What happens if you need healthcare abroad, and what does a GHIC actually cover?
It depends entirely on where you are and what agreement exists — and the most expensive misunderstanding in travel is believing a state health card is a substitute for insurance. It is not, and the two cover different things.
What a GHIC or EHIC provides. Access to state-provided healthcare in participating countries, on the same terms as a resident of that country — which is the key phrase and the source of most surprises.
Same terms as a resident means:
Where residents pay a contribution, so do you. Many countries charge co-payments for consultations, prescriptions and hospital stays, and a card does not remove them.
Where treatment is private, it is not covered at all. Walking into a private clinic — which is what many resorts and tourist areas offer, and what a hotel will recommend — falls entirely outside the card.
It covers medically necessary treatment until your planned return, including care for pre-existing conditions, routine maternity care where you are not travelling to give birth, and dialysis or oxygen therapy if arranged in advance.
What it does not cover at all, and this is where insurance is essential:
Repatriation. Being flown home with medical escort can cost tens of thousands, and no state health card covers it in any country. This is the single biggest financial exposure in travel.
Mountain rescue, which is charged for in several countries.
Private treatment, cutting short a trip, or returning for a funeral.
Lost belongings or cancellation.
Where no agreement exists. In much of the world you are a private patient, payment is expected upfront or a guarantee is required from your insurer, and hospitals may withhold discharge until payment is settled.
What to actually do:
Carry both a valid card and insurance, and tell the insurer about pre-existing conditions — non-disclosure is the most common reason claims are refused.
Call your insurer's emergency line before treatment where possible, since many policies require authorisation.
Keep every receipt and record, since reimbursement depends on documentation.
Check reciprocal agreements, which exist with some countries outside the card scheme.
General information, not medical or insurance advice.