What Is the European Health Insurance Card (EHIC)? Full Guide

Who is entitled to an EHIC?

You are entitled to a European Health Insurance Card if you are covered by the public or statutory health insurance scheme of an EU country, Iceland, Liechtenstein, Norway, Switzerland or, in some post-Brexit cases, the UK.

Entitlement follows your insurance, not your passport. A French citizen registered in Social Security in Portugal deals with Portugal. The relevant question is which country of residence runs the public system you pay into, not where you were born.

This is the point most newcomers miss, and the one that matters most if you have just moved. You do not need to be a citizen. Legal residents who are settled and enrolled in a country's social security or national insurance system can get that country's card. In Portugal, for example, the official Segurança Social guidance confirms the CESD is open to Portuguese citizens, pensioners, students and legally resident foreigners enrolled in the system.

There is one limitation worth flagging clearly, because it is easy to get wrong. Non-EU nationals cannot use their EHIC in Denmark, Iceland, Liechtenstein, Norway or Switzerland, and some EU pages also list the UK here. The exception is for refugees residing in an EU country and for people covered as family members of an EU citizen. France's own public service gives the textbook case: a Mauritian national insured in France can hold a card for most of the EU, but cannot use it on holiday in Denmark.

One more case to keep in mind. If you are a pensioner whose pension is paid by another country's mandatory system, you request the card from the country that pays your pension, not from where you live.

What healthcare services does the EHIC cover?

The EHIC covers the public healthcare and medical treatment that becomes necessary during your stay, so you are not forced to cut a trip short and fly home for care. You are treated under reciprocal healthcare rules, on the same terms and at the same cost as an insured resident of that country.

In practice that includes a doctor's visit, emergency hospital treatment after an accident, sudden illness, the ongoing care of a chronic condition such as diabetes or asthma, and unexpected childbirth. Prescriptions are dispensed on the same basis as for residents.

Two caveats sit on top of this. The card gives you local terms, not free care everywhere, so where residents pay a co-payment, you pay it too, and in some countries you pay the medical care costs upfront and claim them back later. And for treatment that needs specialist equipment or staff, such as dialysis, oxygen therapy or chemotherapy, the EU advises arranging it with the healthcare provider before you travel.

What the EHIC does not cover

The EHIC only works inside the public system, and it leaves several big gaps that catch people out.

Private healthcare

The card covers care from public providers or providers contracted to the public system. If you go to a private clinic or hospital, the EHIC generally does not help.

Planned treatment abroad

It does not cover treatment you travel specifically to receive. Going abroad for a scheduled operation is a different route (the S2 form), not an EHIC matter.

Repatriation and rescue

It does not pay for a medical flight home, mountain rescue in a ski resort, or transport after a serious accident. The EU's own example is a Swedish skier who needed mountain rescue in France and paid the full bill himself, because rescue is not covered.

These three gaps are exactly why travel insurance still has a job to do, which the section below covers.

How long is the EHIC valid?

There is no single EU-wide answer: the period for which the card is valid is set by the country that issues it, so check the expiry date printed on your own card.

As a rule the card lasts a few years, and its validity cannot run past your entitlement to public health insurance. Some worked examples from official sources: in Portugal the CESD is valid for three years, in France the CEAM is valid for a maximum of two years, and Ireland issues cards valid for up to four years.

Two practical notes. An expired card is not reissued automatically, so you have to renew it. And in the countries where the card is embedded on your national health card, its renewal usually follows the national card's own cycle.

How to apply for an EHIC?

To apply for an EHIC, you go to the health insurance institution or social security body in your country of residence. Most countries let you apply online, and many also accept an app, a phone request, post, or an in-person visit. The card is free.

A warning that fits AnchorLess's whole reason for existing: you should never pay a third party for this. The EU explicitly flags that some rogue websites charge a fee to "order" your card. The card costs nothing, so ignore those sites and go straight to your national body.

Below are the two worked examples. The pattern is the same elsewhere in the EU.

Applying in Portugal

In Portugal you apply for the European card through Segurança Social, and the simplest route is online.

Online through Segurança Social Direta

Log in to Segurança Social Direta with your NISS and Chave Móvel Digital or password, open the "Doença" menu, and choose "Obter Cartão Europeu de Seguro de Doença." The card is sent to your registered address within five to seven working days.

If you are travelling within 10 days

If you have to travel before the card arrives, request a Certificado Provisório de Substituição (CPS). It is issued as a PDF you can print, it carries the same rights as the card, and it is valid for three months.

In person or by post

You can also apply at a Segurança Social desk or a Loja or Espaço Cidadão by completing the application form (Modelo GIT 53). The request receipt itself is not accepted by health providers abroad, so apply with time to spare.

Applying in France

In France you request the CEAM, and the recommended route is your online account.

Online through your compte ameli

Log in to your compte ameli, open "Mes démarches," and order the card. It usually arrives in about ten to fifteen days, and the official advice is to request it at least 20 days before departure. If you are late, a provisional replacement certificate (valid three months) is downloadable straight away.

By phone or at a CPAM counter

You can also order it by phone (3646), through the ameli app, or at a CPAM counter. Self-employed workers and people in the agricultural (MSA) or public-service schemes apply through their own fund.

Applying in Spain

In Spain you request the TSE through Seguridad Social, and the card is free. The official services portal is blunt about it: the INSS never charges for the card and does not issue it through outside websites, so use only the official Social Security channels.

Online through the Seguridad Social e-office

Apply through the Seguridad Social Sede Electrónica or the "Tu Seguridad Social" portal, using a digital certificate or Cl@ve, an SMS code sent to a phone registered with Social Security, or a simple form with no electronic ID. The card is posted to your registered address within about five days, and is never handed over in person.

In person at a CAISS, and the provisional certificate

First-time applicants without online credentials go to a CAISS, a Social Security information centre. If the card cannot be issued in time or your trip is imminent, request the Certificado Provisional Sustitutorio (CPS), valid for up to 90 days, which you download and print straight away.

Applying in Italy

In Italy you usually do not apply at all. The TEAM is printed on the back of your Tessera Sanitaria, the national health card, and the Agenzia delle Entrate issues it automatically to everyone enrolled in the public health service (SSN). As it nears expiry, a new card is sent to you.

If you have just enrolled or the card is missing

If you have just registered with the SSN, or the back of your card does not show the TEAM, go to your local ASL, the health district's general-practice desk, with your ID, codice fiscale and regional health card.

New residents register at the district with their codice fiscale, residence permit or Questura receipt, and proof of address. The card is then posted, usually within about 30 days.

If you need it sooner, or it is lost

If you must travel before it arrives, your ASL can issue a provisional substitute certificate that carries the same rights. If the card is lost, stolen or damaged, request a duplicate through the Agenzia delle Entrate website, an Agenzia delle Entrate office, or your ASL.

Applying elsewhere in the EU

In other countries the principle holds: find your national health insurer or social security office, and apply online, in person, or through whatever digital service the country runs. In Germany, Austria, and a few others, you may not need to "apply" at all, because the card is already on the back of your national health card. Wherever you are, request it at least two to three weeks before travelling, and ask for a provisional certificate if your trip is sooner.

EU Countries

Non-EU Countries but participating countries

How to renew or replace an EHIC?

To renew the card, you apply the same way you did the first time, before it expires. Renewal is free, and an expired card is not reissued automatically, so set a reminder. In some countries you can start the renewal in the weeks before the expiry date shown on the card.

To replace a damaged card, you request a new one through the same channel. The replacement is also free.

What to do if your EHIC is lost or stolen

If your card is lost or stolen, contact the body that issued it as soon as you can, and request a Provisional Replacement Certificate (PRC), which proves the same entitlement while you wait for a new card.

The PRC has different local names. In Portugal it is the CPS, requested online through Segurança Social Direta or in person, and valid for three months. In France it is the certificat provisoire de remplacement, downloadable from your ameli account and also valid for three months. Either one acts as the emergency document that lets you keep your cover abroad without the physical card.

If you ended up paying for treatment because you did not have your card or certificate with you, you can usually claim a refund afterwards. Keep the receipts and prescriptions and hand them to your national health body when you get home.

Is travel insurance needed with an EHIC?

The EHIC is not travel insurance, and it does not replace it. You are not legally required to have travel insurance to move around the EU, but the card leaves gaps that only insurance fills, so the two work best together.

The EHIC gets you into the public system on local terms. Private healthcare, a medical flight home, ski-slope rescue, a cancelled trip or lost luggage all sit outside it. Private travel insurance covers those, and it usually covers the medical expenses of a private clinic and the repatriation the EHIC never touches.

A note for anyone moving between the EU and the UK: most UK residents now carry the Global Health Insurance Card (GHIC) rather than an EHIC, while EU citizens can still use their EHIC for temporary stays in the UK. Both serve the same role, and neither removes the need for travel insurance.

The EHIC when you are moving within the EU

Here is the part that matters if you are relocating, not just holidaying. The EHIC covers temporary stays, so it is not the card that covers you in the country you move to once that country becomes your home.

When you settle in a new EU country and register in its public health system, you stop relying on your old country's card for everyday care, and you become entitled to a card issued by your new country. From then on, that new card is what covers your trips back home and elsewhere in the EU.

For cross-border situations and some pensioners, the right tool during a move is the S1 form, not the EHIC. The S1 arranges for one country to cover your healthcare while you live in another, which the EHIC is not designed to do.

So the honest framing for someone moving to Portugal, Spain or Italy is this: the EHIC is the travel companion you pick up once you are in the local system, and the first real step is getting registered, with a social security number and access to public health.

Registering in a new country's systems is exactly the kind of paperwork that is slow and easy to get wrong on your own, and the part of relocation AnchorLess guides you. Once you are set up locally, the European card follows.