Medical Insurance
Medical Insurance


Written by Jennifer Stevenson
1st May 2019

Brexit: what happens to healthcare cover for Brits in Europe?

Holiday travelers and Britons living in France and Spain have been concerned about what will happen to their healthcare cover if and when Britain leaves the EU.

Currently, UK nationals can get free emergency treatment on holiday if they fall in another EU country, if they use their EHIC card.

If there is a no-deal Brexit it will no longer be valid, and all travellers in the EU will need medical insurance.

Taking care of Britons resident abroad

And what about the three quarters of a million UK nationals living in the EU: retired to a sunny lifestyle in Spain, or working and telecommuting from France, Germany or elsewhere?

Under the current system, the UK pays for the healthcare costs of 180,000 Brits receiving healthcare across the EU.

The process is a reciprocal function of EU membership: EU countries and EFTA states (Iceland, Norway, Liechtenstein and Switzerland) reimburse each other for the healthcare of their citizens living abroad who would be covered by their respective social security schemes in their home countries.

Temporary cover by the government in the case of a no-deal Brexit

In March, with the first exit deadline looming, the UK government committed to funding the healthcare costs of current treatments for people for whom the UK is responsible, who currently benefit from the S1 certificate which gives them rights to the same healthcare as nationals of the country in which they leave.

The government’s commitment was for up to one year (until the end of 2020).

The deal also applies to people who have applied for treatments in the EU prior to and on exit day, for up to one year, said health minister Stephen Hammond. The deal was yet to be agreed with each member state.

Healthcare for Britons living in France

Presently, UK citizens who have been living in France for three months and who aren’t working or receiving a pension, can apply to be covered by the French healthcare system, PUMA. They receive the same state healthcare as French nationals.

In the case of a no-deal Brexit they will need to apply for residence permits to be eligible for PUMA. Authorities have yet to decide how much this will cost.

UK residents in France who are employed should be registered by their employer to pay social security, which makes them eligible for French healthcare. Self-employed Britons need to register themselves.

For UK pensioners in France, in the case of a no-deal Brexit they will continue to receive French state healthcare as before, while the two governments decide what a future arrangement will be.

It’s possible they will need to pay an annual fee to be eligible for PUMA, of 8% of their income above a certain level (in 2018 the threshold was €9,933 (£8,725).

Healthcare for Britons living in Spain

An estimated 300,000 British nationals live in Spain – more than in any other EU country. A no-deal Brexit would affect different groups of UK citizens differently.

Britons working in Spain and paying Spanish social security contributions would still be able to access state health-care.

The situation for pensioners is unclear – they may be eligible for care under Spain’s law regarding universal healthcare.

Healthcare for Britons living in Ireland

The Common Travel Area (CTA) means that the relationship between the UK and Ireland is different to elsewhere in the EU. It allows each country’s citizens access to the host country’s emergency, routine and planned healthcare.

In the case of a no-deal Brexit, both governments are committed to maintaining the CTA.

Returning to the UK for healthcare

Health minister Hammond also announced that UK pensioners living abroad would be able to return to the UK to receive treatment on the NHS if they face changes in their healthcare status.

They will be considered “ordinarily resident” upon arrival if it is clear that are in the UK to reside “on a properly settled basis for the time being,” he said.

Claire Ginnelly, managing director of Premier Choice, says the health minister’s comments relating to Britons returning to the UK for treatment are confusing: “It reads as though they may have to be resident back here.”

She recommends that Britons living in Europe should look at some sort of health insurance cover.

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