Everyone should have a European Health Card, as it entitles you to basic medical care in all member states of the EU plus a few others with reciprocal agreements (but not, annoyingly, the Channel Islands). There is a temptation to think that if you are travelling to one of these countries you do not really need to buy normal travel insurance.
This is not necessarily a good idea – unless you are aware of the risk you are taking. The level of health care offered in Europe varies from country to country and, in many countries, you will have to pay for some things that would be free in Britain. If you need to be repatriated, you could face substantial costs – even buying an extra seat on an aircraft, if you break a leg, could cost you quite a large sum. Also, you will be missing all the normal travel insurance items such as cancellation cover, third-party liability (easily forgotten, but it can be very important in rare instances), baggage etc.
EHICPlus is an insurance designed to work as a top-up to the EHIC card. It gives cover for the standard travel items such as baggage mentioned above – but, often, for slightly lower limits than the more expensive normal policies. Repatriation is also covered. The medical section of the policy is limited to £2 million (compared to £5 million or £10 million for more expensive policies) and this pays for all the extras that are not covered by the state in whichever country you happen to fall ill (these can mount up since most countries make some form of charge for accommodation and medication as well as other items). There is no cover for treatment in private hospitals. In the event of an accident or going to a hospital, you have to insist that you are taken to a state hospital. As with a standard travel policy, there is a medical helpline and you must inform them immediately you go to hospital to ensure you are covered and they can agree your care and charges.
There are a number of disadvantages with this policy. First, the quality of medical care varies between European countries. In France, Germany, the Netherlands and some other countries, it is at least as good as Britain’s, but there are places where you really would not wish to subject yourself to a state hospital. Second, we are just a little concerned about the practicalities of having to insist to hotel staff when you have collapsed from food poisoning that you must have state treatment. Well-meaning hoteliers (or less-well-meaning ones on commission) may pack you off to a private hospital willy-nilly.
Obviously, the major advantage of the policy should be its price but, again, we are not fully convinced by this. An annual policy costs around £20 but there are standard policies on the market for less than £40 – and they cover more countries and offer full private health care.
The main market for this cover is probably older people, especially those who have some form of health condition that makes standard insurance unaffordable. The policy has no upper age limit but, like any other insurer, EHICPlus insists that you declare any existing illnesses and it will increase the premium to allow for these. However, since so much of the health risk is taken away, the level of increase should be much smaller than with a standard policy.
We feel that EHICPlus would be a false economy for most people. If age or your medical record, or both, mean that your travel insurance is too expensive and if you are going to one of the European countries with a good standard of state care, then it might be worth looking at this policy – providing you still get quotes from standard insurers for comparison and that you are visiting a European country with a satisfactory health service.
Note: Many standard travel policies will delete the deductible if you begin your health treatment in a state hospital or if you are able to claim back some of the costs using your EHIC. You should read your policy carefully to check what the specific requirements are.
o If you are buying insurance to cover a single trip, as opposed to an annual, multi-trip policy, you should buy the policy as soon as you have spent a significant amount of money. Many people leave purchasing insurance until just before departure but they lose the benefit of the cover for cancellation. Obviously, if your flights and hotel are fully flexible, you have nothing to lose but it is more common to buy some form of fixed arrangement, which you would lose if you had to cancel.
o Most travel policies specifically exclude losses when you are ‘under the influence’. The exact wording varies between insurers and so it is worth checking the specific exclusion in your policy. A few years ago, we mentioned the story of a lady who fell down the stairs at a villa in Florida. Presumably, the hospital noted that her breath smelled of alcohol (or perhaps she was very obviously drunk). The insurers were informed and refused to make a payment, leaving the lady with a medical bill of over £50,000. We doubt that many insurers would invoke the clause in normal circumstances, but they may well try to deny a claim for a lost wallet if you said you were in a nightclub at the time. Besides this, drinking and driving is not just a criminal offence in most countries but also almost certain to invalidate your insurance.
o Annual multi-trip policies require that you inform the company immediately of any change to your health. If the application form asked you to confirm that you do not take any medication and you start to take some pills during the period of your insurance, you should inform the insurers, or they could reject a claim.
o The duty of disclosure about your own health is normally extended to any relatives whose illness or death would require you to cut short your holiday. If your mother-in-law has a serious heart problem and suddenly has a heart attack while you are in California, it is quite unlikely the insurers will pay for your return home, unless you told them of her condition when you bought the policy.
o The reciprocal health scheme with the Channel Islands expired in May. This has received very little publicity but means that anyone going to the Islands must have normal medical travel insurance. The Channel Islands are not in the EU; so your EHIC card is of no benefit.
o Insurers will only accept liability for hospital costs from the time they have been contacted on the medical emergency helpline and approved the treatment. Obviously, it is unlikely you will have the presence of mind to call them from the back of an ambulance as you are whisked off to hospital with a heart attack, but you need to do this as soon as is practicable.