What Happens After Brexit With the EHIC European Health Card?

UK NHS provision is of its standard.

There are fees paid for dental and medical prescriptions.

By and large a full range of emergency, acute and chronic health conditions are covered for UK citizens even if they are not contributing to NHS through taxes collected in National Insurance Contributions.

EU Reciprocal Healthcare for Expats and Travellers

Under EU reciprocal agreements the UK cannot discriminate against EU nationals who have free right to enter the UK and includes NHS health care. So because all UK nationals are entitled to NHS care, all EU Expats and their family relocating to the UK before Brexit day 29/3/2018 are entitle to NHS healthcare, and if a transitional period is agreed NHS healthcare will be available to EU Expats through this period. Indeed it could well be EU Expats could still relocate to the UK as late as December 2020 and still qualify for NHS healthcare.

The reverse is true: UK Expats can relocate to any EU country before Brexit day, or, during a transitional period, and qualify for the local healthcare of that country.

This does not mean the same cover is available. The medical cover offered by different countries may be more or less comprehensive than the UK, and may involve more point of treatment fees. 

Before relocating or travelling Expats or Holiday makers should checkout the healthcare of their EU destination. It could be that private medical cover, or travel insurance is cheaper than the fees you would pay in the overseas location.

Healthcare After Brexit for EU Expats

After the Brexit and any Tranistion period, we wait to see what evolves. The UK could agree a similar reciprocal agreement with the EU social security coordination agreement for travel or relocation to each country.

The UK could make new reciprocal social insurance agreements any EU country on a bilateral basis, as this is a fiscal and tax matter.  Cross-border healthcare for EU citizens is covered under EU social Security Coordination agreements, but these are not binding and sovereign powers remain with each State. 

There is not full EU control over fiscal tax matters, so individual countries have the freedom to make reciprocal tax and social insurance agreements.  An existing bilateral treaty exists between Cyprus and UK and this could be renewed and updated.

Living and Working Abroad 

Of course if relocating permanently to work in another country any Expat can contribute to the local Social Insurance scheme and qualify for a medical card cover and other welfare benefits like unemployment and sickness, again according to local rules.

This could mean a minimum qualifying period for contributions before benefits including healthcare are claimed.

European Health Card - EHIC

Over the last 10 years Expats and EU holidaymakers have become familiar with the European Health Card - the EHIC.

This has 3 main uses:

  1. Emergency Healthcare cover for EU citizens holiday and short term travelling within the EU (1 or 2 uses per trip)

  2. Long term reciprocal healthcare for those receiving state welfare pensions or long term benefits.

  3. Short term reciprocal healthcare cover for temporary work in another EU country

The EHIC card provides health care on a reciprocal basis as described above. To qualify for a card the law is specific, making it complicated - because all EU 27 countries plus the UK plus 3 EEA countries* are involved.

Who Qualifies for an EHIC Health Card

To qualify for an EHIC card you must be be insured under an EU/EEA social insurance scheme.

For the UK qualification for NHS Healthcare is based upon residence. If you are not UK based, even if you pay national insurance in the UK you may well not qualify for NHS cover or a EHIC health card. 

For Example: An overseas contractor, returning to their UK home at the end of every 8 week contract overseas, would qualify as being habitually resident in the UK.

A UK expat working in Spain for a local employer, returning to the UK at the end of a season to stay with family or friends, would not be covered.

A retired UK expat Living and Working Abroad  and receiving a state pension, will qualify for an EHIC health card as they are entitled to the social benefit payment, and the EHICH card is issued by the state paying the benefit.

A UK family Living and Working in the UK all can receive an EHIC Health card for Holidays, school trips, internship overseas, gap year travel and work, short term overseas work contracts up to 18 months.

What Happens After Brexit to EHIC Health Card

Once the UK is out of the EU and EEA then it is no longer subject to the EU Social Security Agreement.  

Therefore there will be no framework or validity for the UK to issue an EHIC Health Card. They could stop.

If there is a transition agreement, then in this period  EHIC health cards will continue to be issued and valid from March 2019 to December 2020.

So look out for a transition period whereby the UK and EU agree to maintain all existing agreements as if the UK remains in the EU.

Travel Insurance

Generally the EHICH health card should not be considered as a replacement for travel insurance.  Consider this well.  You should always take travel insurance to be sure.

Many credit cards offer free travel insurance for trips booked and paid for using their card.

Some bank accounts offer inclusive travel insurance.

Annual travel insurance plans are available for frequent travellers.

Or buy a policy just to cover the period of your trip.

Bilateral Social Insurance Agreements

Once out of the EU the UK is likely to reintroduce reciprocal social insurance agreements on a country by country bilateral treaty basis.  UK and Cyprus have an existing scheme that can be continued.  

The procedures and methods of applying this will only become clear once we know if any transitional period is agreed upon - the transitional period essential being to allow a status quo, while the new rules are agreed.

*European Economic Area (EEA) are countries cooperating within the EU and EEA rules without necessarily being full EU members. This includes the EU 28 plus the EU, Norway, Iceland, Liechtenstein. Switzerland has some associations but not all EEA. The UK has membership of the EEA only by its EU membership Technically the UK leaves the EEA when it leaves the EU.


Meanwhile contact us the ProACT Expat Experts for more guidance and know how on Living and Working Abroad for Family and Business across borders and down the generations.