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How does Brexit affect British holidaymakers' free healthcare abroad?

British holidaymakers planning to visit a European Union country in 2021 might wonder whether they can still receive free healthcare post-Brexit through their European Health Insurance Card.

The answer is "yes" at the moment - but changes are taking place that will gradually phase out the old EHIC and replace it with a new UK Global Health Insurance Card, known as the GHIC.

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While the transition period for Britain leaving the EU officially ended on 31st December 2020, it seems healthcare for Brits abroad is still in its own transition of sorts.

Currently, the GOV.UK website is still providing information on the EHIC and has no further details of its replacement.

British tourists whose EHIC, soon to be the GHIC Card is still valid can continue to use it until the expiry date. This includes cards issued up to the end of 2020, during the Brexit transition period, even though Britain officially left the EU on 31st January 2020.

However, if your EHIC card, or the GHIC Card, has already run out, the latest government advice is to make sure healthcare is included in your private foreign travel insurance, as details of how to apply for the GHIC card haven’t yet been released.

What is the EHIC, now known as a GHIC Card

The EHIC card, which has now been replaced by the GHIC card was launched in 2006 to replace its predecessor, the E111 form. For the past 14 years, it has been providing EHIC card holders with free access to state medical care in all 27 EU countries and the four member states of the European Free Trade Area – Iceland, Lichtenstein, Switzerland and Norway.

The blue EHIC card lasts for five years, so anyone who applied for and received the card during 2020 can currently use it in all EU countries until 2025 unless there are any further legislative changes in the interim.

However, if you’re travelling to the four European Free Trade Area countries, your EHIC is no longer valid after 31st December 2020. You must purchase private travel insurance with healthcare cover for travelling to these countries from 2021 onwards.

The EHIC card, which is now being replaced with the new GHIC card, enables the holder to access free, or reduced-cost, state healthcare during their trip if it’s needed because of an illness or an accident. It also covers the holder for pre-existing or chronic health conditions and routine maternity care.

The government has always advised that the EHIC card isn’t an alternative to purchasing travel insurance, as it doesn’t cover private medical healthcare. Nor does it cover the costs for treatment on cruises, mountain rescue in ski resorts, or being flown back to the UK as a result of illness or accident.

Having both an EHIC card certificate and a private travel insurance policy has always been recommended, as it isn’t intended to cover “health tourism” if people are going abroad specifically for medical treatment, including giving birth.

Many EU countries have a level of health service care that is comparable to our NHS, but this isn’t always the case, as standards differ throughout Europe. British holidaymakers needing hospital care in some EU countries may need to pay for items such as bedding and food during a hospital stay, as their own citizens must do.

In addition, the EHIC card, which is now known as the GHIC Card, won’t cover the costs of the air ambulance, should you have a serious illness or accident while on holiday, so getting you home for long-term treatment in the UK would be a costly problem without private health insurance.

Air ambulances can cost from £15,000 to £30,000, depending on where you’re on holiday and the length of the flight home to Britain, so you need private travel insurance with health cover regardless, in the event of such an emergency.

When you have travel insurance, you’re entitled to be treated in a private hospital. This may be preferable to a state hospital, as it will cover all your medical expenses up to your policy’s limit.

Currently, 27 million Brits have a European Health Insurance Card issued before the end of 2020. The somewhat sketchy information about the proposed UK Global Health Insurance Card in the national press has left holidaymakers feeling confused about what will be covered health wise from 1st January 2021.

Media reports suggested there had been a last-minute “scramble” by Brits applying for the free EHIC card online before the 31st December cut-off point, as confusion surrounded what the alternative would be.

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What do we know about the GHIC Card?

The government has released little information to date about the new GHIC, although it is anticipated it will be launched in 2021. A deal on the post-Brexit relationship between the UK and the EU – and how it will affect healthcare – was announced on 24th December, including the continued use of the EHIC card until its expiry date.

It has been confirmed the GHIC card will replace the EHIC card and that it will cover existing or chronic illnesses, routine maternity care and medical emergencies due to accidents or illnesses in EU and EFTA countries.

Under the terms of Brexit, any specialised treatment will require a “prior agreement” between the individual patient and the EU state hospital or medical centre, to make sure the necessary treatment is available there. This would include treatments such as dialysis, or cancer treatment, for example.

Speculation has been rife about whether the new GHIC card (UK Global Health Insurance Card) will offer the same level of medical protection for British tourists as the old EHIC (European Health Insurance Card). No-one knows the definitive answer yet, although media outlets are forecasting this will be the case.

However, the government’s advice, regardless of the terms of the GHIC, is still that British tourists should buy travel insurance with healthcare cover before going on holiday to EU countries.

What about EU citizens living in the UK and the GHIC?

The terms of post-Brexit health cover for EU citizens living in the UK have also been updated to reflect the change. This will affect the estimated 3.7 million EU nationals living in the UK, who make up 5.6% of Britain’s total population, according to the latest statistics.

The rights of EU nationals already residing in the UK have been protected by the terms of the EU withdrawal agreement, which has been written into UK law. Any EU citizens who lived in the UK before 31st December 2020 can still use the NHS for their medical needs while here.

They can also continue to use their EHIC card, now known as a GHIC Card when travelling to any EU country. They will be entitled to apply for a new UK card to cover their medical needs.

Like British citizens, EU nationals living in the UK will also need to take out additional private travel insurance with health cover when travelling to EU countries from 2021 onwards.

Further details of how EU nationals can apply for continued post-Brexit healthcare are available on the website of the NHS Business Services Authority. The organisation comes under the umbrella of the Department of Health and Social Care.

It provides a number of support services for the National Health Service, including processing prescriptions for pharmacists, managing the NHS pension scheme in England and administering the EHIC or E111 scheme.

The organisation’s website offers post-Brexit healthcare advice for nationals of the EU, Norway, Switzerland, Liechtenstein and Iceland who are normally resident in the UK and who have a registered E121, S1, E106 or E109 form.

In some circumstances, EU citizens who fall into any of these groups may be able to add their parents, grandchildren or grandparents to the EHIC card, as long as they meet certain residency and nationality conditions.

The updated health advice also applies to UK students currently studying in the EU, or in one of the four European Free Trade Area nations. Some British State Pensioners who reside in the EU – and their families – may also be eligible for a new UK-issued EHIC after 1st January 2021.

They are advised to inquire via the NHS Business Services Authority for further eligibility information on this often complex issue with regards to the new GHIC ( UK Global Health Insurance Card).

What about travel to non-EU countries and the EHIC Card?

The UK has been discussing and finalising healthcare deals with non-EU countries and has a number of reciprocal health deals in place with a few countries, including New Zealand and Australia. Under the new legislation, British visitors will be able to receive urgent treatment in these countries free, or at a reduced cost.

They are entitled to be treated as if they are a resident of the country in question, wherever the deal is in place. However, unlike the conditions of the EHIC, the new agreements drawn up with non-EU countries don’t cover pre-existing medical conditions.

As with every other holiday scenario, private travel insurance with healthcare cover is recommended by the government as being a must in these circumstances.

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How does Brexit impact on the GHIC and travel in Europe in general?

British citizens wishing to travel or go on holiday in the EU after 1st January 2021 will be subject to several updates to the legislation. You can still enjoy visa-free travel for six months and won’t need a special permit to drive on the continent. However, holiday homes might cost more in general.

If you’re planning on travelling across Europe without a visa in 2021, you can do so for up to six months in one year, for a maximum of 90 days within any 180-day period. This would have been the case in a no-deal Brexit scenario as well.

However, due to ever-changing coronavirus restrictions, anyone considering travelling to Europe will need to check the latest advice before embarking. The government also advises you must have at least six months left on your passport before you travel.

From 2022, UK residents will have to pay to join a visa-waiver scheme when visiting some EU countries. The fee will be decided at a later date by the EU and will cover a three-year period.

If you have a holiday home in any EU country, it is currently a grey area as to how any legal safeguards for your property will be impacted post-Brexit. However, experts have warned the property tax could increase to a higher rate that applies to non-EU citizens.

It could also become more difficult for British citizens to buy a holiday home in an EU country because they will not be able to get a mortgage as easily.

Regardless of the specific legislation relating to holiday homes, any British citizens who own property in an EU country will continue to be protected by the European Convention on Human Rights and the UN Universal Declaration of Human Rights.

What level of private healthcare insurance do you need with your GHIC Card?

If you’re planning a holiday in the EU in 2021, make sure you purchase travel insurance with the relevant level of healthcare insurance included to avoid a costly holiday disaster.

Prior to travelling, you must make sure your travel insurance covers all your holiday healthcare needs. The absolute basics that you need to check are the level of healthcare cover your insurance includes, how much travel disruption cover it includes and the terms and conditions.

While reading the small print may be something you don’t do as a rule, it is extremely important you understand even the fine print of your holiday healthcare insurance. At the end of the day, your health is extremely important and it’s well worth the extra ten minutes to make sure you have read and understood the various insurance clauses.

Regardless of whether your EHIC card also known as the E111 Card is still valid – or even if the new GHIC card has been launched by the time you go on holiday – never set off without private medical insurance in place too.

According to a survey by holidays watchdog ABTA, around 20% of Brits never take out private health insurance for a holiday in an EU country – yet one in eight people fall ill, or have an accident, while on holiday.

The most common causes for requiring medical attention include limb injuries – including breaks, torn ligaments and sprains – stomach complaints, infections and fevers.

While some ailments and injuries may be covered by an in-date EHIC, or the new GHIC – enabling treatment in a state hospital at your holiday destination – more serious problems might require an urgent flight home by air ambulance – and this doesn’t come cheap.

Don’t be caught out by the post-Brexit changes to EU holiday healthcare and make sure you’re covered before your departure date to avoid a health scare totally ruining your holiday.

GHIC & EHIC Card FAQs

Can British holidaymakers still use their EHIC in EU countries?

British tourists who have a valid European Health Insurance Card issued before 31st December 2020 can still use it in EU countries until its expiry date, which is five years from the date of issue.

However, the government strongly recommends taking out private travel insurance with healthcare cover to make sure every eventuality is covered in the event of an accident or illness while abroad.

What does the new GHIC card cover?

The government has announced a new UK Global Health Insurance Card will replace the old EHIC post-Brexit, but as yet, there is very limited information on what it will cover in terms of health conditions. There has been plenty of speculation that the GHIC card will offer the same type of protection as the EHIC card.However, until this is clarified – and until there is an official launch date for this new type of holiday health cover – holidaymakers without a valid EHIC card will be even more reliant on private insurance at present.

How does this affect EU citizens living in the UK & their EHIC Card?

There are an estimated 3.7 million EU nationals currently residing in Britain, making up 5.6% of the UK’s total population. Their rights to healthcare are protected by the terms of the EU withdrawal agreement.

EU citizens who lived in Britain before 31st December 2020 can still use the NHS for their medical needs while here and can continue to use their EHIC card (GHIC) when travelling to any EU country. They can apply for a new UK card in 2021.

How does the change affect British pensioners living in EU countries?

Some British State Pensioners who live in the EU – and their families – may be eligible for a new UK-issued EHIC after 1st January 2021. This means expats should continue to receive healthcare abroad post-Brexit.

British citizens should still be entitled to state health care in any EU country for “medically necessary” treatments and treatment for pre-existing conditions.

Why is it important to buy private health insurance as well as have a GHIC Card?

As with the EHIC, the new GHIC card is not meant to replace holiday health insurance taken out privately. Although the GHIC card will probably cover state health care in any EU country, so British tourists can continue to receive free, or reduced price treatment, some medical treatments won’t be covered.

This includes the cost of having to be flown home to the UK in an air ambulance. Everyone should buy private health insurance for EU holidays in 2021, regardless of whether they have an EHIC or GHIC card, to cover every potential issue and avoid turning a holiday mishap into a crisis.

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