Travelling abroad with only your state health cover exposes you to a financial risk that is frequently underestimated. In Europe, the European Health Insurance Card (EHIC) gives you access to urgent treatment, but reimbursements are calculated on French reference rates, well below actual local costs. Outside Europe, the cover narrows even further. Travel health insurance, included in a comprehensive travel insurance policy, picks up where state cover leaves off and pays your real medical bills on the ground.
Get my travel insuranceWhat French state health cover does (and does not) include abroad
In Europe: the EHIC, a limited safety net
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The European Health Insurance Card (EHIC) gives you access to care that becomes necessary during a stay in the European Union, the European Economic Area, Switzerland or the United Kingdom. It covers urgent or unplanned treatment, including for a pre-existing chronic condition or an ongoing pregnancy. You must request it at least 15 days before departure via your ameli.fr account; it is valid for up to two years and applies on an individual basis (every family member needs their own card).
In practice, the EHIC has some significant real-world limitations:
- Reimbursements are calculated on French standard reference rates, not on the fees charged in the country you are visiting. If you see a doctor at a private Spanish clinic for €150, French state insurance will only reimburse 70% of the French reference rate for an equivalent procedure, which is often considerably lower.
- It does not cover planned treatment (arranged before departure).
- It does not include medical repatriation.
- Some private establishments abroad do not accept the EHIC.
To understand clearly why these two types of cover are not interchangeable, our article on the differences between travel insurance and health insurance breaks down exactly what each one covers.
Outside Europe: very narrow cover
Outside Europe, French state health insurance may reimburse certain urgent and unforeseen medical costs, but only on the decision of your scheme’s medical officer and always calculated on French reference rates. You must pay all costs upfront, keep every receipt and submit them using form S3125 on your return.
In the United States or Canada, a single night in hospital can run to several thousand euros. This mechanism offers only very partial protection against bills of that scale.
What travel health insurance adds
Health insurance included in your travel policy steps in where state cover stops. It covers:
- Your actual medical costs: consultations, hospitalisation and medication prescribed locally.
- Emergency dental treatment (depending on your policy).
- Medical repatriation: arranging and funding your return to France if your condition requires it, by air ambulance or with a medical escort.
- 24-hour assistance: connecting you with local partner doctors and, depending on the policy, settling costs directly so you do not have to pay upfront.
Medical repatriation deserves particular attention. It is not included in the EHIC, is rarely covered by standard bank cards and can cost tens of thousands of euros depending on the destination. Our dedicated page on repatriation insurance details the real-world situations where this benefit makes all the difference.
Which medical expense limits should you choose, by destination?
The reimbursement ceiling is the key figure to compare across policies. Here are the benchmarks drawn from specialist travel insurance comparison tools:
| Destination | Recommended limit |
|---|---|
| Europe (to complement the EHIC) | €50,000 to €150,000 |
| South-East Asia, Africa, Latin America | €150,000 minimum |
| United States, Canada | €500,000 minimum |
| Schengen visa (legal minimum requirement) | €30,000 |
A hospital stay in the United States can exceed €100,000 in certain states. An insufficient limit leaves you to cover the shortfall out of your own pocket. These thresholds vary between insurers and policy tiers: always read the small print carefully.
What to check before you buy
A few points not to overlook when choosing your policy:
- The medical expense ceiling: does it reflect the actual cost of healthcare at your destination?
- Pre-existing conditions: some policies exclude them or impose specific terms. Always declare your situation accurately to ensure you are covered when it matters.
- The excess: the amount you remain liable for even after the insurance has paid out.
- Upfront payment: some policies require you to pay first and claim later. Others offer direct billing (international cashless cover), so you do not need to find a large sum at short notice.
- The maximum duration covered: essential if you are travelling for several months or doing a round-the-world trip. Our guide on how to get insured for a round-the-world trip gives you everything you need for longer journeys.
- Repatriation: included as standard or available as a paid add-on?
If you live abroad or are planning a long-term move, your needs differ significantly from a standard holiday trip. Read our article on choosing expat health and repatriation insurance to find the right cover for your situation.
FAQ
Does the EHIC replace travel health insurance?
No. The EHIC only covers urgent or unplanned treatment in the relevant European countries, and reimburses on the basis of French reference rates. It does not include medical repatriation, does not work in all private establishments and does not apply outside Europe. For genuine protection, it must be supplemented by a travel insurance policy that includes medical expenses.
Does my bank card cover me abroad?
Some premium cards (Visa Premier, Mastercard Gold, Amex) include medical assistance benefits. However, the limits are often low, the eligibility conditions are strict (the trip must be paid for with the card) and repatriation is not always included. A dedicated travel insurance policy offers clearer, and generally more comprehensive, cover.
Can I be covered if I fall ill before departure?
Medical costs incurred before departure are not covered by travel health insurance, which covers treatment received during your trip. However, if you need to cancel your trip for medical reasons, your cancellation cover comes into play, provided it is included in your policy.
Do I need travel health insurance even for a short trip in Europe?
Yes. Even for a week in Rome or Barcelona, the EHIC may prove inadequate: treatment at a private hospital, costs reimbursed only in part, no repatriation cover. A short-stay policy is usually inexpensive and provides significantly better protection.
What is medical repatriation and when does it apply?
Medical repatriation is arranged by the insurer when the policyholder’s condition requires a return to France to a suitable medical facility. It involves coordination between local and French medical teams, and may include an air ambulance or an escort by medical personnel. It is activated by a joint decision between the local doctor and the insurer’s medical officer.
