Request

Hello, this is a Freedom of information request about EHIC and GHIC cards and the cost of healthcare for UK citizens in Europe.

1. We define overseas medical bills as the cost or expense of UK travellers that receive medical treatment while abroad, that is then re-charged to the NHS, as a result of either the GHIC agreement or reciprocal health agreement. Would you be able to provide me with me insight around the total annual cost of overseas medical bills charged to the NHS per year due to travellers receiving medical treatment while abroad and using their EHIC/GHIC towards the total medical fee? Please would you be able to break these costs down by year, starting from 2016 until now (2025).
2. Would you be able to provide me with data on the number of EHIC cards, as of Jan 1, 2025 that are due to expire this year?
3. Would it be possible for you to provide me with proportionate data around how many British citizens now have a GHIC in comparison to how many British citizens had an EHIC? I am looking for some insight (figures) around the number of British citizens who hold/have held a valid EHIC/GHIC by year, from the year 2016 until the present (Jan 2025).

Date Range: 01/01/16 to 31/12/24

The NHS Business Services Authority (NHSBSA) received your request on 28 January 2025.

We have handled your request under the Freedom of Information Act (FOIA) 2000.

Our response

I can confirm that the NHSBSA holds the information you have requested.

All data as of 4 February 2025.

Question 1

We define overseas medical bills as the cost or expense of UK travellers that receive medical treatment while abroad, that is then re-charged to the NHS, as a result of either the GHIC agreement or reciprocal health agreement. Would you be able to provide me with me insight around the total annual cost of overseas medical bills charged to the NHS per year due to travellers receiving medical treatment while abroad and using their EHIC/GHIC towards the total medical fee? Please would you be able to break these costs down by year, starting from 2016 until now (2025).

I can confirm that the NHSBSA holds the information you have requested and copy is attached. Please read the below notes to ensure correct understanding of the data:

• Data for 2025 includes claims up to 4 February.

• The ‘Year’ is the year a claim is accounted against. In most cases this is the year that treatment was completed.

• The ‘Amount accepted’ is the amount that has been agreed between the UK and the member state to pay for that year

• EEA regulations state a healthcare institution can return/reject a claim for reasons such as the claim is incomplete or there are concerns, the treatment has been provided outside the validity period of the entitlement. This may result in an increase of the presented figures when reviewed back through the years allowing for the entitlements to be validated.

Question 2

Would you be able to provide me with data on the number of EHIC cards, as of Jan 1, 2025 that are due to expire this year?

I can confirm that the NHSBSA holds the information you have requested.

The total number of EHICs, UK GHICs and UK EHICs which have expired or will expire in 2025 is 1,811,140.

Question 3

Would it be possible for you to provide me with proportionate data around how many British citizens now have a GHIC in comparison to how many British citizens had an EHIC? I am looking for some insight (figures) around the number of British citizens who hold/have held a valid EHIC/GHIC by year, from the year 2016 until the present (Jan 2025).

Data Prior to 1 January 2020

I am writing to advise you that following a search of our paper and electronic records, I have established that the information you requested has been destroyed in accordance with the NHS Business Services Authority’s records management practice.

A copy of the NHS Business Services Authority’s (NHSBSA’s) records retention schedule can be found at the following web link. EHIC and GHIC retention is listed under the ‘Retention’ tab, row 273.

https://www.nhsbsa.nhs.uk/our-policies/policies-and-procedures

Data After 1 January 2020

I can confirm that the NHSBSA holds the information you have requested.

A copy of the information is attached. Please read the below notes to ensure correct understanding of the data:

• The data provided represents the number of valid entitlements on the date shown in the first column, but not the number of individuals with valid entitlements. This is because one individual can, for example, hold both the UK GHIC and UK EHIC.

• The provided data also does not represent the number of British citizens. We are unable to provide data specifically for British citizens.

The data has been broken down by the following three types of entitlements:

• EHIC – this entitlement was replaced by the UK GHIC as of 1 January 2021. Any existing EHICs remain valid until their expiry date and provide access to state-funded, medically necessary healthcare cover in the EU countries.

• UK GHIC – from 1 January 2021, this entitlement provides access to state-funded, medically necessary healthcare in the EU, EEA, for most people in Switzerland and some countries outside of the EU. Those who are ordinarily resident in the UK may be eligible for a UK GHIC.

• UK EHIC – from 10 November 2020, this entitlement provides access to state-funded, medically necessary healthcare in the EU, EEA countries and Switzerland. Those who are covered under the Withdrawal Agreement may be eligible for a UK EHIC.

Data Queries

Please contact foirequests@nhsbsa.nhs.uk ensuring you quote the above reference if you have any specific questions regarding this response; or, if you feel you may be misunderstanding or misinterpreting the information; or, if you plan on publishing the data.

Reusing the data and copyright

If you plan on producing a press or broadcast story based upon the data please contact communicationsteam@nhsbsa.nhs.uk. This is important to ensure that the figures are not misunderstood or misrepresented.

The information supplied to you continues to be protected by the Copyright, Designs and Patents Act 1988 and is subject to NHSBSA copyright. This information is licenced under the terms of the Open Government Licence detailed at:

http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/

Should you wish to re-use the information you must include the following statement: “NHSBSA Copyright 2025” Failure to do so is a breach of the terms of the licence.

Information you receive which is not subject to NHSBSA Copyright continues to be protected by the copyright of the person, or organisation, from which the information originated. Please obtain their permission before reproducing any third party (non NHSBSA Copyright) information.