The EHIC (European Health Insurance Card) and the UK's GHIC (Global Health Insurance Card) let visitors from the EU/EEA and the UK access medically necessary state healthcare in Spain during a temporary stay, on the same terms (and cost) as a Spanish public patient — so emergency and necessary treatment is covered, often free or low-cost. But it has clear limits: it covers necessary care, not planned/elective treatment, doesn't cover private healthcare, doesn't cover repatriation home, and isn't a substitute for travel insurance (which covers cancellations, repatriation, private treatment and more). Crucially, the EHIC/GHIC is for visitors and non-residents only — once you become resident in Spain, you need a proper resident's route (work, S1, convenio especial or private cover); relying on an EHIC as a resident is not valid. Visitors should carry their card and travel insurance. We advise newcomers on the transition from visitor cover to a resident route.
EHIC vs GHIC
Both cards do essentially the same job — give visitors access to state healthcare in Spain — but they come from different places:
- EHIC (European Health Insurance Card) — held by residents of EU/EEA countries, giving access to state healthcare when visiting another EU/EEA state (including Spain).
- GHIC (UK Global Health Insurance Card) — the UK's post-Brexit replacement for the EHIC for most UK residents, providing broadly equivalent access to necessary state healthcare in the EU (including Spain). Some UK residents may still hold a valid EHIC under the post-Brexit arrangements; both work similarly in Spain.
For a British visitor, the practical point is that the GHIC is the card to have (it replaced the EHIC for most people after Brexit), and it continues to provide access to necessary state healthcare in Spain much as the old EHIC did — so the common worry that "the EHIC doesn't work after Brexit" is misplaced for visitors, who simply use the GHIC instead. Both cards are free to obtain from your home country's health service/authority (you shouldn't pay a third-party site for one). Whether you hold an EHIC (EU/EEA resident) or a GHIC (UK resident), it functions in Spain as your access to necessary state-provided care during a visit — with the same limits, covered next.
What It Covers
The EHIC/GHIC gives you access to medically necessary state healthcare during a temporary stay, on the same basis as a Spanish public patient — meaning treatment that can't reasonably wait until you return home. In practice this covers:
- Emergency treatment — accidents, sudden illness, urgent care at public hospitals/urgencias.
- Necessary care for an unexpected condition arising during your stay.
- Treatment of pre-existing/chronic conditions that needs management during the visit (e.g. routine dialysis or oxygen, which may need arranging in advance).
- Maternity care where the need arises during the stay (not for the purpose of giving birth abroad).
Because it's access on the same terms as a public patient, treatment is generally free or low-cost at public facilities (you may pay the same co-payments a Spanish patient would, e.g. on some prescriptions). The key qualifier throughout is "necessary": the card covers care you need that can't wait, not care you choose to have in Spain. For a typical holidaymaker who has an accident or falls ill, the EHIC/GHIC means they can be treated in the public system without facing a large private bill — which is exactly its purpose. But it's a state healthcare access card, not comprehensive insurance, and the gaps below are why it's only part of a visitor's protection.
What It Doesn't Cover
The EHIC/GHIC's limits are where people get caught out. It does not cover:
| Not covered | Why it matters |
|---|---|
| Private healthcare | The card only gives access to state facilities — if you're treated privately (or taken to a private hospital), it doesn't apply and you'll be billed. |
| Repatriation | It does not cover the (often very high) cost of being flown/transported home for medical reasons — a major travel-insurance function. |
| Planned / elective treatment | It covers necessary care, not treatment you travel to Spain to have. |
| Non-medical travel costs | Trip cancellation, lost baggage, extended stays, a companion's costs — none of which a health card covers. |
| Some co-payments | You may still pay what a Spanish public patient pays (e.g. prescription charges). |
The private healthcare and repatriation gaps are the most serious. In tourist areas, you might be taken to or choose a private clinic/hospital — common on the coasts — where the EHIC/GHIC doesn't apply and you face the full private bill. And if you need to be flown home after a serious illness or injury, repatriation can cost a great deal and the card covers none of it. These two gaps alone are why the EHIC/GHIC is not enough on its own for a visitor — it's a valuable backstop for necessary state care, but it leaves you exposed precisely where costs are highest. That's the case for travel insurance, next.
The card won't cover private treatment or flying you home
The EHIC/GHIC covers necessary state care only — it doesn't apply at private clinics (common in tourist areas) and doesn't cover repatriation home, which can be very expensive. Those two gaps are why every visitor should also have travel insurance, not rely on the card alone.
Why Travel Insurance Still Matters
The EHIC/GHIC and travel insurance are complementary, not alternatives — and a sensible visitor has both. Travel insurance fills exactly the gaps the card leaves: it covers repatriation (getting you home, with medical escort if needed), treatment in private facilities (and being taken to the nearest hospital regardless of whether it's public or private), non-medical costs (cancellation, curtailment, baggage, extended stays), and often provides English-speaking assistance and a 24-hour helpline to coordinate care — invaluable when you're unwell abroad and don't speak Spanish.
The ideal is to carry your EHIC/GHIC and hold travel insurance: the card means state treatment is accessed on the best (cheapest) terms, and the insurance covers what the card doesn't (and can handle the private-facility and repatriation scenarios). Some travel-insurance policies even ask you to use your EHIC/GHIC where possible, working alongside it. For visitors and second-home owners, this combination is the right protection. Relying on the card alone is the common mistake — it leaves you exposed to private bills and repatriation costs; relying on insurance alone is fine but the card may reduce what you (or the insurer) pay for state treatment. Both together is the belt-and-braces approach for any trip to Spain.
Using It in Spain
To use the EHIC/GHIC, present it (with photo ID) when you receive treatment at a public/state healthcare facility — a public health centre or public hospital. The card identifies you as entitled to state-provided care on the same terms as a Spanish patient, so you're treated and (for necessary care) generally not billed for the treatment itself beyond any standard co-payments.
A few practical pointers: the card only works at state facilities, so if you're unwell, going to a public health centre or hospital (rather than a private clinic) is what lets the card apply — important in tourist areas where private clinics are prominent and may be the first option presented. In an emergency, call 112 and you'll be taken for emergency care; show your card at the hospital. Keep your card and ID accessible while travelling, and if you have a chronic condition needing routine treatment during your stay (like dialysis), arrange it in advance as some treatments must be pre-booked. If you're directed to or end up at a private facility, your travel insurance is what covers you there. Using the card correctly — at state facilities, with ID, and alongside travel insurance — is straightforward once you know the public-vs-private distinction matters.
Not for Residents
This is the single most important point for the PLS audience: the EHIC/GHIC is for visitors and temporary stays — not for residents. It provides access to necessary state care while you're visiting Spain on the basis of your home-country entitlement. Once you become resident in Spain, that basis no longer applies — your healthcare should come from a proper resident's route (cover through work, the S1, the convenio especial, or private insurance), not the EHIC/GHIC.
The trap is people who move to Spain and keep relying on their EHIC/GHIC, assuming it covers them as it did on holiday. It doesn't — using it as a substitute for a resident's healthcare route is not valid, and can leave you effectively without proper cover (and potentially facing bills, or problems if it's discovered you're using a visitor card as a resident). New arrivals can reasonably use their card in the very early days before they've become resident and set up a route, but the priority on moving is to establish a resident route promptly. This visitor-vs-resident distinction is exactly where we help newcomers: making sure they transition from the EHIC/GHIC (fine as a visitor) to a proper resident healthcare route (essential once resident), so there's no gap and no reliance on a card that no longer applies to their situation.
If You Have No Cover
If you're treated in Spain with no EHIC/GHIC and no travel insurance — for example a visitor who forgot the card and didn't insure, or someone treated at a private facility without cover — you'll generally be treated as a private patient and billed for the care. Emergency treatment will still be provided (hospitals treat genuine emergencies regardless), but you can face a significant bill afterwards, and private treatment in particular is charged at full private rates. This is the scenario the EHIC/GHIC and travel insurance exist to prevent.
If this happens, options include paying and (where you had entitlement) potentially reclaiming some costs — for example, if you were entitled to an EHIC/GHIC but didn't have it to hand, there can be routes to recover some state-treatment costs afterwards via your home-country health service, though this is administratively harder than simply using the card at the time. Travel-insurance claims, where you had a policy, cover the rest. The clear lesson is prevention: as a visitor, get your free EHIC/GHIC and buy travel insurance before you travel; as someone moving to Spain, set up a resident route quickly. Being uninsured and facing a Spanish medical bill — especially a private or repatriation one — is exactly the avoidable situation this guide is about. If you're facing such a bill, it's worth getting advice on whether any costs can be recovered.
How We Help
Our role here is less about the cards themselves (which you obtain free from your home country) and more about the transition that catches expats out: moving from visitor cover (EHIC/GHIC + travel insurance) to a proper resident healthcare route. We make sure newcomers don't drift along relying on an EHIC/GHIC that no longer applies once they're resident, by establishing the right route promptly — work cover, the S1, the convenio especial or private insurance for a visa — and handling the registration. For visitors and second-home owners, we can advise on where the card fits alongside insurance. It's part of our relocation support, in English on a clear quote. Book a consultation if you're moving and need to move beyond visitor cover.
Related Guides
Healthcare in Spain
The resident routes you need once you move — the pillar guide.
Healthcare pillar →Frequently Asked Questions
Both give visitors access to necessary state healthcare in Spain. The EHIC (European Health Insurance Card) is held by EU/EEA residents; the GHIC (UK Global Health Insurance Card) is the UK's post-Brexit replacement for most UK residents, providing broadly equivalent access. Some UK residents may still hold a valid EHIC under the post-Brexit arrangements. For a British visitor, the GHIC is the card to have, and it works in Spain much as the old EHIC did. Both are free from your home country's health service.
Medically necessary state healthcare during a temporary stay, on the same basis as a Spanish public patient — treatment that can't reasonably wait until you return home. That includes emergency treatment, necessary care for an unexpected condition, management of pre-existing/chronic conditions during the visit (some needing pre-arrangement), and maternity care where the need arises. Treatment is generally free or low-cost at public facilities, though you may pay standard co-payments. The key qualifier is necessary care, not elective treatment.
Private healthcare (it only applies at state facilities), repatriation home (often very expensive), planned/elective treatment, and non-medical travel costs like cancellation, baggage and extended stays. You may also still pay some co-payments. The private-healthcare and repatriation gaps are the most serious — in tourist areas you might be taken to a private clinic where the card doesn't apply, and being flown home isn't covered. These gaps are why the card isn't enough on its own.
Yes — they're complementary, not alternatives. Travel insurance fills the card's gaps: repatriation, treatment at private facilities, non-medical costs (cancellation, curtailment, baggage), and English-speaking 24-hour assistance. The ideal is to carry your EHIC/GHIC and hold travel insurance: the card means state treatment is accessed on the cheapest terms, and the insurance covers what the card doesn't. Relying on the card alone leaves you exposed to private bills and repatriation costs.
Present it with photo ID when treated at a public/state healthcare facility — a public health centre or public hospital. It identifies you as entitled to state care on Spanish-patient terms. It only works at state facilities, so going to a public (not private) facility is what lets the card apply — important in tourist areas where private clinics are prominent. In an emergency, call 112 and show your card at the hospital. If you're directed to a private facility, your travel insurance covers you there.
No — it's for visitors and temporary stays, not residents. It provides access to necessary state care while you're visiting on your home-country entitlement. Once you become resident, that basis no longer applies and your healthcare should come from a resident's route (work, S1, convenio especial or private insurance). Relying on the card as a resident is not valid and can leave you without proper cover. New arrivals should establish a resident route promptly rather than keep using the card.
You'll generally be treated as a private patient and billed — emergency treatment is still provided regardless, but you can face a significant bill afterwards, especially at private rates. If you were entitled to an EHIC/GHIC but didn't have it to hand, there can be routes to reclaim some state-treatment costs afterwards via your home-country health service, though that's harder than using the card at the time. The clear lesson is prevention: get your free card and travel insurance before travelling.
For visitors, yes — through the GHIC. The UK introduced the GHIC as the post-Brexit replacement for the EHIC for most UK residents, providing broadly equivalent access to necessary state healthcare in the EU including Spain, and some may still hold a valid EHIC. So the worry that "the EHIC doesn't work after Brexit" is misplaced for UK visitors, who simply use the GHIC. What did change is that this is visitor cover only — UK citizens who move to Spain are now non-EU residents needing a proper resident route.