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EHIC in the Wake of Brexit: What's Next for UK Travellers and Expats?

July 13, 2016

The European Health Insurance Card (EHIC) has long been taken for granted by many UK citizens, who have enjoyed access to reduced-cost — and sometimes free — state health care when travelling in the European Economic Area (EEA) and Switzerland.

Now, after the UK’s vote in June to leave the EU, the future of the EHIC is up in the air, which could leave UK travellers and expats without the proper cover. So what’s next?

International Medical Group (IMG) experts Philip Wright and Geoff Tothill weigh in on misconceptions about the EHIC, what UK travellers and expats need to know, and the advantages of travel medical insurance and international private medical insurance (iPMI) — viable alternatives to the state-funded cover.

“Prior to the vote, a lot of people didn’t realise that even with the EHIC, they may still have medical bills for care they receive outside of the UK,” says Wright, managing director of IMG’s European division. “On the government-issued card, it says, ‘Make sure you have valid travel insurance.’ It’s printed very clearly that the EHIC may not cover the full cost of treatment abroad.”

For expats, the problem is even bigger. Prior to the vote to leave the EU, UK citizens who worked or lived outside of the EEA on a permanent basis were not entitled to receive medical treatment under the National Health Service (NHS), and most were not entitled to use the EHIC to access care abroad. This means that even before “Brexit,” some UK expats needed to find alternative international health cover.

Misunderstandings about the benefits the EHIC provides continue to pose a problem for travellers and expats, and will remain an issue if the UK — like Switzerland — decides to use the EHIC even when it is no longer a member of the EU.

“With the EHIC, people have become used to travelling in Europe with some level of comfort about what medical cover they have,” Wright says. “Because the card is free and government-funded, they don’t often consider other forms of international health cover. However, without the EHIC, I’m worried that some people could have large medical bills they’ll struggle to pay, unless the UK makes another provision.”

Tothill, IMG’s chief medical officer, says he suspects the UK will either continue using the EHIC or will develop another provision with member states, similar to Switzerland’s arrangement.

“I can’t imagine England opting out of reciprocal health care agreements,” Tothill says. “There are lots of things in Europe that have to function as a group, and health care is one of them.”

Regardless of the outcome of UK negotiations surrounding the EHIC, people can’t continue to bury their heads in the sand when it comes to their health care, Wright says.

Now more than ever, it’s important for travellers and expats to understand the benefits the EHIC provides, and the gaps in cover it leaves.

“People often travel with EHIC cover, but they’re not aware of its limitations,” Tothill says. “It’s designed to simply cover the costs of emergency treatment — not to provide ancillary services or cover for routine medical care, elective procedures, medical evacuations, medical repatriation or patient transfers.”

Travel medical insurance and iPMI, on the other hand, fill the gaps in cover left by the EHIC, and can serve as viable alternatives for UK travellers and expats.

The chief advantage of a travel medical or iPMI plan is that the policyholder can often seek treatment wherever is most convenient for them, including at private and state facilities. Most iPMI providers don’t force the patient to receive care at an EHIC-qualifying hospital. In some cases, this could mean the patient receiving better care at a higher-quality facility.

For expats, one added benefit of iPMI is especially important: stability.

“iPMI provides a stable, consistent platform for delivering health care around the world. With a long-term iPMI policy, there’s consistency in what’s delivered to the client and when and how, whereas there’s much more variation in the delivery of benefits under the EHIC, which is subject to a lot of economic pressures,” Tothill says. “iPMI provides expats comfort knowing that their health care will remain the same well into the future.”

Although we’re years away from any decision about the use of the EHIC in the UK, it’s important for travellers and expats to be aware of the misconceptions surrounding the EHIC and the alternative forms of cover available.

“If you have access to the EHIC, then you should make sure you’re enrolled and have the card, because there are times when it can be useful. However, it’s important to stress that the EHIC provides only a small part of the more comprehensive cover that can be provided by travel medical insurance or iPMI,” Tothill says.