Short answer
An EHIC or UK GHIC gives you medically necessary state healthcare during a temporary stay in Spain, on the same terms and at the same cost as a Spanish insured person. It does not cover private clinics, repatriation or planned treatment, and it is not a way to access healthcare once you live in Spain. Residents need their own entitlement instead: Spanish Social Security through work, a registered S1, the convenio especial, or private insurance.
Key facts
- EHIC and GHIC cover state healthcare only; they cannot be used in private clinics.
- GOV.UK says UK visitors pay 50% of prescription prices in Spain, or 10% with a UK State Pension.
- The EU says people who move should register an S1 rather than rely on the EHIC.
- A UK GHIC is free and lasts up to five years.
- Residents covered in Spain can request a free Spanish EHIC from Social Security.
What the EHIC and GHIC actually do
The European Health Insurance Card (EHIC) is a free card, issued by your national health insurer, that gives temporary access to medically necessary, state-provided healthcare in the 27 EU countries, Iceland, Liechtenstein, Norway, Switzerland and the UK. You are treated on the same terms and at the same cost as insured residents of the country you are in, which may be free (European Commission).
The UK Global Health Insurance Card (GHIC) is the UK's post-Brexit equivalent. It is free, lasts up to five years and covers state healthcare that cannot reasonably wait until you get home: emergency care, treatment for long-term conditions and routine maternity care, though not giving birth abroad as a planned trip (NHS). Some UK residents with Withdrawal Agreement rights hold a UK-issued EHIC instead, and an existing UK EHIC remains valid until its expiry date.
In Spain, both work the same way for a visitor.
Using the card on a visit to Spain
For UK visitors, GOV.UK sets out the practical rules (GOV.UK: visiting Spain):
- Show the card at any state hospital or doctor. You get medically necessary treatment on the same basis as a Spanish citizen, free or at reduced cost.
- You cannot use either card for private healthcare. Many clinics in tourist areas are private, so ask before you are seen.
- Prescriptions: you pay 50% of the price, or 10% if you have a UK State Pension (you may need to prove it). These charges are non-refundable. Spain changed its co-payment bands on 14 May 2026, so the rate you are charged may differ from GOV.UK's figures; see prescriptions and pharmacy costs.
- If you do not have the card with you, you may have to pay in full. Call NHS Overseas Healthcare Services on +44 (0)191 218 1999 about a Provisional Replacement Certificate (PRC), which gives the same cover as the card.
- Planned treatment, such as travelling to give birth, is not covered. Oxygen therapy needs a written request to the Spanish health authority at least a month before you travel.
What the cards never cover
| Covered | Not covered |
|---|---|
| Medically necessary state treatment on a temporary stay | Private hospitals and clinics |
| Care for existing long-term conditions that cannot wait | Repatriation, such as a medical flight home |
| Routine maternity care on a temporary stay | Mountain or ski rescue |
| Treatment at local patient charges | Travel made specifically to get treatment |
| Lost or stolen property |
The European Commission is direct: the EHIC "is not an alternative to travel insurance". GOV.UK advises visitors to carry both.
Why the card stops working when you move
The EHIC and GHIC are built for temporary stays. The European Commission says that if you relocate and make another country your habitual residence, you should "register using the S1 form" instead of relying on the EHIC. Spain's Ministry of Health makes the same distinction, noting that the European card covers temporary stays, not residence (Ministerio de Sanidad).
Once Spain is your home, the question is no longer "which card do I carry" but "which system is responsible for me". Under EU coordination rules, that depends on your economic status and where you live, not on your nationality (Your Europe).
Which route applies to residents
| Your situation | Residence healthcare route | Read more |
|---|---|---|
| Working or self-employed in Spain | Spanish Social Security, on the same basis as a Spanish worker | Workers and autónomos |
| EU, EEA, Swiss or UK state pensioner | S1 issued by the paying country and registered with the INSS | How to register an S1 |
| Posted worker, under two years | Usually stays insured at home; S1 if moving to Spain | How to register an S1 |
| Not working, no pension entitlement, resident over a year | Convenio especial (€60/€157 a month) or private insurance | Convenio especial |
| Not working, first year of residence (including most visa holders) | Private health insurance | Residency requirements |
GOV.UK says the same in short form for UK nationals: if you have lived in Spain for less than a year and cannot get healthcare cover, you will need private health insurance (GOV.UK: healthcare in Spain).
Students and temporary workers
Students are the main group for whom a card can remain the right tool during a longer stay. GOV.UK says UK students in Spain can apply for a Student GHIC covering their study period, and anyone with a valid Student EHIC can keep using it until it expires. The NHS asks for a letter from your university or college confirming the course, dates and your study address abroad.
For EU students, Your Europe explains that you need comprehensive health insurance in the host country; if you are not employed, the EHIC may meet that need if you are eligible. If you take a job in Spain, you must join the Spanish scheme. Some home insurers cover students only up to a certain age, often 28 or 30, after which you need local or private cover.
Whether a card satisfies a student visa's health insurance condition is a separate question decided by the consulate. See health insurance for Spain's student visa.
Cards for people who live in Spain
Living in Spain does not mean giving up European cover for travel. It means getting a card from whichever system is responsible for you:
- Covered by Spanish Social Security (workers, Spanish pensioners, beneficiaries): request the Spanish EHIC, the Tarjeta Sanitaria Europea, free through Social Security, delivered to the address held for you (Seguridad Social).
- UK S1 holders registered in Spain: you may be eligible for a UK-issued GHIC, or a UK EHIC if your S1 has been in place since before 1 January 2021 (NHS).
- Convenio especial members: for temporary stays in the EU, EEA, UK or Switzerland, the INSS issues a provisional replacement certificate (Certificado Provisional Sustitutorio) rather than an EHIC (Ministerio de Sanidad).
- Privately insured only: you have no European card from Spain. Check whether your policy covers trips abroad, and buy travel insurance if not.
UK nationals in this position will find more detail in healthcare and insurance for UK citizens in Spain, and EU citizens in healthcare evidence for EU citizens living in Spain.
Common questions
Can I use my GHIC if I live in Spain?
Not as your residence cover. The GHIC is for temporary stays. Residents need Spanish entitlement or private insurance, although UK S1 holders registered in Spain can get a UK GHIC for trips to other EU countries.
Is the EHIC accepted as health insurance for a Spanish visa?
Do not rely on it. Visa health insurance requirements are set by the immigration rules and consulates, and an EHIC proves something different. Use the consulate's own checklist.
Do I pay anything with a GHIC in Spain?
You may. Treatment is on the same basis as for a Spanish citizen, which can mean free or reduced cost, and GOV.UK says UK visitors pay 50% of prescription prices, or 10% with a UK State Pension. These charges are non-refundable.
What if I forget my card?
You may have to pay in full. UK residents can call NHS Overseas Healthcare Services on +44 (0)191 218 1999 for a Provisional Replacement Certificate, which gives the same cover.
Sources
- European Commission: European Health Insurance Card
- Your Europe: health insurance cover when living abroad
- NHS: Apply for a free UK Global Health Insurance Card
- GOV.UK: Healthcare for UK nationals visiting Spain
- GOV.UK: Healthcare in Spain
- Ministerio de Sanidad: Convenio especial
- Seguridad Social electronic office: healthcare services