NHS HEALTH COVER - What does it show about the State We are in Over Brexit 

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What Does The State Of EU Brexit Mean For Expat Healthcare.

What are the healthcare options for Expats when returning to the UK? 

What are the healthcare options for EU Expats entering the UK?

How does Brexit Change this State of Affairs?

As temperatures rise, and ill feeling spreads, ProACT Sam examines the State we are in with EU Brexit and Healthcare for Expats Living and Working Abroad. 


Free UK NHS Healthcare for Residents

The right to NHS healthcare treatment is dependant upon ‘ordinary residence’ in the uk and from day one for Expats.

Ordinarily resident does not mean a British citizen, it means that you are based in the UK, and can demonstrate this.

If you have home in the UK, and spend large parts of the year living and working abroad, but use UK as the base, you have access to free NHS cover.

An Expat relocating to the UK to live and work, and who have work and pay taxes will also qualify for free NHS cover, along with their family.

Under EU rules, the UK cannot discriminate against any EU citizen, so, has to offer the same NHS Health treatment to all EU Citizens - but only before before Brexit day. 

Outside the ‘EU common rules zones’ any sovereign country can discriminate against Expats.


Relocating & the UK

The day an Expat leaves the UK they no longer qualify for free NHS treatment in the UK. 

If a UK Expat returns to the UK and establish their home there then they will qualify for medical treatment from day one. 

People with a broader range of benefit needs could have issues and delays, say regarding nursing care needs. 

I try to emphasis to clients that pretending to be uk based at a family friends address is not a sound basis for a healthcare strategy. 

EU Expats living and working in the UK as tax payers will qualify for NHS without delay also. 


The Same But Different. 

Under any reciprocal agreement for health care the state health care available will be different country by country. Richer Northern European countries tend to offer a more comprehensive cover and treatment, and may include medicines, nursing care, and social care. Charges at point if provision can vary by country. 

Expats should check out what state healthcare is on offer in their country of residence. 


Earning Qualification for State Healthcare

Expats can qualify for NHS state healthcare in the EU generally in one of 4 ways;

  1. State Retired Age can transfers state healthcare benefits 
  2. Certain disabilities can qualify a younger person for transfer of state healthcare benefits 
  3. Working people can get up to 18 months temporary transfer for contract work
  4. Working people can, like the UK example above, relocate and commence social insurance contributions in their new country of residence, to then qualify for local health care. 


Outside the EU 

If an Expat or his family member are not EU citizens then different rules apply. 

This group of clients that struggle includes Expats returning from working around the world with non eu partners. The rules are significantly different here and the UK government policy is clear. 


Levy Applied

Non EU Expats must pay £200 per year per family member for UK NHS cover - even if working and paying taxes. 

In addition UK employers of non EU expats must pay a £1000 per year levy in addition to payroll taxes. 

This levy doesn’t apply to UK expats returning to the UK. Nor does it apply to EU Expats Living and Working Abroad in The UK. 

Before Brexit. 

Once the UK is outside the EU, EU citizens could have the same rules applied when Living and Working Abroad in the UK. 

Unless there is a bilateral treaty for healthcare between two countries - as exists between Cyprus and The UK. 

Or Unless the UK has a Common agreement with the EU 27 countries. 

“And this is where the state of health of EU Brexit negotiations are causing anxiety and I’ll feeling at this time “ Says ProACT Sam


The State We Are In - No Holding Back 

The current negotiations for Brexit are anything but healthy. Of course it is politics with the noise and haggling over customs agreements for a withdrawal treaty. A customs treaty which would save big EU business the expense of applying changes, and that would allow the EU to keep the UK closer for longer. 

Since Article 50 was triggered by the UK the 2 year negotiations have been focused on a withdrawal treaty. This would allow an orderly exit from EU Brexit Day 29/3/19, via an extended transition period, during which new trade agreements between the UK and EU could be agreed, to be then applied from the start of 2021. 

But if there is no withdrawal treaty, there is no transition period, then EU Expats trying to enter the UK after EU Brexit day will face Healthcare rules in the UK for non EU citizens with the additional rules and expenses. 

It is interesting the EU Brexit negotiations have moved into intensive care with the EU struggling with its rules based administration negotiating with a political UK government looking to create a mutual agreement. 



The EU rules means that article 50 is terminal and can’t be reversed and the UK must now leave the EU. 

Technically by EU rules The UK would have to leave then negotiate any re-entry to join again. 

The EU rules don’t allow them to negotiate a new trading agreement for a non-eu UK government until the UK has left the EU. The purpose of the transition period was to provide this time. 

Such trade agreements may takes years, but EU rules means they cannot start this negotiation with the UK until after EU Brexit. 

The EU have many exceptional trade agreements already with 3rd countries - Norway Switzerland Japan Canada Ukraine Liechtenstein. 

Although the UK Trade, customs and laws are aligned today, the EU are not able to make a deal before Brexit to smooth the way. Like a rabbit caught in the headlights the EU rules have created a state of affairs where we have a ‘No Deal Brexit ‘ option looming. 



In which case all the politics of the Brexit negotiations since article 50 have been a waste of time. The UK could have EU Brexit sooner to then enable new trade agreement discussions to start. 

Why have a transition period to only allow another period of extended uncertainty for business, families and Expats?

The UK carries out 80% of its Trade globally, the UK-EU trade with no deal Brexit would carry on - the same but different. 

Big business can shout loudest, but do they represent what is best for most people and Expat family and business?

For me the worse scenario would then be the fudge - to ‘suspend ‘ Brexit day and leave the UK in and out of the EU indefinitely, with the sickly negotiations are extended. 


Waterloo to Brussels 

Leaders should lead. Take decisions. Let’s hope the operation and remedies applied over the next 9 months are a good medicine. Winter is coming - there are many battles to fight in the coming months before we have a clear vision.


ProACT Guide for Expats 

ProACT sam has produced a guide ‘How EU Brexit Affects Overseas Property Business and Pensions 

You can get your copy in our shop. 

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