Heading for the ski slopes...are you covered?

Skiers are in for a shock if they totally rely on the EU health insurance card, says Helena Crow

The European Health Insurance Card, which replaces the old E111 form, claims to cover "any medical treatment that becomes necessary during your trip". However, loopholes in the system could leave those holidaymakers heading for the ski slopes of Europe this winter thousands of pounds in debt if they are not fully aware of what the card does and does not cover.

The card, administered in the UK by the NHS, allows holders to receive basic medical treatment abroad to the same level as nationals of the country they are visiting. That means that many countries will ask patients to pay out for medication, ambulance, and numerous other extras. The card does not cover the costs of emergency repatriation should a traveller be taken seriously ill. And many of the newly emerging ski resorts in non-EU Eastern Europe are not within the scheme at all.

France, Italy and Switzerland are traditionally the most popular European ski destinations for British tourists. Although they provide up-to-date ski facilities, they do not do so well on free medical provision. In France and Italy, ambulance and air-lift fees must be paid for by the injured individual even if they hold an EHIC, a cost that can amount to several thousand pounds. In Switzerland, only 50 per cent of ambulance and air travel will be paid, leaving those without travel insurance who have to be air-lifted having to pay out around £1,000.

In France, you will have to pay up to 65 per cent of the cost of prescribed medicines, even those used within the hospital, while Swiss hospitals demand a fixed daily in-patient fee, including the price of medication, which reaches a larger figure if the patient stays for more than 30 days.

Italy's healthcare system is even more complicated, being subject to numerous regional variations. The NHS suggests that tourists speak to the appropriate local authority through the Italian embassy to see if their ski area is covered. But it adds that "travellers without extra insurance should be prepared to pay".

The new card is not valid in Bulgaria, the leading ski destination in non-EU Eastern Europe. However the country has a reciprocal healthcare agreement with the UK which entitles holidaymakers to hospital treatment at an in-patient charge similar to that paid by locals, except in an emergency, when it is free.

The disturbing reality for winter tourists is that the small print in the EHIC agreement varies from country to country.

For further information call the NHS Health Customer Service Centre (020-7210 4850).