The United Kingdom will issue new versions of the European Health Insurance Card (EHIC) that can be used for emergency and necessary treatments in Europe, as the country and the EU have agreed to continue reciprocal healthcare arrangements after Brexit.
European Health Insurance Cards ensure access to public healthcare during temporary stays in EU countries, plus Iceland, Liechtenstein, Norway and Switzerland (the EFTA countries).
As part of the new arrangements, the UK will replace the EHIC with two new cards.
Citizens from the European Union, Norway, Iceland, Liechtenstein and Switzerland who were living in Britain before the end of the Brexit transition period are entitled to a new UK EHIC under the withdrawal agreement.
All other UK residents are entitled to the new UK Global Health Insurance Card (GHIC) under the EU-UK trade deal agreed in December 2020.
The UK National Health Service (NHS) will continue to accept EHICs issued by EU member states.
Who is entitled to the new EHIC
EU and EFTA nationals protected under the EU-UK withdrawal agreement have the right to receive a new EHIC issued by the NHS Business Services Authority (NHSBSA).
The new EHIC provides the same entitlements of the current one and will remain valid for as long as the holder is “covered under the [withdrawal] agreement”.
The card will mention in the top right corner ‘CRA’, to show it is issued in compliance with the Citizens Right Agreement, the NHSBSA says.
Persons who receive a UK state pension or another exportable UK benefit and live in the EU, Norway, Iceland, Liechtenstein or Switzerland by the end of 2020 can continue benefiting from state-provided healthcare where they live using this new card.
Frontier workers, that is individuals who work in the UK but live in the EU, Norway, Iceland, Liechtenstein or Switzerland, or workers posted temporarily to such countries before 31 December 2020 are entitled to the new UK EHIC too.
Family members of the above groups also have the right to get the new card, according to UK government guidance.
In addition, the UK will issue the card to UK students, including citizens from non-EU countries who reside in Britain and have paid the UK’s Immigration Health Surcharge (or are exempt), who are attending schools and universities in EU or EFTA countries at the end of the Brexit transition.
How to request the new card
The new EHIC must be requested from the NHSBSA through an online portal launched on November 9 2020.
Access to the portal is staggered. The first groups invited to apply were pensioners or recipients of UK benefits who live in the EU and their family members, frontier workers and their family members, and students.
Citizens from EU countries, Norway, Iceland, Liechtenstein and Switzerland who live in the UK, and their dependants, were invited to apply from December 21.
To issue the new card to EU and EFTA nationals, NHS Digital is expected to “validate” their settled status, the scheme securing their post-Brexit residence rights, the NHSBSA website says.
Europe Street has tested the application system for EU citizens. There is a short list of questions about personal data, including the NHS number. It is possible to request the card for family members and dependants through the same form.
At the end of the process, the response is:
“We will now review your application. To check your eligibility for a new UK EHIC, we need to check your right to reside in the UK and your UK residency. This is not a credit check and will not affect your credit score in any way. If you added any dependants to your application, we will also make the necessary checks to confirm they are eligible. Once we have done this, we will process your application. We will email you and let you know if your application has been successful or not. If we require any further information, both for yourself and any dependants you have added, we will contact you and let you know what we need. Once all the information we need has been accepted, you will receive an email to confirm”.
One day later, the NHSBSA requested via email to provide proof of residency. “We have been unable to confirm your entitlement to a UK EHIC and require further information to support your application,” the email says.
After sending the documents to the email address provided by the NHSBSA (email@example.com), the response was: “The recipient’s mailbox is full and can’t accept messages”.
On January 14 2021 the NHS announced on Twitter it had worked on the email problem and asked to re-send evidence to a new email address (firstname.lastname@example.org).
This time the response was: “Thank you for your email, we aim to respond as soon as possible”.
The NHSBSA initially said applications will be processed within 5 working days, but now says that “due to the current increased demand… all applications will be processed in due course”.
‘Information campaign needed’
Maike Bohn, co-founder of citizens’ rights group the3million, told Europe Street: “With less than 50 days to go, it is crucial that the UK government runs a strong communications campaign about who is entitled to the EHIC and what they need to do to get one, even if they haven’t successfully applied for settled or pre-settled status yet”. The deadline to apply for settled status is 30 June 2021.
Bohn noted clarifications are also needed “for dual nationals who are covered by the withdrawal agreement but can’t apply for settled status”. The same is true for Irish citizens, who are not required to apply for the EU settlement scheme.
At the time of writing, the system allows dual EU-UK citizens to apply for the EHIC and request another for UK family members (e.g. spouses and children), but does not let UK citizens born in the UK be the main applicants.
Kalba Meadows of British in Europe, a coalition of groups representing Brits in the EU who recently published a post-Brexit social security guide, said they were “pleased” that “a process has been put into place” for the recognition of the EHICs.
However, “we wait to hear what plans the NHSBSA intends to put in place to contact relevant EHIC holders directly to inform them of the need to apply for a replacement card,” she added.
Who is entitled to the GHIC
The EU-UK trade and cooperation agreement continues reciprocal healthcare arrangements for all other UK residents travelling between the UK and EU countries. In this regard, the UK government launched on January 11 a new UK Global Health Insurance Card (GHIC).
This will offer equivalent protection for emergency and necessary healthcare, including for pre-existing or chronic conditions, during temporary stays in the EU.
However, the GHIC is currently not valid in Liechtenstein, Norway, Iceland and Switzerland. The UK is still seeking to conclude a new deal on social security coordination with these countries.
Until a new agreement is in place, the UK and Norway will apply an amended version of their 1991 Convention on Social Security and Protocol on Medical Treatment, which covers necessary healthcare, the NHSBSA says.
UK residents will continue to be able to access necessary healthcare in Ireland by showing proof of residency or the EHIC or the GHIC, under the Common Travel Area arrangements.
The GHIC can be requested online. People are advised to apply at least 2 weeks before travelling to ensure the card arrives on time. UK residents within the scope of the withdrawal agreement do not need to apply for a GHIC as they are already covered by the EHIC, the NHSBSA specifies.
The UK has reciprocal healthcare arrangements with Australia, New Zealand, some Crown Dependencies and overseas territories (such as Isle of Man, Jersey, Gibraltar), and some Balkan states (Bosnia, Serbia, Montenegro, Kosovo), the government reminds. But these require different documents.
Britons living in the EU
Britons in the EU affiliated to the social security system of the country where they live by the end of the Brexit transition will continue to be eligible for the EHIC issued by that country, so they won’t need a new one.
The British government has also clarified that if they return to the UK, they will be able to use the NHS like any other UK resident.
How the EHIC and GHIC work
EHICs and GHICs are issued free of charge and are not a substitute to private insurance, EU and UK official websites remind. They cover only medical care that cannot wait returning home, ensuring that treatments are provided at the same conditions of patients of the country they are in (in some cases for free, in others for a fee).
The right to the EHIC is based on the affiliation to the social security system of a participating country, not to nationality.
Non-EU citizens who live and work in the EU are entitled to the EHIC issued by the country where they live, which can be used across the EU but not in Denmark, Iceland, Liechtenstein, Norway and Switzerland, unless they are refugees or family members of an EU citizen.
All current cards remain valid until their expiry date.
For any issue arising while travelling in the EU without an EHIC, the NHSBSA can be contacted directly by calling +44 191 218 1999 Monday to Friday, 8am to 6pm GMT.
Questions can also be asked via the Twitter account @NHSBSA_OHS.
Claudia Delpero © all rights reserved
This article was first published on November 15 2020. It was updated with the opening of applications to EU citizens on December 22 and with information about the EU-UK trade agreement and the GHIC on January 18 2021. Photo by Arnaud Devillers © European Union 2017 – Source : EP.
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