Can You Use Your EHIC Instead of Health Insurance Abroad?
Your European Health Insurance Card (EHIC) gives you access to public healthcare across the EU at the same cost as locals — but it is NOT a replacement for full health insurance when studying abroad. The EHIC covers emergency and medically necessary treatment through public providers, but it does not cover medical repatriation, private hospitals, dental prosthetics, or comprehensive mental health therapy. In many EU countries, the moment you take a part-time job, your EHIC alone is no longer legally sufficient. Here is exactly what the EHIC covers, what it does not, and when you need additional coverage — country by country.
Short answer: the EHIC works for short stays and emergencies, but falls short for a full semester or year abroad. Here is what you need to know, country by country.
What Is the EHIC?
The European Health Insurance Card (EHIC) is a free card issued by your home country’s national health authority. It proves that you are insured in an EU/EEA country and entitles you to medically necessary, state-provided healthcare during a temporary stay in any of the 27 EU member states, plus Iceland, Liechtenstein, Norway, and Switzerland.
Key facts about the EHIC
- Free to obtain — apply through your home country’s health insurer or social security authority
- Valid for up to 5 years (varies by country)
- Covers medically necessary treatment at state-run hospitals and doctors
- Same conditions as locals — you pay the same co-pays (or nothing) that residents of the host country pay
- Not travel insurance — it was never designed to replace comprehensive health coverage
- Based on EU Regulation 883/2004 on the coordination of social security systems
The EHIC works on a simple principle: when you are temporarily in another EU country, you receive necessary medical treatment under the same conditions and at the same cost as people insured in that country. If healthcare is free for locals, it is free for you. If locals pay a co-payment, you pay the same co-payment.
EHIC vs. S1 Form — What Is the Difference?
You may have heard of the S1 form (formerly E106/E109). While the EHIC is for temporary stays, the S1 form is a “Portable Document” that transfers your health coverage from your home country to the host country for a longer period. It allows you to register with the host country’s national health service as if you were a local resident — including access to a GP, specialist referrals, and the full benefits package.
In practice, some EU countries (notably Italy) encourage or require students staying longer than 3 months to obtain an S1 form rather than relying on the EHIC. However, not all home countries issue S1 forms to students easily, and the availability depends on your national authority’s policies. If you can get one, it provides significantly broader coverage than the EHIC alone.
What the EHIC Covers
The EHIC provides access to medically necessary treatment in the public healthcare system of any EU/EEA country. Specifically, it covers:
- Emergency treatment — ambulance, accident & emergency departments, urgent surgery
- Medically necessary treatment — conditions that arise during your stay and cannot wait until you return home
- Ongoing treatment for chronic conditions — if you have diabetes, asthma, or another pre-existing condition, the EHIC covers continued treatment (e.g., insulin, inhalers, check-ups)
- Routine maternity care — prenatal appointments and delivery if you are already pregnant (but you cannot travel abroad with the purpose of giving birth)
- Kidney dialysis, oxygen therapy, chemotherapy — if you need ongoing treatments, the EHIC covers them at state-run facilities (book ahead with the local provider)
- Prescriptions — medications prescribed by a state-run doctor, at the same cost as locals pay
Important: “Same Cost as Locals” Can Still Mean Co-Payments
In many EU countries, residents pay co-payments for healthcare. For example:
| Country | Typical Co-Payment |
|---|---|
| France | 30% of medical costs (Sécurité Sociale reimburses 70%) |
| Germany | €10 per quarter for non-emergency ambulance transport |
| Sweden | SEK 250–400 (~€22–35) per GP visit |
| Italy | €36.15 “ticket” fee for specialist visits |
| Belgium | ~25% of costs for most outpatient care |
With your EHIC, you pay these same co-payments. You are not entitled to free care in every country — only to the same terms as insured residents.
What the EHIC Does NOT Cover
This is where many students get caught out. The EHIC has significant gaps that can lead to bills of thousands of euros:
1. Medical Repatriation — The Biggest Gap
If you are seriously ill or injured and need to be flown home, the EHIC does not cover any repatriation costs. An air ambulance from Spain to Poland can cost €15,000–€40,000. A medical repatriation flight from Sweden to Greece can exceed €20,000. Without supplementary insurance, you or your family would have to pay this out of pocket.
This is by far the most critical gap. Student and travel insurance policies almost always include medical repatriation coverage of €100,000 or more.
2. Private Hospitals and Doctors
The EHIC only covers treatment at state-run or state-contracted facilities. If you go to a private hospital or private doctor, you pay the full cost yourself. In many countries, especially Spain and Italy, private care is significantly faster — but the EHIC will not help you there.
3. Dental Treatment Beyond Emergencies
Most EU countries limit publicly funded dental care. The EHIC covers emergency dental treatment (e.g., extracting an infected tooth) but typically not:
- Dental prosthetics (crowns, bridges, implants)
- Orthodontics
- Cosmetic dentistry
- Routine check-ups and cleaning (in most countries)
If you need a crown or root canal while studying abroad, expect to pay €300–€1,500 without supplementary dental insurance.
4. Comprehensive Mental Health Treatment
The EHIC covers acute psychiatric emergencies. However, ongoing psychotherapy, counselling, or mental health treatment is handled very differently across EU countries. In many countries, there are long waiting lists for public mental health services (6–12 months in Germany, for example), and private mental health coverage is not covered by the EHIC.
5. Planned Treatment
If you travel to another EU country specifically to receive medical treatment, the EHIC does not cover it. You need a separate authorization (S2 form) for planned cross-border treatment.
6. Mountain Rescue, Helicopter Evacuation, Search and Rescue
Studying in Austria and going skiing? The EHIC does not cover mountain rescue, helicopter evacuations from ski slopes, or search-and-rescue operations. These can cost €5,000–€15,000 in the Alps.
7. Personal Liability and Legal Assistance
The EHIC is purely a healthcare card. It does not cover any damage you cause to others (personal liability) or legal assistance — both of which are commonly included in student insurance packages.
Summary: EHIC Coverage Gaps
| Covered by EHIC | NOT Covered by EHIC |
|---|---|
| Emergency treatment at public facilities | Medical repatriation |
| Medically necessary treatment | Private hospitals/doctors |
| Chronic condition management | Dental prosthetics, orthodontics |
| Prescriptions at local rates | Comprehensive mental health therapy |
| Routine maternity care | Planned cross-border treatment |
| Dialysis, chemo, oxygen therapy | Mountain/helicopter rescue |
| Personal liability |
Country-by-Country: Is EHIC Enough for University Enrollment?
Here is where it gets complicated. Each EU country has different rules about whether the EHIC is accepted for university enrollment, residence registration, and — critically — what happens when you start working.
Germany: EHIC Accepted, But Working Changes Everything
For enrollment: German universities accept the EHIC for enrollment (Immatrikulation). EU/EEA students present their EHIC at a German statutory health insurance fund (like TK, AOK, or Barmer), which then confirms your insurance status to the university via a so-called “M10” notification. You do not need to pay for German health insurance as long as you are not employed in Germany.
The working student trap: The moment you take any employment in Germany — even a mini-job earning €1/month — you become subject to German social security law. EU students with a side job in Germany must have German health insurance. This is based on the Lex loci laboris principle (German: Beschäftigungsstaatsprinzip — the law of the country where you work applies). Your EHIC from your home country is no longer sufficient once you are employed.
This means:
- Not working: EHIC is sufficient for enrollment and healthcare access
- Working (any amount): You must join German public health insurance (GKV) at the student rate of approximately €120/month, or get private health insurance
Read our complete guide to student health insurance in Germany and our detailed article on working as a student in Germany for the full picture.
Bottom line for Germany: If you plan to work at all during your studies — and most students do — budget for German health insurance from day one.
France: EHIC + Sécurité Sociale Registration
For enrollment: All students in France — including EU students with an EHIC — must register with the French Sécurité Sociale (social security system). Since the 2019 reform, this registration is free. You also need to pay the CVEC contribution (Contribution Vie Etudiante et de Campus) of €105 for 2025/2026, which funds student services.
How it works for EU students:
- Present your EHIC when registering with Sécurité Sociale
- You are automatically affiliated with the French system
- Sécurité Sociale reimburses 70% of medical costs — you pay the remaining 30%
- A mutuelle (top-up insurance) costs €10–€50/month and covers the remaining 30%
Is EHIC enough? Technically yes, but practically most students find the 30% co-payment problematic. A GP visit costs €26.50 in France, of which you would pay €7.95 with EHIC alone. Specialist visits, lab tests, and prescriptions add up quickly. A basic mutuelle at €10–€15/month eliminates these out-of-pocket costs.
Explore our France student insurance guide for full details on the Sécurité Sociale system and mutuelle options.
Netherlands: Mandatory Dutch Insurance If You Work
For enrollment: EU students who are purely studying (not working) can use their EHIC in the Netherlands. Universities accept the EHIC for enrollment.
The employment trigger: If you take any paid employment — including a part-time job, internship, or zero-hours contract — you are legally required to purchase Dutch basic health insurance (basisverzekering). Since September 2025, even EU students with a paid internship must have Dutch insurance. The basisverzekering costs approximately €148/month in 2026, with a mandatory annual deductible (eigen risico) of €385.
Good news: Low-income students (earning below ~€38,520/year) qualify for the zorgtoeslag (healthcare allowance) of up to €144/month, which can nearly cover the entire insurance premium.
The rules in summary:
| Situation | Insurance Required |
|---|---|
| Studying only, no work | EHIC sufficient |
| Any paid work (even zero-hours) | Dutch basisverzekering mandatory |
| Internship with pay (since Sept 2025) | Dutch basisverzekering mandatory |
| Unpaid internship | EHIC sufficient |
Read our full Netherlands student insurance guide for details on the zorgtoeslag application process and the best Dutch insurance providers for students.
Spain: EHIC Covers Public Healthcare
For enrollment: EU students can use the EHIC in Spain to access the public healthcare system (Seguridad Social). Most universities accept the EHIC for enrollment, though some regional NIE offices may request additional documentation.
What works well: Spain’s public healthcare is comprehensive and largely free at the point of care for residents and EHIC holders. GP visits, hospital stays, and emergency care are covered with minimal or no co-payments.
Limitations: Waiting times in the public system can be long (weeks for specialists), private healthcare is not covered by the EHIC, and dental care is limited to extractions and emergency treatment. Many international students in Spain opt for private insurance (from €35/month) for faster access and English-speaking doctors.
See our Spain student insurance guide for private insurance options and NIE registration requirements.
Italy: EHIC for Short Stays, S1 Form for Longer
For stays under 3 months: The EHIC is sufficient for accessing the Italian public healthcare system (SSN — Servizio Sanitario Nazionale).
For stays over 3 months: Italy encourages students to register with the SSN. EU students can do this by presenting an S1 form from their home country. If you cannot obtain an S1 form, you can register with the SSN by paying an annual fee of €149.77 — which gives you the same healthcare access as Italian citizens, including a local GP (medico di base).
Important: If you have neither an S1 form nor SSN registration, and your EHIC is your only coverage, you are limited to emergency and necessary treatment at public facilities. You will not have a GP or be able to easily access specialists.
Explore our Italy student insurance guide for SSN registration steps and private alternatives.
Austria: EHIC Accepted, But OeGK Recommended
For enrollment: Austrian universities accept the EHIC. EU students can access the public healthcare system with their EHIC card.
Recommended: The Austrian student health insurance through OeGK (Oesterreichische Gesundheitskasse) costs €78.84/month (2026) and provides full access to the Austrian healthcare system, including a GP (Hausarzt), specialists, and an e-card. Many universities and student organizations recommend joining OeGK even if you have an EHIC, as it simplifies bureaucracy and provides more seamless access.
Read our Austria student insurance guide for full details.
Sweden: EHIC Covers EU Students Well
For EU students: Sweden is one of the most EHIC-friendly countries. EU students with a valid EHIC have full access to the Swedish healthcare system at the same rates as Swedish residents. Healthcare in Sweden has small patient fees (typically SEK 250–400 / €22–35 per GP visit) but is otherwise comprehensive.
Registration: EU students staying for longer programs should register with Forsakringskassan (Swedish Social Insurance Agency) for smoother access.
Note: Sweden has an annual out-of-pocket cap (hogkostnadsskydd) of SEK 1,400 (€125) for healthcare and SEK 2,850 (€255) for prescriptions. Once you hit these limits, care and medication are free for the rest of the year.
See our Sweden student insurance guide for non-EU student requirements and Forsakringskassan registration.
Other EU Countries — Quick Overview
| Country | EHIC for Enrollment? | Key Notes |
|---|---|---|
| Belgium | Yes | Co-payments of ~25% for outpatient care. Mutuelle recommended. |
| Denmark | Yes | Free healthcare for registered residents. EU students register at citizen service center. |
| Finland | Yes | Small patient fees (€20–40 per visit). KELA registration for longer stays. |
| Greece | Yes | Public healthcare free at point of care. Long waiting times for specialists. |
| Ireland | Yes | GP visits cost €55–65 even for residents (not covered by medical card unless low-income). |
| Poland | Yes | Very affordable public healthcare. No co-payments in most cases. |
| Portugal | Yes | Public healthcare with small fees (€4.50 per GP visit). Good coverage. |
| Czech Republic | Yes | Free public healthcare for insured persons. |
The “Working Student” Trap — Why EHIC Stops Being Enough
This deserves its own section because it catches thousands of EU students every year.
The EU principle of Lex loci laboris (law of the place of employment) means that the country where you work determines your social security obligations — including health insurance. The moment you take a job in your host country, you generally fall under that country’s social security system, not your home country’s.
What this means in practice
- Germany: Any employment (even a minijob) requires German health insurance. Your EHIC from France, Poland, or Spain is no longer valid as your primary coverage.
- Netherlands: Any paid work (including paid internships since September 2025) triggers mandatory Dutch basisverzekering at ~€148/month.
- Austria: Employment triggers mandatory Austrian social security contributions, including health insurance through OeGK.
- France: If you work in France, you are covered by the French Sécurité Sociale through your employer’s contributions. Your home country’s EHIC takes a back seat.
- Belgium: Working students must register with a Belgian mutualiteit (health insurance fund).
The financial impact
Many EU students plan to work 10–20 hours per week to fund their studies. If you budget only for EHIC coverage and then discover you need to pay €120–€150/month for local health insurance, that is an unexpected expense of €1,440–€1,800 per year. Plan for this from the start.
Our article on working as a student in Germany covers the detailed rules, tax implications, and insurance obligations for Werkstudent positions.
Erasmus+ and EHIC — What Erasmus Provides (and What It Does Not)
Erasmus+ is the EU’s flagship exchange program, sending over 600,000 students abroad each year. Many Erasmus students assume the program provides insurance. It does not.
What Erasmus+ provides
- A monthly grant (€250–€700 depending on the destination country and type of mobility)
- Academic coordination between universities
- No health insurance whatsoever
What Erasmus recommends
The European Commission and the EACEA (Education, Audiovisual and Culture Executive Agency) set minimum insurance requirements for Erasmus+ participants:
- EHIC — You should have a valid EHIC from your home country
- Supplementary insurance — The Commission recommends additional insurance covering:
- Medical repatriation
- Personal liability
- Accident coverage
- Luggage/travel disruption
Cost of supplementary insurance for Erasmus
A supplementary policy that fills the EHIC’s gaps typically costs €20–€40/month. Some universities have group deals with insurance providers for their Erasmus students — always check with your international office.
For more on health insurance for exchange students, including Erasmus-specific advice, see our dedicated guide.
GHIC for UK Students — What Changed Post-Brexit
After Brexit, UK residents lost access to the EHIC. The UK Global Health Insurance Card (GHIC) is the replacement, and it covers UK residents traveling to or studying in the EU.
What the GHIC covers
- Same coverage as the EHIC — medically necessary treatment at state-run facilities in EU countries, Switzerland, Norway, Iceland, and Liechtenstein
- Same conditions as locals — same co-payments, same access to public healthcare
- Valid for 5 years, free to apply via the NHS website
- Students studying in the EU are explicitly covered
What the GHIC does NOT cover
- Exactly the same gaps as the EHIC: no repatriation, no private care, no dental prosthetics, no planned treatment
- Does not cover healthcare outside the EU (unlike the EHIC, which covers EEA + Switzerland)
- Not valid in non-EU countries — if you travel to Turkey, the Balkans, or other non-EU countries during your studies, the GHIC offers no protection
GHIC vs. EHIC — Key Differences
| Feature | EHIC | GHIC |
|---|---|---|
| Issued to | EU/EEA/Swiss residents | UK residents |
| Valid in | 27 EU + EEA + Switzerland | 27 EU + EEA + Switzerland |
| Coverage | Medically necessary treatment | Medically necessary treatment |
| Repatriation | No | No |
| Private care | No | No |
| Validity | Up to 5 years | 5 years |
| Application | Home country health authority | NHS website (free) |
| Post-Brexit status | Still valid for EU citizens | Replaced EHIC for UK residents |
Important for UK students
If you held a UK EHIC before Brexit, it may still be valid until its expiry date. Nearly 2 million UK EHICs expired in 2025 and nearly a million more are expiring in 2026. Once expired, you must apply for a GHIC.
Bottom line: The GHIC gives UK students the same basic protections as the EHIC, but the same gaps apply. You still need supplementary insurance, especially for repatriation and dental coverage.
When to Get Additional Insurance — A Decision Checklist
Use this checklist to determine whether your EHIC/GHIC alone is enough:
You NEED additional insurance if:
- You plan to work in your host country (even part-time, even a minijob)
- Your stay is longer than 12 months (S1 form or local insurance recommended)
- You want access to private doctors or hospitals (faster appointments, English-speaking)
- You need dental treatment beyond emergencies
- You want mental health/therapy coverage
- Your host country has high co-payments (France: 30%, Ireland: €55–65 per GP visit)
- You want repatriation coverage (strongly recommended for everyone)
- You plan to travel outside the EU during your studies (EHIC/GHIC is invalid)
- Your university or visa office requires comprehensive insurance beyond the EHIC
EHIC alone MAY be enough if:
- You are on a short exchange (1 semester / 3–6 months)
- You will not work in the host country
- Your host country has low or no co-payments (Germany, Denmark, Czech Republic)
- You have a separate repatriation insurance from your home country
- You are comfortable with public healthcare only
Even if you fall into the “may be enough” category, a supplementary policy at €20–€40/month is a modest investment for significant peace of mind.
Recommended Supplementary Insurance Options
If you decide the EHIC alone is not enough (and for most students studying abroad for a full year, it is not), here are your options:
1. EHIC Supplementary / Top-Up Insurance (€15–€40/month)
These policies are specifically designed to fill EHIC gaps:
- Medical repatriation (€100,000+)
- Private doctor/hospital access
- Dental treatment
- Personal liability
- Luggage and travel disruption
- 24/7 assistance hotline
This is the most cost-effective option for EU students who already have an EHIC and just need to close the gaps.
2. Full International Student Insurance (€40–€120/month)
If your EHIC is expired, invalid, or if you need to meet strict visa/enrollment requirements, a comprehensive international student insurance policy covers everything:
- All medical treatment (public and private)
- Dental and optical
- Mental health
- Repatriation
- Personal liability
- Often accepted for visa applications
3. Host Country Local Insurance
In countries where you must join the local system (Germany if working, Netherlands if working), you will need to enroll in the national insurance scheme:
- Germany GKV: ~€120/month student rate
- Netherlands basisverzekering: ~€148/month (minus zorgtoeslag subsidy)
- Austria OeGK: €78.84/month
- France mutuelle: €10–€50/month (on top of free Sécurité Sociale)
Compare student insurance plans and find the right coverage for your destination on our destinations overview.
Frequently Asked Questions
Is the EHIC enough for Erasmus?
The EHIC covers emergency and necessary medical treatment during an Erasmus exchange. However, it does not cover medical repatriation, private care, or comprehensive dental treatment. The European Commission recommends supplementary insurance for all Erasmus participants. A top-up policy costs €20–€40/month and is strongly recommended.
Do I need EHIC AND health insurance?
It depends on your situation. If you are only studying (not working) and your host country accepts the EHIC for enrollment, you can rely on the EHIC for basic public healthcare. However, you should get additional insurance if you plan to work, want private healthcare access, or need dental/mental health coverage. Most students benefit from at least a supplementary policy alongside their EHIC.
What happens if I work part-time while studying abroad?
In most EU countries, taking any employment triggers local social security obligations. In Germany, any employment requires German health insurance. In the Netherlands, any paid work (including paid internships) requires Dutch basisverzekering. Your EHIC from your home country is no longer sufficient as primary coverage.
Can I use my EHIC at a private hospital?
No. The EHIC only covers treatment at state-run or state-contracted healthcare providers. Private hospitals, private clinics, and private doctors are not covered. You pay the full cost yourself unless you have supplementary or private insurance.
Is the EHIC valid for a full degree abroad (3+ years)?
Technically, the EHIC is designed for temporary stays. If you relocate to another EU country for a full degree, you may be expected to register with the local healthcare system. In practice, many EU countries accept the EHIC for student enrollment regardless of program length, but some (like Italy for stays over 3 months) prefer the S1 form or local registration. Check with your specific university.
What is the difference between EHIC and GHIC?
The EHIC is issued to EU/EEA residents. The GHIC (Global Health Insurance Card) is the UK’s post-Brexit replacement, issued to UK residents. Both provide the same basic coverage: medically necessary treatment at public facilities in EU countries. The main difference is who issues them and eligibility.
Does the EHIC cover repatriation?
No. This is the single biggest gap in EHIC coverage. If you need to be transported back to your home country due to a serious illness or injury, the EHIC does not cover any of the costs. Medical repatriation can cost €15,000–€40,000 or more. Supplementary insurance with repatriation coverage is strongly recommended for all students abroad.
My EHIC expired — what should I do?
Apply for a new one through your home country’s health authority. Processing times vary (1–4 weeks). In the meantime, you can request a Provisional Replacement Certificate (PRC) which provides the same coverage as the EHIC for a limited period. If you are a UK resident and your EHIC expired after Brexit, you need to apply for a GHIC instead through the NHS website.
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