- A UK GHIC is free and lasts for up to 5 years, according to the NHS.
- The GHIC covers medically necessary state healthcare in the European Economic Area and some other countries, on the same basis as a resident.
- The GHIC does not cover medical repatriation, treatment in a private medical facility, or ski or mountain rescue.
- The NHS states the UK GHIC is not a replacement for travel insurance.
- Some insurers may waive the medical excess if you use an EHIC or GHIC, according to gov.uk guidance.
The UK Global Health Insurance Card (GHIC) and a travel insurance policy are often discussed together, and they do overlap in one narrow area: state hospital treatment abroad. They are not interchangeable, though. The GHIC is a government scheme that gives access to public healthcare systems in certain countries. Travel insurance is a private contract that pays for a much wider range of costs. Understanding where each one starts and stops is the difference between a manageable trip abroad and a bill that runs into the tens of thousands of pounds.
What a UK GHIC actually covers
The NHS describes the UK GHIC as a card that "lets you get necessary state healthcare in the European Economic Area (EEA), and some other countries, on the same basis as a resident of that country." The key phrase is "on the same basis as a resident": you are slotted into the local public system, so if residents pay a co-payment for treatment, you pay it too.
According to the NHS, the GHIC covers state healthcare that cannot reasonably wait until you return to the UK. That includes emergency treatment and visits to A&E, treatment or routine medical care for long-term or pre-existing medical conditions, and routine maternity care. Two features make it valuable: it is free, and it lasts for up to 5 years. Beyond the EEA, the NHS lists coverage in Montenegro, Australia, Switzerland (subject to nationality and status conditions), Jersey, Guernsey, the Isle of Man, and the territories of St Helena, Tristan da Cunha and Ascension.
What the GHIC does not cover
The gaps are where the card stops being a safety net. The NHS is explicit that the GHIC does not cover being flown back to the UK (medical repatriation), treatment in a private medical facility, or ski or mountain rescue. Each of these can be the single most expensive part of a medical emergency abroad.
Repatriation is the clearest example. If illness or injury means you cannot fly home on a scheduled flight, an air ambulance or a medically escorted journey can cost tens of thousands of pounds, and the GHIC pays none of it. The Association of British Insurers (ABI) reported that one of its members paid out more than 1 million pounds for a single customer who needed emergency hospital treatment in the USA followed by repatriation. The USA also illustrates a geographic limit: the GHIC works only in the listed countries, so it is of no use across most of the world, including the United States.
Private treatment is the second gap. If you are treated in a private clinic rather than a state facility, the GHIC does not apply, even within a country where the card is otherwise valid. In some destinations, the nearest or fastest care available to a tourist is private, and that cost falls on the patient unless travel insurance steps in.
What travel insurance covers that the GHIC does not
Travel insurance is built to fill exactly these gaps. The gov.uk foreign travel insurance guidance advises that a policy should cover the full length of your trip, treatment in state or private hospitals, emergency transport such as an ambulance (which is often charged separately to other medical expenses), and repatriation costs if you or a family member die abroad.
The scale of those costs is documented. The ABI reported that its members paid 472 million pounds across more than 500,000 travel claims in 2024. Of that, medical claims accounted for 262 million pounds, with an average medical claim of 1,528 pounds, and medical claims made up 34% of all claims, up from 29% in 2023. A GHIC would not have touched the private treatment, repatriation or ambulance elements wrapped inside many of those payouts.
Travel insurance also reaches well beyond medical cover into areas the GHIC never addresses at all: cancellation, lost baggage, missed departures and personal liability. The gov.uk guidance notes that cruises generally require an additional level of cover, and that some activities such as sports or adventure tourism may need specialist insurance or an add-on. None of that exists within the GHIC scheme.
How the GHIC and travel insurance work together
The two are designed to complement each other rather than compete. The gov.uk guidance states plainly that cards such as the EHIC and GHIC are "not alternatives to travel insurance as they do not cover any private medical healthcare costs, repatriation or additional costs such as mountain rescue in ski resorts." The NHS uses similar language, advising travellers to have private travel and medical insurance for the duration of the trip.
There is, however, a financial reason to carry both. The gov.uk guidance notes that some insurers may waive any excess on medical treatment if you use an EHIC or GHIC. In practice, presenting a GHIC for the state-funded part of treatment can reduce what the insurer has to pay and, in turn, what you pay as an excess. Carrying the card alongside a policy can therefore lower your out-of-pocket cost on a claim, which is one reason many policies ask whether you hold one.
Pre-existing conditions and declarations
The GHIC and travel insurance treat existing medical conditions very differently. The NHS confirms the GHIC covers treatment or routine medical care for long-term or pre-existing conditions within the state system, with no declaration and no extra cost. Travel insurance works on the opposite principle. The gov.uk guidance is clear that you must declare existing conditions or pending treatment or tests so that you are covered if there are related complications. Failing to declare can leave a related claim unpaid, however valid the card might be for the state-funded element of the same treatment.
Common pitfalls when relying on a GHIC
Several assumptions get travellers into trouble. The first is treating the GHIC as full cover. It is state healthcare access in specific countries, not a global insurance policy, and it pays nothing toward repatriation or private care. The second is geography: the card does not work in the United States and many other popular long-haul destinations, where medical bills are often highest. The third is the resident-basis rule. Because you are treated on the same terms as a local, any co-payment a resident would face is yours to pay, and the GHIC does not refund it. The fourth is the winter sports and adventure gap, where ski and mountain rescue sit entirely outside the card and require specific insurance cover instead.
Which one you need
For a trip within the countries where the GHIC is valid, the card and a travel insurance policy address different risks and are most useful held together. The GHIC handles access to the public system, including pre-existing conditions, at no cost and across a five-year lifespan. Travel insurance handles repatriation, private treatment, ambulance charges, cancellation, baggage and the activities or cruises that need an add-on. For any trip outside the GHIC's listed countries, the card offers nothing, and travel insurance carries the full weight of medical and non-medical risk on its own.
Frequently asked questions
Is a GHIC free?
Yes. The NHS states that a UK GHIC is free and lasts for up to 5 years. You should apply only through the official NHS service, as third-party sites may charge a fee for an application that is free.
Does a GHIC replace travel insurance?
No. The NHS states the UK GHIC is not a replacement for travel insurance and advises travellers to have private travel and medical insurance for the duration of the trip. The gov.uk guidance adds that the card does not cover private medical costs, repatriation or additional costs such as mountain rescue.
Does a GHIC work in the USA?
No. The GHIC covers state healthcare in the European Economic Area and a defined list of other countries and territories, which does not include the United States. The ABI has reported a single member payout of more than 1 million pounds for emergency USA hospital treatment and repatriation, costs a GHIC would not cover.
Does a GHIC cover skiing or mountain rescue?
No. The NHS states the GHIC does not cover ski or mountain rescue. Winter sports cover usually needs to be arranged through a travel insurance policy or add-on.
Why hold both a GHIC and travel insurance?
The two cover different risks, and there can be a cost benefit. The gov.uk guidance notes that some insurers may waive any excess on medical treatment if you use an EHIC or GHIC, so carrying the card alongside a policy can reduce what you pay on a claim while the policy covers repatriation, private care and non-medical losses.
Does a GHIC cover pre-existing conditions?
Within the state systems where it is valid, yes. The NHS confirms the GHIC covers treatment or routine medical care for long-term or pre-existing conditions. Travel insurance is different: gov.uk guidance says you must declare existing conditions or pending treatment so that related complications are covered.
