Healthcare
EHIC / GHIC Card
Also known as: European Health Insurance Card, GHIC, Global Health Insurance Card
The EHIC was introduced in 2004 to replace the earlier E111 paper form. It's issued free of charge by the holder's national health authority (Spanish INSS, UK NHS via the GHIC equivalent post-Brexit, German TK or AOK, etc.) and is valid for 1-10 years depending on issuer.
What EHIC/GHIC covers:
• Necessary medical care during a temporary stay in another EU/EEA country (or Switzerland for EHIC; the GHIC covers EU/EEA but not Switzerland — UK residents need a separate provision for Swiss travel).
• Treatment is provided on the same terms as a local resident — meaning if locals pay a co-payment, EHIC holders pay the same co-payment.
• Examples: emergency-room visit in Spain when the holder is on holiday from Germany; diabetes care for a Polish resident on a 3-week trip to France; treatment of a chronic condition exacerbation in Italy for a Belgian retiree on holiday.
What EHIC/GHIC does NOT cover:
• Private healthcare facilities — only state-funded providers honour the card.
• Medical tourism (deliberately seeking treatment in another country) — covered separately under EU Directive 2011/24 on Cross-Border Healthcare, with prior-authorisation requirements and reimbursement at home-country rates.
• Repatriation / medical evacuation — not covered. Travel insurance is needed.
• Long-term residents — once an EU national takes residence in another EU country and registers with the local health system, the home-country EHIC ceases to be the operative document. The new country's local registration takes precedence.
• Non-EHIC countries — does not work in the US, Canada, Australia, Türkiye, most of Asia, Africa, or Latin America. Travel or international health insurance is required.
For expats:
• If you're a UK national who moved to Spain pre-Brexit and have S1 (frontier worker / pensioner) status, the UK pays Spain to cover your healthcare under bilateral provisions. Your S1 card and Spanish TIS card together provide full access; EHIC/GHIC is for short-term holidays elsewhere in the EU.
• If you're a US citizen residing in Portugal on a D7, you don't have EHIC but you can register with Portugal's SNS as a legal resident, which gives broader cover than EHIC anyway.
• If you're an Irish citizen on holiday in Italy, your Irish-issued EHIC (or PRSI-equivalent) covers necessary care at the Italian SSN.
Sources
Last factual review: 2026-05-08.
Related terms
SNS (Serviço Nacional de Saúde Portugal)
The Serviço Nacional de Saúde is Portugal's universal public health service, established by the 1979 Health System Law. SNS provides primary care, specialist care, hospitalisation, and emergency services. Most services are free at the point of use or carry small co-payments (€4-€20 per consultation, capped). Legal residents — including holders of D7, D8, and Golden Visa permits — are entitled to register and use SNS on the same terms as Portuguese citizens.
International Health Insurance
International Private Medical Insurance (IPMI) is health coverage designed for individuals living abroad. It covers in-patient and out-patient care across multiple countries, typically with worldwide options excluding or including the US. Major providers: Cigna Global, Allianz Care, Bupa Global, GeoBlue, William Russell, IMG Global. Annual premiums for a healthy 40-year-old expat range $2,500-$8,000+ depending on coverage scope, deductible, and US inclusion.
Schengen Area
The Schengen Area is a passport-free travel zone of 29 European countries (27 EU + Iceland, Norway, Switzerland, Liechtenstein), where internal border checks are abolished. Non-EU short-stay visitors can spend up to 90 days within any rolling 180-day period across the entire area. Romania and Bulgaria fully joined for land borders on 1 January 2025, completing the area's expansion.