Should expats living in Europe be worried about healthcare?

Should expats living in Europe be worried about healthcare?

With Brexit still very much undecided, we cover how expats living in Europe are worried about healthcare abroad

Britain Thinks has conducted extensive research on people’s experience of the Brexit process. “The public struggle to see a route out of the chaos,” a whopping 83% “is totally fed up of hearing about Brexit” and 64% “worry about the impact on their mental health” - just some of the April 2019 conclusions. 

For many, a quick fix may be all that’s needed: deep breathing exercises, a spot of karaoke, dancing or yoga, meditation or a quick run – any distraction may do! Others may contemplate escaping to a Buddhist retreat centre for a week or two or to a lush tropical landscape. For millions, though, the uncertainty of what Brexit could finally entail, is overwhelming – potentially affecting in which country they live, which nationality they hold, rights of residence, which jobs are available, impact on family members and a host of associated factors relating to an uncertain lifestyle and future. 

The many who relocated overseas before the referendum may have escaped the massive UK media coverage devoted to Brexit over the recent past but they are far from being free from worry, particularly when it comes to their medical care. Others considering a permanent move may find their plans in disarray. Of paramount concern is their medical care. 

What may happen because of Brexit in regards to the European health card?

Reciprocal healthcare arrangements which currently exist between EU member states may not survive if the UK leaves the EU without a deal. For emergency treatment on holiday, UK nationals can currently use their EHIC card if they fall ill in another EU country, but if there is a no-deal Brexit it will no longer be valid. Although the UK is trying to reach agreements with EU governments to extend them, it is far from certain this will happen.

The UK has issued 27 million European Health Insurance Card (EHIC) cards which cover pre-existing medical conditions and emergency care on the same terms as the citizens of the country they are visiting. Although agreement has been reached that a transition period to 31 December 2020 should apply to allow further negotiations, this is subject to the UK parliament and the EU ratifying the “Withdrawal Agreement”. If the UK “crashes out”, a transition agreement is at risk. If there is a deal, and, therefore, a transition period, all EU law would continue to apply in the UK and citizens would have exactly the same rights and guarantees as before - the EHIC card would remain valid. Furthermore, the transition period could be extended by two years. Beyond the transition period, it is anybody’s guess as to the fate of EHIC. 

The UK has reciprocal health insurance arrangements with a few non-EU countries, including Australia and New Zealand, under which visitors can receive free urgent treatment. These will be unaffected by Brexit negotiations. In other countries it is essential to read the terms and conditions. 

How do expats have access to medical care when living abroad in Europe and what is that like compared to the NHS?

According to the ONS, there were about 3.7 million EU nationals living in the UK in 2018 and they will continue to access the NHS free of charge irrespective of a deal or no deal provided they are granted “settled status” by 30 June 2021.

A government memo circulating in Whitehall predicts that between 50,000 to 250,000 British expats currently living in the EU could return to the UK in the event of a no-deal Brexit: Not just any expats … but pensioners who – the memo states – would put a lot of pressure on the UK’s overstretched healthcare system and a “worst-case scenario” is that 150,000 return in the first year. Or, as dispatches puts it: 

“Those expat pensioners will be hightailing it back to Blighty because the British government just notified them the Queen will no longer pay for their healthcare should the UK leave the EU without a deal.” 

An “S1 Certificate” is available to anyone receiving a UK state pension. Not anymore. In a little-publicised no-deal technical notice published this week, the UK government said: “An S1 certificate helps you and your dependents access healthcare in the EU/EEA country where you live. If you have an S1 certificate, it will be valid until 29 March 2019. After this date, the certificate may not be valid, depending on decisions by member states.” 

Whether that applies or not is anybody’s guess given the latest Brexit extension to Halloween (31 October 2019) but given that the same technical notice strongly advised reviewing (your) access to healthcare and that it will differ according to the country you live in, not to do so would be a risk too far. 

Why moneycorp and Babylon benefit expats

Babylon’s mission is to put an accessible and affordable health service in the hands of every person. On first reading, that statement seems wildly ambitious but not after the number of smartphone users is factored in. The core message is one of complementing the NHS, and working together to alleviate the burdens associated with a growing and ageing population. Embracing technology and artificial intelligence (AI) Babylon Healthcare Services Limited provide an online GP consultation service employing GP’s on the General Medical Council (GMC). Patients are able to book consultations 24/7 and interact through video or phone calls.

A major ground-breaking initiative is underway in Birmingham by a leading NHS hospital. It will encourage patients to use online (live and automated) chat services, symptom checking and video consultations with doctors and nurses using digital technology to access how ill they are and thus help reduce A&E and outpatient appointments. 

“The way patients access and receive healthcare in Birmingham will be unrecognisable in five to 10 years’ time, with technology playing a hugely enhanced role,” said Dr David Rosser, the trust’s chief executive. “This is the first case of technology of this kind being deployed at such a scale to aid the hospital sector.” The benefits to expats are clear for those returning permanently to the UK and seeking a new GP with all the potential associated problems. For those forced by a Brexit no-deal to to-and-fro, the digital breakthrough is a godsend. 

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