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Health insurance is a prerequisite for most international visas, and sourcing affordable, quality treatment remains a concern for many expats in a post-Brexit world.

Let’s look at how the EU Health Insurance Card (EHIC) scheme has changed and what British expats need to do to ensure they are fully covered abroad. Please get in touch for further guidance around any information discussed here or to implement robust insurances to protect your family’s health.

EHIC Health Cover for UK Nationals in Europe

The first step is to explore what is happening with existing EHIC cards.

As part of the Withdrawal Agreement, EHIC cards already issued before 1st January 2021 remain valid and can run for up to five years. Your card is eligible until the expiry date shown on the front.

If you live permanently abroad or work outside of the UK, you can use an EHIC card in any EU country for:

  • Emergency treatments and A&E admissions.
  • Treatment for pre-existing or long-term conditions.
  • Routine treatment for existing conditions.
  • Maternity care (excluding travel overseas to give birth).
  • Dialysis and oxygen therapies.

Note that using your EHIC card doesn’t necessarily mean that these services are free – there may be charges or contributions required depending on the state healthcare system in that country. It’s also wise to consider comprehensive medical cover and travel insurance.

An EHIC card does not cover repatriation costs and only applies to treatments that are considered urgent and can’t wait for you to travel back to Britain. You are also subject to standard waiting times in the local hospital or clinic system and cannot receive treatments available only to private patients.

Replacing an EHIC Card When it Expires

You can apply for a replacement card when your existing EHIC card has six months left, and will receive the new version, called a UK Global Health Insurance Card, or GHIC.

Like the EHIC, a GHIC card has limitations, although applying is free of charge. Be wary of any sites charging a fee for a GHIC card – this service is available to all British citizens at no cost.

GHIC cards entitle you to:

  • Access healthcare during a short-term stay in the EU of up to 90 days.
  • Emergency treatments and necessary therapies as detailed above.

If you plan to live permanently outside of the EU or Switzerland, while a GHIC card is a ‘global’ permit, it won’t cover any healthcare costs. Many expats in the EU also need advance approval or to pre-arrange required treatments unless there is an unexpected crisis.

State-provided medical treatment and healthcare services are available throughout the EU and in Switzerland, Norway, Iceland and Liechtenstein. The caveat remains that not all treatments are free, and you may need to cover the cost personally. A GHIC card lasts for five years and shows the expiry date on the front.

Outside of the EU, there are several reciprocal agreements with non-European countries, such as New Zealand and Australia. These agreements mean that British visitors can receive emergency treatments for free or at a reduced cost. The drawback is that this applies only to essential healthcare needs and won’t cover any pre-existing or long-term conditions.

Accessing Medical Care Without an EHIC or GHIC Card

If you have an accident or become unwell while overseas and don’t have your EHIC or GHIC card with you, there is a Provisional Replacement Certificate (PRC) system, which proves your entitlement. The coverage provided is the same, and you need to contact the NHS Overseas Healthcare Service to apply.

They will ask for your personal details, National Insurance number and contact information for the facility or department where you are seeking treatment.

S1 UK-Funded Healthcare

Another scheme that may be beneficial is the S1 form, which entitles some British citizens, in receipt of a UK State Pension, to receive free healthcare in the EU and Switzerland.

Eligible applicants need to apply for a certificate of entitlement, and if successful, the UK will pay for any treatments required. You need to live in an EU country or Switzerland and provide information to prove your nationality before a certificate is issued.

Expats receiving a state pension from a foreign country and the UK simultaneously are not eligible since your host country is considered responsible for your healthcare costs.

EHIC/GHIC Cards vs Private Medical Insurance

It remains important to take out private medical cover when travelling to any overseas country or living abroad as a UK national. The EHIC and GHIC cards are designed for emergencies and to ensure British citizens receive urgent treatment when required, but they aren’t a replacement for adequate insurance.

For example, an EHIC or GHIC card will not:

  • Cover costs for all treatments since this is usually restricted only to conditions where treatment is considered urgent.
  • Pay for repatriation expenses, which can be extremely high where medical flight transportation is needed.
  • Allow for UK nationals to access all maternity services or give birth overseas.
  • Enable expats to receive free healthcare treatment – the costs depend on the country in question. You may need to pay for all or some of your medication, hospital stay or emergency transportation.

Private medical care, such as a rescue situation in a ski resort, is also not covered by the health insurance card system and will be an out of pocket expense if you do not have any cover.

Professional Healthcare Insurance Advice for UK Expats

There are thousands of insurance products out there, and the best way to ensure you have comprehensive coverage to protect your wellbeing in any scenario is to seek independent advice. Medical insurance varies considerably in cost and coverage. The ideal policy will safeguard you against all eventualities and ensure that you receive swift treatment at the best facilities in your host country if you become unwell or are involved in an accident.

Please contact the Chase Buchanan team for further guidance about coverage options abroad or to evaluate whether your existing expat health insurance provides sufficient coverage for you and your family.