Travel insurance for residents and what your EHIC covers

Key rules

• EHIC: Your card is a safety net for state care only, so buy private cover for everything it excludes.
• Medical limit: Choose a higher medical limit for the USA, Canada and other costly destinations.
• Cancellation: Changing your mind is normally not a covered reason to cancel.
• Baggage claims: Get a loss report from the airline or police, or your baggage claim may fail.

What your EHIC gives you

The EHIC covers only medically necessary state-provided care at local rates. It does not cover private care, repatriation, cancellation, baggage or delays. Treat it as a basic safety net, not as travel insurance.

In Spain the card is the Tarjeta Sanitaria Europea. It is issued by the INSS and is for people insured in the Spanish public health system and their dependants. It works for temporary stays in participating countries, not for moving abroad.

Care is given on the same terms as for insured residents of that country. It is free where locals pay nothing. Where locals pay a co-payment, you pay it too. Reimbursement and co-payment rules differ by country.

What it can cover

• Emergencies that arise during your stay.
• Treatment of a chronic or existing condition that needs care during the visit.
• Routine maternity care.
• Oxygen or dialysis, which may need arranging in advance.

The treatment must come from a public provider, or one contracted to the state system. Planning a trip in order to get treatment is not covered.

What it does not cover

• Private healthcare.
• Medical transport home, and mountain rescue.
• Trip cancellation, lost or stolen baggage, theft and delays.
• Anything the local public system itself does not cover.

These gaps are why most residents add private travel insurance.

Choosing private cover

Match the cover to the trip. Check three things.

Medical expenses. Limits are usually lower for Europe than for worldwide trips. Basic European plans typically sit in the tens of thousands of euros. For the USA, Canada and similar places, choose a much higher limit, because care costs far more there. Check the exact limit in the policy before you buy.

Cancellation. Cover usually applies to:

• serious illness, accident or death of you, a close relative or your travelling companion;
• a court summons or jury duty;
• serious damage to your home or business;
• dismissal from work or a forced change of job dates;
• unforeseen quarantine.

Some plans add pregnancy complications, a failed exam or visa refusal. "Cancel for any reason" is sometimes an upgrade, with a partial refund. Common exclusions are chronic or existing conditions, changing your mind, events you knew about when you booked, and epidemics unless named. Dental, mental-health and pregnancy cover tend to be restricted. Read the exclusions before you pay.

Baggage. Policies usually cover lost, stolen or damaged bags up to a total of a few hundred to a few thousand euros. There is a per-item cap, with lower limits for electronics, jewellery and cameras. Delayed baggage is often a smaller, separate amount. You generally need a loss report from the airline or the police, so get one before you leave the airport or place.

Single trip or annual

The comparison below sets out single-trip, annual, card-linked and EHIC cover side by side. Annual policies suit frequent travellers. A single-trip policy suits one expensive or distant trip. The questions below cover pre-existing conditions, refunds when you change your mind, and normal limits.

Single-trip, annual, card and EHIC cover compared

Single-trip, annual and card cover can all pay for medical care abroad, but they differ on cancellation, home-country trips and price. The EHIC is much narrower. The right choice depends on the trip: where you go, how often, and whether you have money at stake in the booking.

The four sources side by side

How to choose

• One short trip in Europe: a single-trip policy is the cheapest way to get real medical cover. Add cancellation only if you have prepaid flights or hotels you could lose.
• Several trips a year: an annual policy usually costs less than buying single-trip cover each time. Check the maximum trip length against your longest trip.
• A trip to the USA or Canada: use a policy with a high medical limit, because care costs far more there. Worldwide cover costs more than Europe-only cover.
• You already hold a travel card: read its terms before paying for anything else. If you did not pay for the trip with that card, the cover may not apply. Check the limit too.
• A trip to your home country: do not assume any source covers it. Look for the wording on country of residence or home country before you buy.
• EHIC: carry it for EU, EEA and Swiss trips as a free baseline, but do not rely on it alone. It pays for nothing outside the public system, and it will not bring you home or refund a cancelled trip.

What else to compare

Before you buy, also compare luggage, delay and civil liability cover. Check whether the policy pays first or only tops up other cover. Price rises with age, higher limits, family cover and extras. Limits and conditions differ by insurer and card, so read the policy terms.

Prices and limits differ by insurer and card, so check the policy terms and a current quote before you buy.

Frequently asked questions

Does the EHIC cover care I already need, like a chronic condition?

Yes, the EHIC covers treatment of a chronic or pre-existing condition if you need care during your stay, but only from a public provider or one contracted to the state system. Oxygen or dialysis may need arranging before you travel.

Can I cancel a trip because I changed my mind and still get a refund?

No, a voluntary change of mind is normally excluded from cancellation cover. Covered reasons usually include serious illness, accident or death of you, a close relative or a travelling companion, a court summons, serious damage to your home, dismissal from work, or unforeseen quarantine. Some plans sell cancellation for any reason as an upgrade, with only a partial refund.

How much medical cover should my travel policy have?

Medical limits in Spanish policies are usually lower for Europe than for worldwide trips, with basic European plans in the tens of thousands of euros. Choose a much higher limit for the USA, Canada and similar places, where care costs more. Premium plans can reach very high or near-unlimited limits.

What baggage limits are normal in a travel policy?

Baggage cover usually has a total limit of a few hundred to a few thousand euros, with a lower cap per item. Electronics, jewellery and cameras have even lower sub-limits, and delayed baggage is often a smaller separate amount.