UK no deal Brexit and access to cross-border healthcare

A no deal Brexit for the UK on the 31 October is a very real prospect.  Ian Youngman looks at what the European Commission says will happen to access to EU cross-border healthcare, if the UK leaves the EU with no deal.

IMTJ aims to track the facts on Brexit and its impact on healthcare, rather than reproducing the political spin.  We will keep readers updated on the effect of any negotiations between the UK and the EU-27, and subsequent deals between the UK and individual countries.

The notes below are from the latest official EU document on cross-border travel and healthcare, in the scenario that the UK leaves with no deal:

European Commission: Notice on travelling between the EU and the United Kingdom following withdrawal of the United Kingdom from the EU.

(July 2019 version)

The United Kingdom (UK) submitted on 29 March 2017 the notification of its intention to withdraw from the Union pursuant to Article 50 of the Treaty on European Union. Following a request by the UK, the European Council (Article 50) agreed on 11 April 2019 to extend further the period provided for in Article 50 until 31 October 2019. This means that the United Kingdom will be, as of 1 November 2019 (the withdrawal date) a third country.

The notes below apply if the EU and UK have not reached a new deal or not extended the leaving period beyond 31 October 2019.  If the UK leaves the UK on 1st November this is what happens instantly:

Entitlement of healthcare under Union law on social security coordination

Union law provides for access to healthcare during a temporary stay abroad based on the European Health Insurance Card (EHIC) or, for planned treatments, based on the prior authorisation by the relevant competent institution (e.g. the institution with which the person concerned is insured).

Costs of such healthcare are reimbursed between the relevant institutions of the Member States involved.

As of the withdrawal date, these rules no longer apply vis-à-vis the UK.

As of the withdrawal date, nationals of EU-27 Member States and their family members will not be able to access healthcare for unexpected care in the UK on the basis of EHIC. UK nationals will not be able to access healthcare in the EU-27 on the basis of EHIC as of the withdrawal date.

In the UK withdrawal agreement, the EU is trying to agree solutions with the UK to ensure reimbursement, recovery and offsetting in relation to events that occurred before the end of the transition period.

Where reimbursement is not guaranteed, people concerned should consider taking out private travel insurance.

As of the withdrawal date, prior authorisations for planned treatments in the UK can no longer be issued by EU-27 Member States on the basis of Union law. No prior authorisations can be issued by the UK for planned treatments in the EU-27 on the basis of Union law.

In the context of the negotiations of the EU-UK withdrawal agreement, the EU is trying to agree solutions with the UK to ensure reimbursement, recovery and offsetting in relation to events that occurred before the end of the transition period.

Entitlement of reimbursement for cross-border healthcare under Union law on cross-border healthcare

Apart from the system of social security coordination, Union law also provides for the possibility to obtain, under certain circumstances, reimbursement by the Member State of affiliation for a cross–border healthcare treatment in another Member State.

As of the withdrawal date, patients affiliated in an EU-27 Member State will no longer benefit from the rules on reimbursement set out in that legislation as regards the cross-border treatment provided in the UK.

Nor will patients affiliated in the UK any longer benefit from EU rules on reimbursement.

It will be up to the EU-27 Member State of affiliation and the UK to decide on the reimbursement of such healthcare based on national law in the same way as it is now for other third countries.

Patients intending to obtain, as of the withdrawal date, reimbursement from an EU-27 Member State of affiliation for a treatment provided in the UK should query with their National Contact Points.

The same applies to patients intending to obtain, as of the withdrawal date, reimbursement from the UK.

Union law obliging the EU Member States to maintain National Contact Points to inform patients about cross-border healthcare will no longer apply to the UK as of the withdrawal date.