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  4. Scary Healthcare Myths: What Expats Get Wrong About EHIC, the Carte Vitale, and Private Insurance
Expats debunking myths about EHIC, Carte Vitale and health insurance in Europe

Scary Healthcare Myths: What Expats Get Wrong About EHIC, the Carte Vitale, and Private Insurance

Published October 29, 2025

Halloween or not, some myths about European healthcare are truly frightening: 'everything's free,' 'the Carte Vitale works everywhere,' 'you don't need private insurance.' These false beliefs cost expats dearly. Here's a clear, human guide to understand your rights, avoid costly mistakes, and never find yourself uncovered abroad.

1. EHIC = free healthcare?

False. The European Health Insurance Card (EHIC) grants access to public healthcare at local rates, not for free. You pay the same co-pays or patient fees as locals.

Example: In Portugal, a public doctor visit costs around €15. EHIC reimburses that rate—but not private comfort or transport.

Solution

Always check local healthcare costs before travel. If staying over 3 weeks, top up with travel or premium credit card insurance to cover gaps and emergencies.

2. "The Carte Vitale works across Europe"

Wrong. It only works in France. Abroad, use EHIC (temporary care) or S1 form (for residents abroad).

Example: French retirees in Spain must register their S1 to access Spanish healthcare locally.

Solution

Request your EHIC from ameli.fr at least 15 days before travel. Keep digital and paper copies. If moving permanently, apply for S1 immediately. For more details, check our comprehensive guide on European healthcare for expats.

3. "All European hospitals are the same"

Not quite. Standards differ: waiting times, technology, spoken languages, and admin steps. Germany: fast but costly. Italy: slower, cheaper.

Tip: Save contact info of an English-speaking hospital or clinic near you. In big cities like Paris, Berlin, and Madrid, such options exist but aren't automatic.

Solution

Identify a public hospital + private clinic nearby. Note the EU emergency number (112). Check if your insurance covers repatriation or translation assistance. If settling in a new country, read our guide on finding a family doctor and managing vaccinations.

4. "Private insurance is pointless"

Big mistake. EHIC and public systems cover urgent care—but not dental, optical, evacuation, or non-EU treatment.

Real story: Sarah, an expat in Geneva, needed medical evacuation to Lyon. Without private insurance: €4,800 bill. With her global policy: €0.

Solution

For long stays (>6 months) or remote work abroad, get international health insurance (April, Cigna, Allianz Care, Henner). Look for plans with:

  • Emergency + hospitalization coverage
  • 24/7 assistance & evacuation
  • Multilingual support + multi-currency refunds

Compare via European aggregators like Reassure.me or Selectra Santé—€30/month can save you thousands.

5. "I can see a doctor without a local number"

Often false. In Spain, Italy, or Germany, clinics require a local ID (NIE, Codice Fiscale, Anmeldung). Without it, you'll be billed as a private patient—not covered by EHIC.

Solution

Right after arrival:

1. Get your local tax/social ID

2. Register your address with city hall or local insurer

3. Carry a printed EHIC or policy card

Bonus: A phone photo of your card can help in emergencies.

Just like managing administrative paperwork abroad, good healthcare preparation prevents nightmares.

6. Practical checklist before you need it

Before travel:

  • Order EHIC via service-public.fr
  • Save emergency numbers: 112 (EU), 116 117 (non-urgent)
  • Keep prescriptions in English/French
  • Verify vaccines on ReopenEU

On site:

  • Keep all invoices
  • Request named, dated receipts
  • Submit reimbursements within 6 months to your insurer (CPAM, Krankenkasse, etc.)

In emergency:

  • Dial 112 for EU-wide emergency
  • Ask for the nearest public hospital
  • Contact your insurer before evacuation

Real-life example

Ana, Portuguese student in Lyon, thought EHIC was enough. After surgery, she got a €1,200 invoice for non-covered fees. One student global plan could've halved that. Now she helps newcomers prepare properly.

If you're moving for study or work, also check our complete moving abroad checklist.

Key takeaway

Europe's healthcare is excellent—but not automatic. Remember this trio: Plan, Proof, Protection. With a valid EHIC, a private top-up, and a local ID, you'll face no horror stories—just good care wherever you go.

For successful integration in your new country, discover our tips for building your life abroad and adapting to local culture.

Frequently Asked Questions

Does EHIC cover medical evacuation?

Never. It only covers necessary treatment in the host country. Get travel or international insurance with evacuation and assistance.

How long is EHIC valid?

Two years from issue date—always check before you travel.

Does EHIC reimburse private clinics?

No—EHIC only applies to public or state-contracted facilities.

How do I claim reimbursement after return?

Send original invoices with form S3125 to your home insurer. You have six months after treatment to file.

Stay updated

For more practical insights on this topic, explore our related articles:

  • Your Health Insurance Stopped 6 Months Ago (You Just Don't Know It Yet)
  • The Peptide Craze Is Exploding in 2025 — What Expats in Europe Need to Know Before Crossing a Legal Line
  • What Really Happens When an Expat Gets Sick in Europe - and isn't Properly Registered
  • Winter 2025: Emergencies, Pharmacies, EHIC, LAMal, Health Cards — The Expat Winter Healthcare Guide

Conclusion: European healthcare isn't free or identical—but it's among the best worldwide. Know your rights, keep your documents, and add the right insurance. In short: **Plan. Protect. Travel with peace of mind.**

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About the author:

Jules Guerini is a European expat guide sharing practical, tested advice for navigating life abroad. From admin to housing to healthcare, he focuses on simple strategies that actually work. Contact: info@expatadminhub.com

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