it was the usual type of stuff).

In the end I paid the hospital and after a struggle the insurance company reimbursed me but were quite adamant that if I had any further problems I must deny having insurance and use my EHIC.

I am sure you all remember that song, by Harry Belafonte I think, 'There's a hole in the bucket, dear Lisa, dear Lisa'..........

Anyway bottom line is that for the first time I have come to Spain without insurance. What is the point? I refuse to lie and deny having insurance if I have it, and what is the point in paying for insurance - plus the extra for declared medical conditions , which by the way had nothing to do with my illness last year, if they won't cover you for emergency medical treatment?

And FYI my annual multi-trip travel insurance was with the C&CC."


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## barryd (May 9, 2008)

This is not the first time I have heard about this in Spain. I think there have been a few threads about it on the forums and the BBC reported about it here. http://www.bbc.co.uk/news/world-europe-22714147


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## wug (May 19, 2011)

The problem in Spain may be declining. There's a longish article about the results of the EC investigations in a travel trade journal: Game Over?


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## Glandwr (Jun 12, 2006)

There is a latent problem in Spain. They are about to have a huge drain on their health and welfare services by northern europeanions as they become geriatric having sold up in their home country and moved to the sun.

Spain's UKIP is already exploiting resentment. Will it be the UK or Spain to refuse first?

Dick


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## Camdoon (Sep 21, 2012)

EU nationals are leaving Spain in droves
http://www.telegraph.co.uk/news/features/10782662/Has-the-sun-set-on-the-expat-dream-in-Spain.html


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