18 March 2020

Whether you are a British citizen planning to emigrate to the Spanish coast or a European citizen arranging a hiking holiday in Scotland, Brexit means that all of these transnational endeavours are likely to progress slightly less smoothly and extra caution will be required. With the current heightened risk of incurring a coronavirus infection, it is more important than ever to have adequate health care arrangements in place. We therefore set out the main changes to take into account when arranging any foreign travel within the UK and EEA/Switzerland.

Short-term travel: EHIC cards
Currently short-term travel is covered by the European Health Insurance Card, which EEA, Swiss and British citizens can freely apply for. In case they fall ill during their holidays in another EEA country or Switzerland, they can be treated there whilst their country of residence will reimburse them.

This paperwork-free procedure is likely to disappear from 1 January 2021 onwards, when the transitional period is scheduled to end. Whilst Theresa May’s White Paper published in July 2018 indicated that it wanted the scheme to remain in place, the Johnson government has not yet formulated a similar intent. The UK’s abolition of the EHIC card does not necessarily mean travellers will be left without assistance. As the UK has several reciprocal social security arrangements with other states, the UK can be expected to seek some form of arrangement with member states. However, these arrangements are likely to be less substantial (eg, excluding chronic and pre-existing conditions) and involve a lot more paperwork.

Notably, EEA and Swiss nationals currently working in the UK will not be able to circumvent the abolition of the EHIC card by applying for the card in their home country. The issuance of the card is on the basis of residence, not nationality, so they are subject to the arrangements of the state where they make their social security contributions.

Long-term residency
All British nationals in the EEA or Switzerland and all EEA/Swiss nationals in the UK before the end of the transition period, meaning before 31 December 2020, will benefit from the old EU arrangements. Consequently, they will continue to have the same access to health care in the state where they reside as nationals from that state.

Anyone arriving from 1 January 2021 onwards, however, cannot be certain to be permitted to make use of the host state’s health care system in the same way nationals of the host state can. The reciprocal use of healthcare systems is currently the subject of negotiations between the EU and the UK.

EEA/Swiss nationals moving to the UK should be particularly concerned, as the Johnson government has clearly indicated that it intends to subject EEA/Swiss nationals to the same rules as other immigrants. Consequently, they are likely to face the extortionate “Immigration Health Surcharge” of £624 on top of the immigrant’s contributions via income tax. With this tax, a European family of four would end up paying £10,940 up front when seeking immigration permission for a period of five years.

Whilst the position of British nationals in the EEA or Switzerland is equally insecure, they are unlikely to face similar health care taxes, simply because many European states refrain from demanding such high contributions.