How you pay, by country
| Country | How it works | Notes |
|---|---|---|
| Spain | Direct | Free state care at public centres; prescriptions at subsidised rate; medicines only in pharmacies |
| France | Pay & reclaim | Pay the doctor, get a feuille de soins, reclaim ~70% of GP fees |
| Germany | Direct (statutory) | Use statutory providers; the card is not accepted at private Privatpraxis |
| Italy | Co-pay ticket | SSN care on the card; you pay the regional “ticket”, not refundable in Italy |
| Portugal | Direct (SNS) | Largely free; a fee for ER use without referral; prescriptions part-subsidised |
| Greece | Direct (ESY) | Public hospital care free; small fees; islands can be limited |
| Netherlands | GP gatekeeper | See a public-scheme GP first for any referral; some co-payments |
| Croatia | Small co-pays | Use HZZO-contracted providers; small per-visit and per-day charges |
Where the card does not work
- Turkey: not in the scheme; rely on insurance.
- Switzerland: conditional only; carry proof of nationality or status.
- Iceland, Liechtenstein, Norway: not covered by the GHIC.
Common questions
Do I pay upfront to see a doctor in France?
Yes. France works on pay-upfront-and-reclaim: you pay the doctor or pharmacy, receive a feuille de soins, and reclaim a partial refund. With the card you typically recover around 70% of GP fees; insurance can cover the rest.
Is healthcare free in Spain for tourists?
With a valid GHIC or EHIC you get medically necessary state care in Spain on the same basis as a resident, generally free at public centres and hospitals. It must be a public provider, not a private clinic.
What is the Italy hospital ticket?
Italy charges a regional co-payment called the ticket for some care. The card covers SSN treatment, but the ticket is paid by the patient and is not reimbursed within Italy.
Can I use the card at a private clinic?
No. The GHIC and EHIC cover public, state-system providers only. Private clinics are paid out of pocket and claimed back through travel insurance.
Check it yourself
Rules change, so the official source is the final word.