A broken hip on a package holiday in Alicante sounds like exactly the kind of thing your GHIC card was built for — and for the emergency surgery itself, it is. The Spanish public hospital will treat you at the same cost a local resident pays, which in most cases means nothing changes hands at all. What nobody tells you at the check-in desk is what happens next: the air ambulance that flies you home to a UK hospital bed, arranged privately because the NHS doesn't send its own aircraft to collect stranded tourists, can run past £30,000. Your GHIC has already done its job by then. It just never covered that part.
What the GHIC Actually Pays For
Your Global Health Insurance Card replaced the old EHIC after Brexit, and if you're travelling on a card issued back in 2020 or 2021 it's worth turning it over before you book anything, because a Freedom of Information request obtained by MoneySavingExpert found that just over 1.28 million GHICs and 927,000 EHICs are due to expire across the UK during 2026 alone. What the card actually buys you, once it's valid, is state-funded healthcare in the EU — plus Switzerland, Australia and a handful of other countries with reciprocal deals — at whatever rate a local resident would pay, which for genuine emergencies is often free or close to it. The load-bearing word is "necessary": a broken arm, a sudden infection, a diabetic emergency all qualify, and so does routine treatment for a pre-existing condition, such as dialysis, if you happen to need it while you're away. It even extends to maternity care, though only if the trip wasn't planned around giving birth abroad in the first place. None of this applies once you're outside the participating countries — Turkey, Egypt, the USA, Canada and most of Asia sit entirely outside the scheme, so a GHIC in your wallet on a trip to Marrakech or Miami is decorative at best. And even inside the EU, if the ambulance takes you to a private clinic rather than the state hospital, which happens more often than travellers expect in busy resort towns, the card is worthless the moment you walk through that particular door.
The Gap That Bankrupts People
Repatriation is the line item that turns a survivable accident into a financial catastrophe.
GHIC gets you treated in the Spanish, French or Greek public system at local rates, but flying you home afterwards, especially with a medical escort, sits entirely outside its remit — and an air ambulance from the Mediterranean to a UK hospital routinely costs more than £30,000. Cruise-ship medical centres fall into the same blind spot: they charge private, US-style rates regardless of which sea you're sailing, and the card simply doesn't apply on board. Trip cancellation, curtailment, lost baggage, mountain rescue — none of it is GHIC's job, and the NHS itself is explicit that the card is not a substitute for private travel insurance, not a cheaper alternative to it.
The FCA Rules That Changed on 1 January
The Financial Conduct Authority tightened its signposting rules for travellers with pre-existing medical conditions at the start of this year. Insurers now only have to point you towards a specialist-insurer directory once your medical-condition loading pushes the premium above £200, up from the old £100 threshold, and that trigger point will now track the Consumer Price Index every five years rather than sitting fixed indefinitely. The regulator's own review found the original rule had generated roughly 21,000 extra policy sales — a smaller effect than it had hoped for — which is presumably why it's now running a parallel piece of work: a detailed look at claims service quality across the home and travel insurance markets through the second and third quarters of 2026, feeding into a wider value-measures review due to report back before the year is out.
If you've ever been prescribed medication for anxiety or depression and you're tempted to leave that box unticked because the premium jumps £40, don't. Non-disclosure is the single most common reason UK insurers reject a medical claim outright, and it makes no difference whether the condition you hid had anything to do with the claim you're making. The FCA is separately reviewing how insurers underwrite pre-existing mental health conditions, because in plenty of cases the loading looks disproportionate to the actual risk — that's a slow-moving fix, though, and it won't help anyone booking a trip this August.
What Cover Actually Costs This Summer
Price comparison sites will show single-trip European cover from around £12.60 to £14.50 depending on which provider you land on, and MoneySuperMarket's own June 2026 data puts the realistic average for a solo traveller at £16.76 — a figure that drops toward £10 a head once you're travelling in a group of six or more, because most insurers price per policy rather than strictly per person. Annual multi-trip cover for Europe-only travel starts from roughly £15.50; worldwide cover, which you'll need for the US or most of Asia, starts closer to £39.50. If you take more than two trips a year, buy the annual policy — it's cheaper than paying for single-trip cover twice, and it saves you re-declaring the same medical history every time you book a flight. All of these headline prices already include Insurance Premium Tax at 20%, the higher rate applied specifically to travel cover rather than the 12% standard rate charged on most other personal insurance, and it has sat unchanged since 1997 despite periodic speculation that the Treasury will eventually move it. That tax alone adds a meaningful chunk to the price on screen, and it's baked in before winter sports cover, gadget cover or cruise cover get added on top. None of this means the cheapest policy on the page is the right one, though: a £12.60 annual policy that caps single-item baggage loss at £100 isn't actually a bargain if your phone goes over the side of a boat in Kalkan, and the real comparison has to happen on the policy limits, not the number in bold at the top.
Reading the Policy Before You Get to the Gate
Most standard policies exclude anything the government advises against — if the Foreign, Commonwealth & Development Office changes its guidance on a region after you've booked, that's usually the one scenario where cancellation cover pays out cleanly, whereas "I changed my mind" or "the forecast looks bad" almost never qualifies. Activities matter too: paddleboarding and a gentle hike are covered under a standard policy, but skiing, scuba diving below a certain depth, or anything the insurer classes as hazardous needs a specific add-on, and claiming without one is a guaranteed rejection. Before you sign anything, the two-page Insurance Product Information Document is worth five minutes, specifically for:
- The single-item and total baggage limits — often £100–£300 per item, nowhere near what a modern phone or laptop costs to replace
- The excess per claim, and whether it applies once per trip or once per incident
- Cancellation cover reasons, which most policies list explicitly, and "changed my mind" is never on it
- Activity add-ons, if skiing, diving or anything more adventurous than a coastal walk is on the itinerary
- Medical condition disclosure requirements, among other things worth a second read before departure day
A £100 excess against a £16 premium tells you the insurer expects to pay out rarely, while a £25 excess against a similar premium usually means thinner cover elsewhere to compensate. Read that line before anything else on the summary page, because it's the number that decides whether a cracked phone screen is even worth claiming for.
Who to Buy From
For a straightforward two-week trip to Portugal with nothing to declare, a mainstream insurer such as Direct Line, LV= or the Post Office will do the job without any drama, and there's no reason to pay extra for a bigger name. The calculation changes the moment you have something to declare. Staysure and other insurers built specifically around medical underwriting will often quote lower than a mainstream comparison-site result once your actual conditions are priced in properly, because they're not padding the premium with a blanket buffer for risks they'd rather not think through — a mainstream insurer's headline quote can look cheaper right up until you disclose a heart condition and watch the price triple, or watch the policy quietly exclude the one thing you actually needed covered. Saga's travel policies are worth a look too if you're travelling with someone over 65, since age-related loading is where mainstream comparison-site quotes tend to fall apart fastest.
Whichever policy you land on, that two-page IPID takes less time to read than checking in for the flight — and it's the only document that tells you, in plain terms, whether a £30,000 air ambulance bill is actually somebody else's problem or still entirely yours.