If you’re wondering if you really need travel insurance or a European Health Insurance Card (EHIC) then just take a look at the cost of treatment in countries such as the US. According to Sainsbury’s Finance the average cost of visiting a hospital abroad is £2,040. That figure alone tells you that you need travel insurance, especially if you’re visiting a country outside of the EU.

If you’re fit, healthy, and living and staying in Europe then you should be fine with an EHIC; even without travel insurance. As a UK resident this EHIC lets you use the state-healthcare of other countries as if it was the NHS.

Showing your EHIC or E111 to the state provider in question entitles you to receive the treatment for problems that can arise on holiday. You can’t use your EHIC to travel for healthcare purposes, but you can use it to cover any existing chronic issues that arise during your trip. With this card you’ll be treated as if you were a citizen of the country. There are some countries where you will be expected to pay the healthcare costs yourself but will usually have the option to be reimbursed.

Because the EHIC only covers state healthcare and not private healthcare it shouldn’t be considered an alternative to travel insurance. If you’re thinking about whether you should get an EHIC or travel insurance you should keep in mind that the healthcare system of the country you’ll be visiting could be different from what you’d expect with the NHS. For example some European state-run hospitals use private ambulance services and you’ll be expected to pay for an ambulance ride.

You should seek out medical care from a state-funded facility and always present your EHIC before getting treated to avoid private medical bills. If your healthcare arrangements were made through a hotel or travel representative. They will sometimes get you to choose a healthcare provider that you can’t use your EHIC with.

The NHS Choices website has all the information you need about what will and won’t be covered by the EHIC. In countries such as Spain the hospital will offer both state and private healthcare and they’ll expect you to say which one you prefer. If you’re expected to pay healthcare costs upfront at a Spanish hospital then you’ve entered a private service and you won’t be able to use your EHIC.

There are also European healthcare systems where you will have to pay up front and get the costs reimbursed through your EHIC. If that happens then you should try to process the refund before going back home. If that’s not possible then retain all paperwork and receipts so that you can make your claim through the Overseas Healthcare Team in Newcastle on 0191 218 1999.

The UK currently has reciprocal healthcare agreements with select countries outside of the EU, where you couldn’t use your EHIC. These territories include Australia, Croatia, Gibraltar, New Zealand and Russia.

If you spend time in any of these countries and something goes wrong and you need medical treatment then these countries should treat you, a UK national, as if you were from the country. As such as you can get state healthcare at a reduced rate, if not free.

Despite these reciprocal agreements you are still taking a big risk by not purchasing travel insurance that covers medical costs. That’s because these agreements don’t cover the repatriation costs, nor do they cover the cost of monitoring any existing conditions. You could also find that the range medical services offered by the country you visit isn’t as expansive as the NHS.