When buying travel insurance, you choose a cover area, and for trips to Europe you will also hear about the GHIC. Getting both right ensures you are properly covered without overpaying. This guide explains worldwide versus European cover, and how the free GHIC fits alongside your travel insurance.
Cover areas explained
Travel insurance is sold by geographic area, which affects the price. Common areas are Europe, worldwide excluding certain expensive countries such as the United States, Canada and the Caribbean, and worldwide including them. The wider the area and the more expensive the healthcare in your destinations, the higher the premium. Choosing the area is therefore a balance between making sure your destination is covered and not paying for cover you do not need.
Why some destinations cost more
The reason worldwide cover including the United States costs more is the very high cost of medical treatment there. A serious illness or accident in the US can generate enormous bills, so insurers charge more to cover that risk. Countries like Canada and the Caribbean are often grouped with the US for the same reason. If you are travelling to these places, you need the appropriate, higher level of area cover.
Choosing the right area
Pick the area that matches where you are actually going. If you only travel within Europe, European cover is enough and cheaper. If you are heading further afield, choose worldwide cover, making sure it includes the specific countries you are visiting. On an annual policy, choose an area that covers all your planned trips for the year. Matching the area to your travel avoids both gaps in cover and paying for unnecessary protection.
What the GHIC is
The Global Health Insurance Card, or GHIC, is a free card for UK residents that gives access to medically necessary state-provided healthcare in participating European countries, at the same cost as a local resident, which is often free or reduced. It replaced the older European Health Insurance Card, or EHIC, after Brexit. The GHIC can significantly cut the cost of state healthcare if you fall ill or have an accident in a covered country.
Which countries the GHIC covers
The GHIC covers the European Union countries and, for UK citizens, Switzerland, giving access to state healthcare there. Its coverage of some other countries differs from the old EHIC, so the safest approach is to check the current list on the official NHS website before you travel. Importantly, it does not cover destinations such as the United States, Australia or other non-European countries, so it is only relevant for trips to the countries it lists.
The GHIC is free, so beware fees
The GHIC is completely free, and the only official place to apply is the NHS website. Be wary of unofficial third-party websites that charge a fee to process a GHIC application; they add no value, since the NHS issues the card for nothing. Always apply directly through the official NHS route, and allow time for the card to arrive before you travel, as it is not usually issued instantly.
The GHIC is not travel insurance
Crucially, the GHIC is not a substitute for travel insurance. It only covers state healthcare in the countries it applies to, and only at local cost. It does not cover repatriation home, private treatment, cancellation, lost baggage, or anything outside those countries, and it does not cover medical care on a cruise. You need travel insurance for all of that, which is why the advice is always to have both.
Using the GHIC and insurance together
The GHIC and travel insurance work best together. The card can reduce the cost of state treatment in Europe, while your insurance covers repatriation, private care and everything else. Some insurers even encourage using the GHIC by waiving your policy excess on a medical claim where you have used the card. Carrying both on a European trip gives you the fullest protection, with the free card complementing your paid-for insurance.
Existing EHICs are still valid
If you still hold a European Health Insurance Card, or EHIC, you can carry on using it until the expiry date printed on it; there is no need to switch to a GHIC early. Once your EHIC expires, you replace it with a free GHIC through the official NHS route. So if you have a valid EHIC, it continues to give you the same access to state healthcare until it runs out.
If you fall ill in Europe
If you need treatment in a covered country, presenting your GHIC at a state healthcare provider entitles you to care at the same cost as a local, which may be free or reduced. Keep any receipts for costs you do pay, as you may be able to reclaim them, and your travel insurer can help with anything the card does not cover, such as private treatment or getting you home. Using both together gives the best protection.
If your card is lost abroad
If your GHIC or EHIC is lost or stolen while you are away and you need treatment, you can usually obtain a Provisional Replacement Certificate, which provides the same entitlement temporarily. It is worth keeping a note of your card details and the relevant contact number before you travel, so you can arrange a replacement certificate quickly if needed. This ensures a lost card need not leave you without access to state healthcare during your trip.
Cruises and the GHIC
One important gap is that the GHIC does not cover medical care on a cruise, since you are not accessing a country's state healthcare system while at sea. Cruise passengers therefore rely entirely on their travel insurance for medical cover, and many insurers offer or require specific cruise cover. If you are taking a cruise, do not count on the GHIC for medical costs, and make sure your travel insurance includes appropriate cruise cover.
Getting these two things right, the cover area on your insurance and a free GHIC for European trips, gives you well-judged protection at a fair price. The card cuts the cost of state healthcare in Europe, while your insurance handles repatriation, cancellation and everything beyond it. Carry both, apply for the card only through the official NHS route, and you can travel properly covered.
In short
Travel insurance is sold by area, with worldwide cover including the United States costing more due to high medical bills, so choose the area that matches your destinations. The GHIC is a free card giving access to state healthcare in the EU and Switzerland at local cost, but check the current country list on the NHS website. It does not replace travel insurance, which covers repatriation, cancellation and more, so carry both.
Where to get help and next steps
Choose your policy type in single trip versus annual cover, see whether you need it in do you need travel insurance, and start with travel insurance explained. This is general information, not financial advice.