Your guide to the E111 form

By Fred Mawer, The Mail on Sunday

Last updated at 09:39 07 March 2005

British holidaymakers who fall ill or have an accident while visiting a country in the European Union are eligible for free or reduced-cost state medical treatment.

To qualify, you normally need to have a form called an E111, though in some countries, such as Austria, Denmark and Finland, producing your British passport should be sufficient.

The terms of the treatment - what's free and what's not - will be similar to those applying to residents of the country you are visiting. These promising-sounding rights apply not only in the 25 member states of the EU but also in Iceland, Liechtenstein, Norway and Switzerland.

Travellers already in possession of an E111 form will need to apply for a new one this year - the old one became invalid at the end of 2004. The main difference between the old and new forms is that the new one is issued on an individual, not a family, basis.

The new E111 is a transitional document, valid only to the end of 2005. It is being replaced by the European Health Insurance Card, or EHIC, which should be more userfriendly. For, while the E111 is an easy-to-lose sheet of A4 paper, the EHIC will be credit-card sized, so can be kept in your wallet.

The card will not hold any electronic or clinical data - just your name, date of birth and an identification number - and will be valid for up to five years. It will entitle you to the same benefits as the E111.

By applying for the present E111 and ticking the relevant box on the application form, you will automatically be sent an EHIC when it becomes available later this year (around September, says the Department of Health). Further details of how to obtain the card will be released in the next couple of months.

But before heading off on your hols with your E111 (or EHIC), bear in mind that neither should be regarded as a substitute for travel insurance.

Areas of cover provided by travel insurance but not by the E111 include: money, possessions, cancellations, personal liability, expenses for others travelling with you if you're kept in hospital, mountain rescue from ski slopes and repatriation back to Britain in the event of a serious illness or accident (this last cost can run to five-figure sums).

Also, the E111, unlike travel insurance, will not usually cover private medical treatment, which may be the only viable option.

In parts of Spain, for example, you often have to travel some distance to attend a surgery or clinic operated within the state health service. At the same time, state-provided treatment in many EU countries does not cover all the things you would expect to receive without payment on the NHS.

The Department of Health's booklet Health Advice For Travellers (available from post offices or by calling 0800 555777 - the E111 application form is attached) gives a country-by-country breakdown of the often convoluted rules on using the E111, including what treatment you will get free and what you have to pay for.

To pick a few examples: in France, you have to pay around 25 per cent of hospital fees and 30 per cent of doctors' and dentists' fees; in Portugal, though basic hospital treatment is free, you have to foot the bill for X-rays and laboratory tests; while in Switzerland, you have to meet half the costs of the use of an ambulance.

Moreover, in many countries, you often have to pay for some treatments, then apply for a refund to sickness insurance offices in that country.

Though contact details are given in the Department of Health's booklet, and you can instead seek a refund through the Department for Work and Pensions in Newcastle on your return, it looks like a lot of potential hassle.

All of which begs the question: is it really worth bothering to get the E111 or the new health card?

Yes, says travel health expert Dr Richard Dawood. He maintains: 'Having the E111 can make the process of getting treatment happen more smoothly, especially in places such as the Spanish costas, where hospitals are familiar with the form.'

If you want treatment to be covered under your travel insurance, endless communication often has to take place between the hospital and the insurer's representatives, which can slow everything down.

Using the E111 may mean you won't have to contact your insurer, so you can do away with the bureaucracy - and you will have the added advantage of having avoided the trouble of making an insurance claim.

The E111 can save money, too. Many travel insurers will waive the excess (the part of a claim that you have to pay - as much as £75) if you have an E111, since the insurers may then be able to recover some of their costs.

Finally, the E111 covers treatment for chronic or pre-existing illnesses (as long as your reason for going abroad was not to get treatment for that illness-By contrast, travel insurers will often refuse to cover preexisting conditions or charge huge premiums for them.

Given that an E111 is straightforward to obtain and costs nothing, I would say the form is worth having - but as an addition to, not an alternative to, your travel insurance.

If you plan to travel with it, also take the Department of Health's booklet I mentioned earlier. This spells out how best to get treatment using the form in the country you are visiting, possible pitfalls and what you will still have to pay for.

Where you can get the form

The application form for the transitional E111 and the form itself are available from post offices (or can be downloaded from You will need your NHS or National Insurance number (and that of other family members, where known).

The form needs to be stamped and signed at a post office to be validated - a counter clerk can do this on the spot. Though each member of your family now needs his or her own E111, one application form covers all the family.

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