TL;DR
As an FCA-authorised UK insurance expert that has helped arrange over 900,000 policies, WeCovr understands the nuances of private medical insurance. Since Brexit, the landscape for UK travellers seeking healthcare abroad has changed significantly. This guide demystifies the new rules, helping you travel with confidence in 2025 and beyond.
Key takeaways
- Cover for medically necessary treatment during a temporary stay.
- Treatment for pre-existing medical conditions and routine maternity care.
- It was free to obtain.
- Emergency treatment after an accident or sudden illness.
- Treatment for a long-term or pre-existing medical condition that becomes necessary during your stay.
As an FCA-authorised UK insurance expert that has helped arrange over 900,000 policies, WeCovr understands the nuances of private medical insurance. Since Brexit, the landscape for UK travellers seeking healthcare abroad has changed significantly. This guide demystifies the new rules, helping you travel with confidence in 2025 and beyond.
Cross-border cover, EHIC/GHIC rules, and where you stand in 2025
The UK's departure from the European Union reshaped many aspects of life, and healthcare for travellers is no exception. The familiar blue European Health Insurance Card (EHIC) is being phased out, replaced by a new system. For UK citizens who travel, whether for a two-week holiday, a business trip, or long-term residence, understanding these changes is crucial to ensure you are never left with an unexpected, and often staggering, medical bill.
This article breaks down the new reality of cross-border healthcare, explaining the role of the Global Health Insurance Card (GHIC) and, most importantly, where private medical insurance (PMI) fits into this new puzzle.
The Old System: A Quick Reminder of the EHIC
Before Brexit, UK citizens could apply for a European Health Insurance Card (EHIC). This simple card was a passport to state-provided healthcare within any country in the European Union, plus Iceland, Liechtenstein, Norway, and Switzerland.
An EHIC entitled you to the same level of state-provided medical treatment as a citizen of that country. If healthcare was free for them, it was free for you. If they paid a contribution (a 'patient share'), you paid the same amount.
Key features of the EHIC included:
- Cover for medically necessary treatment during a temporary stay.
- Treatment for pre-existing medical conditions and routine maternity care.
- It was free to obtain.
However, the EHIC was never a substitute for travel insurance. It did not cover private medical treatment, repatriation to the UK, mountain rescue, or costs related to trip cancellation or lost baggage. It was a valuable safety net, but one with significant gaps.
The Post-Brexit Shift: Introducing the GHIC
With the end of the UK-EU transition period, the EHIC system has been replaced for most UK residents by the Global Health Insurance Card (GHIC). While existing EHICs remain valid until their expiry date, all new applications will be for a GHIC.
What is the GHIC?
The GHIC provides similar cover to the EHIC but within a more limited geographical area. It allows UK residents to access state-run healthcare when visiting an EU country.
Crucially, the "Global" in its name is currently aspirational. As of 2025, the GHIC covers you in the 27 EU countries but not in other popular European destinations like Switzerland, Norway, Iceland, or Liechtenstein. The UK is pursuing agreements with other countries, but for now, its scope is limited to the EU bloc.
EHIC vs. GHIC: What's the Difference?
The primary difference is the geographical coverage. Here’s a simple breakdown:
| Feature | European Health Insurance Card (EHIC) | Global Health Insurance Card (GHIC) |
|---|---|---|
| Issuing Authority | UK Government (pre-Brexit) | UK Government (post-Brexit) |
| Cost | Free | Free |
| Geographical Cover | EU countries + Switzerland, Norway, Iceland, Liechtenstein | EU countries only |
| Type of Healthcare | Medically necessary state-provided healthcare | Medically necessary state-provided healthcare |
| Private Care Cover | No | No |
| Repatriation Cover | No | No |
Some UK nationals may still be eligible for a new UK-issued EHIC that covers them in Switzerland, Norway, Iceland, and Liechtenstein. This typically applies to EU citizens living in the UK before 1 January 2021 and certain UK students studying in the EU. You can check your eligibility on the official NHS website.
What Does the GHIC Actually Cover?
It's vital to understand the limitations of the GHIC. It is not a blank cheque for all medical needs.
The GHIC covers "medically necessary" treatment. This means treatment that cannot reasonably wait until you get back to the UK. The decision on whether treatment is necessary rests with the healthcare provider in the country you are visiting.
What's typically covered:
- Emergency treatment after an accident or sudden illness.
- Treatment for a long-term or pre-existing medical condition that becomes necessary during your stay.
- Routine maternity care, as long as you're not going abroad specifically to give birth.
- Oxygen and kidney dialysis, although this will need to be pre-arranged with the provider in the country you're visiting.
What's NOT covered:
- Private medical care: The GHIC only works in state-run hospitals and clinics.
- Medical Repatriation: The cost of getting you home via air ambulance or with a medical escort can run into tens of thousands of pounds. The GHIC does not cover this.
- Mountain rescue: If you have a skiing accident, the cost of being rescued from the slopes is not covered.
- Specific treatments: Any treatment that the local health authority deems non-essential or that could wait until your return to the UK.
- Going abroad to give birth: The GHIC covers routine maternity care but not if the express purpose of the trip is to give birth abroad.
Think of it this way: the GHIC might get your broken leg set in a Spanish state hospital, but it won't fly you home, it won't get you a private room, and it won't pay for your cancelled flight.
Where Private Medical Insurance (PMI) Fits In Post-Brexit
This is where the conversation turns from a basic safety net to comprehensive protection. Standard UK private medical insurance (PMI) is designed to cover the diagnosis and treatment of acute conditions that arise after you take out your policy.
Critical Point: A standard UK PMI policy does not cover chronic conditions (like diabetes or asthma) or pre-existing conditions you had before you joined. Its purpose is to provide swift access to high-quality private healthcare for new, curable medical issues within the UK.
However, many of the best PMI providers offer a "travel cover" or "overseas cover" add-on. This extension is specifically designed to fill the gaps left by the GHIC and standard holiday travel insurance, particularly in a post-Brexit world.
How Does a PMI Travel Add-On Work?
A travel add-on to your private health cover typically works in one of two ways:
- Emergency Overseas Cover: This provides cover for unexpected medical emergencies while you are abroad for a limited period (e.g., up to 90 days per trip). It acts as a high-end travel insurance policy, covering costs for private hospital stays, specialist consultations, and, crucially, medical evacuation and repatriation.
- International PMI: For those who spend significant time abroad, a full international private medical insurance policy might be more suitable. This provides comprehensive health cover in multiple countries, acting as your primary source of healthcare rather than just an emergency stop-gap.
The Key Benefits of a PMI Travel Extension
- Access to Private Facilities: If the local state hospital is overcrowded or doesn't meet your standards, a PMI travel extension gives you the option of being treated in a private clinic or hospital.
- Choice and Speed: You often get more choice over the specialist who treats you and can avoid long waiting lists that may exist in the local state system.
- Cover for Repatriation: This is one of the single biggest advantages. If you are seriously ill or injured, your policy can cover the cost of flying you back to the UK, either to an NHS or private hospital, once you are stable enough to travel.
- Peace of Mind in Non-EU Countries: In countries like Switzerland, Norway, or anywhere else in the world where the GHIC is not valid, a PMI travel add-on is no longer just a "nice to have"—it is essential.
Working with an experienced PMI broker like WeCovr can help you compare these add-ons. We can analyse policies from leading insurers to find the one that best matches your travel habits and health needs, all at no extra cost to you.
Navigating Cross-Border Healthcare in 2025: A Practical Guide
Your healthcare rights and needs vary significantly depending on where you are travelling. Here's a breakdown.
For Travel to EU Countries
- Always Carry Your GHIC: Make sure your GHIC is in date and carry it with you. Apply for a new one on the NHS website well before you travel if your old EHIC has expired.
- Understand the Local System: In some countries like France, you may be required to pay for your treatment upfront and claim a reimbursement later (a co-payment system). The GHIC allows you to be reimbursed at the same rate as a local citizen, but you will still be out of pocket initially.
- Supplement with Insurance: Due to co-payment systems, the lack of private care cover, and no repatriation benefit, comprehensive travel insurance or a PMI travel add-on is still highly recommended.
Example Scenario:
- Without PMI: You slip and break your wrist in Portugal. You're taken to a state hospital. You receive good care, but you have to wait several hours and the hospital is very busy. The GHIC covers the main cost of your treatment. You have to arrange and pay for your own flight home, struggling with your luggage and a fresh cast.
- With a PMI Travel Add-On: In the same scenario, you call your insurer's 24/7 helpline. They direct you to a nearby private clinic. You are seen within minutes. Your treatment is covered directly by the insurer. Once you are fit to fly, they may even arrange a business-class seat to give you more space and comfort on your journey home.
For Travel to Switzerland, Norway, Iceland, and Liechtenstein
This is a key area of change post-Brexit. For most UK travellers, the GHIC is not valid in these four countries. Therefore, you have no automatic right to state-funded healthcare.
You MUST have robust travel insurance or a private medical insurance UK policy with overseas cover before you travel. Medical treatment in these countries, particularly Switzerland and Norway, is notoriously expensive. A simple doctor's visit can cost hundreds of pounds, and a hospital stay can quickly escalate into the thousands.
For Travel to the Rest of the World
Outside of Europe, the GHIC is irrelevant. Comprehensive cover is non-negotiable. Whether you are travelling to the USA, Australia, or Thailand, you are personally liable for 100% of your medical costs.
Costs in countries like the USA are astronomical. According to 2021 data from the UK public and industry sources the average cost of a three-day hospital stay in the US is over $30,000. A PMI policy with a worldwide travel extension is one of the most reliable ways to protect yourself against such financially crippling costs.
The Impact on Specific Traveller Groups
Brexit's effects are not uniform; they impact different groups of travellers in distinct ways.
Retirees and Expats in the EU
Many UK nationals retire to countries like Spain, France, and Portugal. Before Brexit, their healthcare was covered through the 'S1 form' arrangement, which effectively registered them in the local state healthcare system, with the cost billed back to the NHS.
The good news is that for those covered by the UK-EU Withdrawal Agreement (i.e., those who were lawfully resident in an EU country before 31 December 2020), the S1 arrangement continues. They can continue to access state healthcare in their country of residence.
However, for those moving to an EU country after this date, the situation is more complex. They are generally not entitled to an S1 form and must arrange their own health cover, either by joining the local social security scheme (if eligible) or by purchasing private medical insurance. This makes having a robust private health cover plan essential for new UK expats.
Students Studying in the EU
UK students on courses in the EU may be eligible for a new UK-issued EHIC, depending on the duration and type of study. However, like tourists, this only covers necessary state care. A supplementary insurance plan is wise to cover any gaps, especially for repatriation.
Frequent Business Travellers
For those who travel regularly for work, Brexit has added a layer of administrative complexity. Ensuring you have the right cover for every single trip is vital. An annual multi-trip travel policy or, even better, an international PMI policy can simplify this, providing seamless cover across multiple jurisdictions without needing to arrange insurance for each individual journey.
Choosing Your Cover: A Traveller's Checklist
Before you travel, ask yourself these questions:
- Where am I going? Is it an EU country (GHIC valid) or elsewhere (GHIC not valid)?
- How long am I going for? A short holiday has different risks from a six-month stay.
- What will I be doing? A beach holiday is lower risk than a skiing or mountaineering trip.
- Do I have any pre-existing conditions? Remember, standard UK PMI won't cover these, but the GHIC might cover necessary treatment for them. Specialist travel insurance may be required.
- What is my risk tolerance? Are you comfortable with only having state-level care, or do you want the peace of mind that comes with private options?
Comparison of Cover Options
This table summarises your main options:
| Coverage Type | What It Covers Best | Key Limitations |
|---|---|---|
| GHIC | Necessary state-provided medical care in the EU. | No private care, no repatriation, limited geography (EU only). |
| Standard Travel Insurance | Trip cancellation, lost baggage, and emergency medical costs (including repatriation). | Medical cover can have low limits; may not cover all activities; quality of clinics can vary. |
| PMI with Travel Add-On | High-limit emergency medical costs, access to private hospitals, repatriation, choice of specialist. | Doesn't cover trip cancellation or baggage; doesn't cover pre-existing conditions. |
The ideal solution for many travellers is a combination: carry your GHIC, have a PMI policy with a travel extension for high-quality medical care, and consider a basic travel policy for cancellation and baggage protection.
To make this process easier, WeCovr provides a complimentary service that includes access to our AI-powered calorie and nutrition tracking app, CalorieHero, helping you stay healthy on your travels. Furthermore, clients who purchase PMI or life insurance through us often receive discounts on other insurance products, creating a comprehensive and cost-effective protection package.
The Financial Reality of Getting Ill Abroad
Underestimating the cost of healthcare abroad can be a disastrous mistake. While the GHIC provides a floor, the ceiling for costs without comprehensive insurance is limitless.
Illustrative Costs of Medical Treatment in Europe (Uninsured):
- Broken Leg (Spain) (illustrative): Treatment in a state hospital might be covered by GHIC, but if you need surgery in a private clinic and a medical escort home, costs could exceed £15,000.
- Heart Attack (France) (illustrative): Emergency state treatment would be covered by GHIC, but an air ambulance back to the UK could cost £20,000 - £25,000.
- Severe Food Poisoning (Italy) (illustrative): A few nights in a private hospital for observation and IV fluids could easily cost £5,000.
- Skiing Accident (Switzerland - No GHIC) (illustrative): Mountain rescue, hospital stay, surgery, and repatriation could total over £40,000.
These figures, based on industry reports and averages, show that relying solely on the GHIC is a significant financial gamble. A robust private medical insurance policy in the UK with an overseas extension is an investment in your financial security and well-being.
Do I still need travel insurance if I have a GHIC?
Does my UK private medical insurance cover my pre-existing conditions when I travel?
Is a PMI travel add-on better than standard travel insurance for medical cover?
Where can I get help choosing the right private health cover for travel?
The rules have changed, but travelling with confidence is still entirely possible. By understanding the roles of the GHIC and private medical insurance, you can build a safety net that protects your health and your finances, no matter where your journey takes you.
Ready to explore your options? Get a free, no-obligation private medical insurance quote from WeCovr today and ensure you have the best protection for your travels.
Sources
- Office for National Statistics (ONS): Mortality, earnings, and household statistics.
- Financial Conduct Authority (FCA): Insurance and consumer protection guidance.
- Association of British Insurers (ABI): Life insurance and protection market publications.
- HMRC: Tax treatment guidance for relevant protection and benefits products.







