Healthcare entitlements in Europe: now and post Brexit

Hospital corridor

At the moment, the United Kingdom is still classed as part of the EU which means if you have an accident abroad or fall ill on holiday in another EU state, you are entitled to the same healthcare treatment that a resident of that country would receive in a medical emergency.

This entitlement also extends to non-EU states forming part of European Economic Area (EEA) including Iceland, Liechtenstein, Norway and Switzerland. 

European Health Insurance Card (EHIC)

In practice, access to healthcare in Europe is through the presentation of a valid European Health Insurance Card (EHIC). For those holidaying within Europe, we would strongly advise obtaining such a card and keeping it in-date.

You can apply for a card, free of charge, by using the online form.

Ordinary UK residents entitled to EHIC

Entitlement to an EHIC is not based on a person’s nationality but instead whether or not they are insurable under EU law.

The UK operates a residency-based healthcare system which means that insurability in the UK is generally determined by residency - and not by the past or present payment of National Insurance contributions or UK taxes.

The upshot is that if you are ordinarily resident in the UK then it is likely that you will be considered to be insured by the UK under EU law and will be entitled to a UK EHIC.

Many Brits missing out on free foreign healthcare

Despite the EHIC being free and enabling us to access foreign healthcare at a significantly discounted rate, a considerable proportion of UK residents do not carry an EHIC at all or carry expired cards which would not help them if they needed access to medical treatment abroad.

Travel insurance is still important

Of course, given that the EHIC only entitles the individual to free, state provided, emergency care on the same basis as a resident of the country in question, it is recommended that it is used alongside travel insurance.

Failure to take out travel insurance could leave you personally liable to a treatment centre or hospital for significant treatment costs not covered by the EHIC.

If I have travel insurance, do I still need the EHIC?

Many UK residents bypass the EHIC in favour of travel insurance but arguably, this is not a sensible approach. Your travel insurance could turn out to be void, expired or your insurer could refuse to indemnify you for treatment costs due to a failure to disclose relevant information.

In the circumstances where the insurer refuses to indemnify you, the basic cover provided by the EHIC is of vital importance.

Further, many UK tourists take the risk of travelling without insurance or find it to be an unnecessary expense on the assumption that they will receive emergency treatment at their EEA destination - again in those circumstances the EHIC scheme provides UK travellers with some comfort.

Of course, travel insurance may offer additional non-health related protection such as cover for lost luggage. You should always check the main terms of your travel insurance to ensure that it provides enough cover and covers the type of activities you intend to participate in while on holiday such as using jet skis. Specific policies may be required for certain activities, such as winter sports.

Uncertainties for British tourists post Brexit

At this stage it is unknown how Brexit will impact on the continued level of protection for ordinary UK residents when holidaying in EU or EAA countries.

For example, as a result of EU Law, UK citizens injured abroad in road traffic accidents can currently bring an injury claim against a foreign insurer in the UK without having to negotiate the hurdles of foreign lawyers and legal systems.

Similarly, a question mark exists over EHIC cover after Brexit. If EHIC cover is not continued, it has been argued by some commentators that UK residents may face increases in travel insurance costs. Travel insurers are likely to argue that this is necessary as they will need to cover the cost of the treatment that is currently available free of charge under the EHIC.

Under the EHIC, the EEA member state providing treatment can claim back the cost from the country whose citizen accessed it. It was reported in 2016 that the UK pays more than £670m to EU countries for Brits' healthcare abroad, while claiming back less than £50m.

Therefore, given that most other EEA members appear to benefit from these reciprocal arrangements, it is suggested that EU negotiators may wish to agree to continue the EHIC or a similar scheme post Brexit.

It could also be argued during negotiation that loss of this emergency treatment provision in Europe may encourage some UK tourists to stay at home or travel to a non-EEA destination such as America. If this were to happen, it would have knock on economic effects for EEA states who currently benefit from high numbers of UK visitors.

However, as it stands there is no agreement on this and UK tourists have to be prepared for the loss of this healthcare entitlement at some point over the course of the next couple of years or during any transitional period that post-dates Brexit.