Travel Insurance for Europe: What Expats Need to Know

Travel Insurance for Europe: What Expats Need to Know

The difference between the EHIC, travel insurance, and expat health insurance for people living and travelling in Europe.

Insurance for European travel is more complicated than it sounds, because three overlapping systems exist: the European Health Insurance Card (EHIC), standard travel insurance, and expat health insurance. Which one you need — and whether you need all three — depends on your nationality, where you live, and what you're doing in Europe. Getting this wrong can mean paying thousands out of pocket for a hospital visit that should have been covered.

The EHIC and GHIC: Who They're For

The European Health Insurance Card (EHIC) provides EU/EEA citizens access to state-funded healthcare in other EU/EEA countries on the same terms as residents of that country. It is free and issued by your home country's social security authority.

Key points:

• Covers medically necessary treatment during a temporary stay — not elective procedures or the reason you traveled
• You pay the same co-pays locals pay (which varies by country — in some places it's free, in others there's a fee)
• Does not cover repatriation costs (flying you home if you're seriously ill)
• Does not cover private healthcare — only state/public hospitals and clinics
• Does not replace travel insurance

UK citizens now hold a GHIC (Global Health Insurance Card), which replaced the EHIC post-Brexit. It provides similar coverage in EU countries on a reciprocal basis. UK residents should apply at the NHS website — it's free.

Non-EU/non-UK nationals do not qualify for the EHIC or GHIC at all. If you're from the US, Canada, India, Australia, or any non-EU country and you're a visitor (not a resident with a social security registration), you have no state healthcare safety net in most European countries.

Travel Insurance: The Essential Layer

Standard travel insurance covers what the EHIC does not, and is the baseline product for any trip to Europe.

What a good European travel insurance policy covers:

• Emergency medical treatment (including at private hospitals)
• Medical evacuation and repatriation
• Trip cancellation and interruption
• Baggage loss or delay
• Flight delays
• Personal liability
• 24/7 emergency assistance line

What to check when comparing policies:

• Medical coverage limit — Aim for at least €1 million; medical evacuation alone can run €50,000–€150,000
• Excess/deductible — The amount you pay before the insurance kicks in; zero-excess policies cost more but reduce stress in a crisis
• Pre-existing conditions — Many policies exclude them or require a premium add-on; disclose everything during application
• Activities covered — Standard policies often exclude extreme sports (skiing, cycling, hiking above certain altitudes). Buy a sports add-on if relevant.
• Cancellation reason — Basic policies cover cancellation only for specific reasons (illness, death in family). "Cancel for any reason" policies are broader but more expensive.

Schengen visa requirement: All applicants for a Schengen visa must have travel insurance with minimum €30,000 medical coverage valid for the entire Schengen area, for the full duration of the visa. This is a hard requirement — no insurance means visa refusal.

Expat Health Insurance: For Long-Term Residents

If you're living in Europe (not just visiting), you need a different product: expat health insurance or private health insurance.

Expat health insurance is designed for people who:

• Live outside their home country for extended periods
• Are not (yet) covered by the local state health system
• Need continuous coverage across multiple countries

SafetyWing is a popular option among digital nomads and remote workers. It operates as a subscription (monthly billing), covers travel medical emergencies in 180+ countries, and is significantly cheaper than traditional expat insurance. It does not cover routine checkups or dental, but works well as a basic safety net while you establish residency and local health coverage.

Cigna Global, Allianz Care, AXA International, and Bupa Global are traditional expat health insurers with more comprehensive coverage including routine care, dental, optical, and maternity. Premiums are significantly higher but reflect full health coverage rather than travel-emergency-only.

Local national health system registration: Once you have a residence permit in most EU countries, you'll be entitled to register in the local health system. This varies by country:

• Germany: mandatory statutory health insurance (gesetzliche Krankenversicherung) if employed
• Denmark, Sweden, Norway: register with the national health service after residency established
• Spain, France: register via your local health authority once you have your residence card

Until that registration is in place (which can take months), private expat insurance is essential.

Who Needs What: Scenarios

EU citizen visiting another EU country: EHIC + basic travel insurance (for repatriation and non-medical coverage). The EHIC handles most medical needs; travel insurance covers the gaps.

UK citizen visiting EU: GHIC + travel insurance. Same principle as above.

Non-EU visitor to Europe (tourist or short-stay): Travel insurance with at least €30,000 medical coverage is mandatory for Schengen visa applicants. Even for visa-exempt travelers, it's essential — you have no state coverage otherwise.

Non-EU national moving to Europe: Expat health insurance until you qualify for and register in the local health system. SafetyWing works as a budget interim option; comprehensive expat insurance if you need routine care from day one.

Digital nomad bouncing across multiple EU countries: SafetyWing or similar subscription-based travel medical coverage, supplemented with destination-specific travel insurance for non-medical trip protection. If in any one country for 3+ months, investigate local registration.

Common Mistakes

• Relying on EHIC alone and skipping travel insurance — the EHIC does not cover repatriation, which is often the most expensive part of a medical emergency abroad
• Buying the cheapest travel insurance without checking the medical coverage limit or exclusions
• Assuming employer health insurance covers international travel — check the policy; most don't cover evacuation
• Forgetting to insure the full period of the trip — a policy that expires on day 20 of a 25-day trip leaves you uninsured at the end
• Not declaring pre-existing conditions — claims related to undeclared conditions are routinely rejected

Travel insurance is one of the few purchases where reading the fine print before you need it is genuinely worth the time.