I would always have it A few years ago a friend of our hurt their back while in Spain the local hospital treated him very well under the EHIC scheme but as it was a long term issue ( it actually carried on for 2 years ) and he could not sit in a plane seat they had to stretcher him into a flight having removed 2 rows of seats. This repatriation cost over £10k which the insurance company paid the alternative was to stay in Spain receiving treatment for 2 years he was only 42 at the time luckily this has now cleared up ,, so my experience is always have it