What do I do if I am ill or injured abroad?

Who to call and in what order, how the health card and the policy divide up between them, and what to do about being asked to pay before treatment.

Difficulty: beginner
Time: 20 min
Read: 4 min
Safety: warning

Short answer

Get emergency help first if it is an emergency. Then call the insurer assistance line — the number is on the policy — before agreeing to treatment or admission, because they authorise the cost, choose the facility and can pay the hospital directly. Use a GHIC at a state facility in a participating country. Keep every document.

Being ill abroad is frightening mostly because the system is unfamiliar, and the two things that go wrong are both avoidable: people go to the nearest private clinic because it is nearest, and they pay for things themselves because they are asked to. Knowing the sequence removes both problems.

Safety

For anything serious, the order is: emergency services, then the insurer twenty-four-hour assistance line, then family. Calling the insurer before treatment is authorised is a condition of most policies and is also what stops you being asked for a large payment up front. In a genuine emergency, treatment comes first and the call follows as soon as anyone is able to make it.

What each layer of travel cover actually pays for

Step by step

For an emergency, call the local emergency number.112 works across the European Union and in many other countries alongside the national number. Find the local emergency number for your destination before you travel and put it in your phone.
Call the insurer assistance line as soon as practical.This is a twenty-four-hour service, it speaks English, and it is the party that authorises treatment. It will tell you which facility to use, contact them, arrange direct settlement of the bill where possible, and take over managing the case.
For minor problems, start at a pharmacy.In much of Europe and beyond, pharmacists diagnose and treat minor illness and can tell you whether you need a doctor. It is faster and vastly cheaper than a clinic, and for stomach upsets, minor infections and skin problems it is usually all you need.
Use the health card at state facilities only.A GHIC gives you medically necessary state-provided treatment on the same terms as a resident of that country in the countries that accept it. That may mean free, or it may mean paying the same patient contribution locals pay. It does nothing at a private clinic, and a taxi driver or hotel will often take you to a private one by default — say explicitly that you want the state hospital.
Do not pay a large sum without speaking to the insurer.Private hospitals in tourist areas routinely ask for card details or a deposit on admission. If the assistance line is engaged, keep trying, and tell the hospital your insurer is being contacted. If you do pay, get an itemised invoice and keep it.
Collect the paperwork as you go.The diagnosis, the treatment record, itemised invoices, prescriptions and receipts, and the name and address of the facility. Ask for it in writing before you leave; obtaining it later from another country is extremely difficult.
Let the insurer manage repatriation.If you need to come home early or with medical support, that is arranged by the assistance company. Booking your own flight home when you are unfit to fly commercially can invalidate the claim and is genuinely dangerous after some conditions.
Tell the airline if your fitness to fly has changed.After some injuries and procedures, flying is contraindicated for a period, and airlines require medical clearance. The assistance company handles this; do not simply turn up.

Tips

Save the assistance number, the policy number and the local emergency number in your phone and on paper before you travel. The paper copy is the one that works when the phone does not.
Take a photograph of the medicine packaging for anything you are prescribed abroad, and of anything you already take. Generic names, not brand names, are what a foreign clinician needs.
If you are travelling alone, tell somebody at home which hospital you are in. The insurer will talk to a named next of kin but only if they know who it is.

If it doesn't work

Hospital is demanding payment before treating

Cause: A private facility with no relationship to your insurer, or an assistance line that has not yet been reached — Fix: Insist that the assistance line is called and give the hospital the policy details. Ask specifically whether there is a state hospital nearby. Keep trying the assistance number — they resolve exactly this daily.

Taken to a private clinic by a hotel or a taxi

Cause: Referral arrangements between local businesses and private clinics — Fix: Ask directly for the public hospital. If treatment has already started and it is not an emergency, call the assistance line before agreeing to anything further.

The GHIC was refused

Cause: The facility is private, or the country does not participate, or the treatment is not classed as medically necessary — Fix: Do not argue at the desk. Call the assistance line — this is exactly what the insurance is for, and the card was only ever a way to reduce the bill.

Questions people ask

Do I need the insurer's permission for a pharmacy visit?

No. Buy what you need, keep the receipt and claim it if it exceeds the excess. Authorisation matters for consultations, scans, admissions and anything expensive.

What if I have no insurance?

You pay. A GHIC will reduce the cost at state facilities in participating countries, and consular staff can help you contact family to transfer money, but nobody will pay a medical bill for you.

Can I be treated on the NHS when I get home instead?

For anything that can safely wait, yes. For anything that cannot, waiting is the wrong decision — and repatriation for treatment is what the policy is for.