Who is entitled to a UK’s European Health Insurance Card (EHIC) after Brexit?

The United Kingdom has left the European Union but will continue to issue European Health Insurance Cards (EHICs) under the provisions of the withdrawal agreement.

European Health Insurance Cards give access to state-provided healthcare during temporary stays (e.g. for work, study or leisure) in other EU countries, as well as Iceland, Liechtenstein, Norway and Switzerland.

EHICs are issued free of charge and are not a substitute to private insurance. They cover only medical care that cannot wait returning home, ensuring that treatments are provided at the same conditions of patients of that country (some healthcare systems provide treatments for free, others for a fee).

The right to an EHIC is not based on nationality, but on the affiliation to the social security system of a country participating in the scheme. For example, EU nationals living in Britain rely on EHICs issued by the NHS when travelling in the rest of Europe.

There are some exceptions, however: non-EU nationals cannot use their EHIC in Denmark, Iceland, Liechtenstein, Norway and Switzerland, unless they are refugees residing in an EU member state or are family members of an EU citizen. Residents of the Channel Islands and the Isle of Man are not eligible for an EHIC, and the card is not valid on cruises.

Now that the UK has left the EU, will the EHIC system continue to operate in Britain? The answer is yes, at least for a while.

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Under the withdrawal agreement, nothing will change during the transition period that will last until 31 December 2020 (and can be extended until 2022). European Health Insurance Cards issued in the UK will continue to be valid in the EU and vice versa.

The NHS will also continue renewing EHICs during this time. “If your EHIC expires before 31 December 2020, you will need to apply for a new EHIC that you can use during this period,” a spokesperson of the Department of Health and Social Care told Europe Street.

EHIC issued to people protected by the withdrawal deal

The Department of Health and Social Care also confirmed with Europe Street that the NHS will continue to issue European Health Insurance Cards after 31 December 2020 to the people that “retain full entitlements to reciprocal healthcare” under the withdrawal agreement.

These include nationals from the EU and EFTA countries (Norway, Iceland, Liechtenstein and Switzerland) residing in the UK, UK students or persons receiving a pension or exportable UK benefit (S1 holders) living in the EU or EFTA territory at the end of the transition period.

Also covered are frontier workers (people who work in one state and live in another) before 31 December 2020 for as long as they remain in the host state. Another group that will continue benefiting consists of workers posted temporarily in an EU or EFTA country and their family members not covered in their own right.

In addition, the agreement says that UK and EU nationals who find themselves in a ‘cross-border situation’ over 31 December 2020 (for example UK nationals on holiday in an EU or EFTA country or students for the duration of their course) can continue using their EHIC until they return to the UK (or vice versa).

Practical details to be resolved

It is still unclear, however, how the NHS will be able to distinguish the people who are entitled to a UK-issued EHIC from those who are not after 31 December 2020.

In theory, the health insurance card could be delivered to the people who have obtained “settled status”, the new residence scheme for EU and EFTA nationals in the UK. But this would exclude dual British-EU nationals, who are not allowed to apply for settled status. Irish citizens, who are covered by separate bilateral arrangements, are also not required to apply, but they can if they wish to.

“The problem with settled status is that it has been set up to prove only UK residence rights. We are yet to understand how it will link to the provisions of the withdrawal agreement. There are people who fall within the scope of the withdrawal agreement, but are not allowed to apply for settled status – for example dual nationals – how will they prove their rights?” asked Monique Hawkins, a campaigner of citizens’ rights group the3million.

The group has been calling for a physical document for EU nationals to prove their rights in the UK after Brexit.

As regards Britons living in the EU, they will also continue to be eligible to EHICs issued by their countries of residence and they will be able to use them when travelling to the UK.

“There are questions about how this would happen in practice in the UK and we will be monitoring the implementation of this to make sure it happens,” said Jane Golding, co-chair of the British in Europe coalition.

These practical details are among the issues to be resolved during the transition period, and perhaps discussed in the next phase of the EU-UK negotiations.

“The agreement we have reached with the EU is that until 31 December 2020 there will be no changes to reciprocal healthcare, including the EHIC scheme. We are discussing the future of reciprocal healthcare arrangements with the EU,” a Home Office official told Europe Street.

More information about the European Health Insurance Card is available on the European Commission and NHS websites.

Claudia Delpero © all rights reserved.

Photo by John Charlton © European Union, 2017.

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