NHS European Office

Reciprocal healthcare

nurses and baby

Under current EU law, EU citizens benefit from rights to reciprocal healthcare when they are in any of the European Union's 28 member states.

These rights apply whether they are travelling temporarily between EU member states, for example, on holiday or studying abroad, residing permanently or long-term in another EU country, or when travelling to another EU member state specifically to receive pre-arranged medical treatment.

Reciprocal healthcare after Brexit

Until 31 December 2020 there will be no changes to the EHIC scheme and EHIC holders can continue using their cards. If you are travelling to the EU between 1 Feb and 31 Dec 2020, you need to be aware of the following:

  • From 1 February 2020 all EHICs issued will not have the European mark. Both the new and the current design will be accepted for treatment within the EEA and Switzerland. 
  • The NHS Business Services Authority will hold the personal data of EHIC holders for 4 years after the expiry of their EHIC, instead of the 2 years it is now. This will allow for treatment cost claims made near the end of the card expiry to be processed.
  • If you don't have your EHIC when you travel, you are still covered by the scheme and can apply for a Provisional Replacement Certificate if you need treatment.
  • The EHIC is not a replacement for travel insurance. People travelling to EU and non-EU countries on holiday should continue to buy comprehensive travel insurance.

The Withdrawal Agreement guarantees that UK citizens legally resident in an EU country, or EU citizens legally resident in the UK before the end of the transition period (31 December 2020), will continue to benefit from their current rights for their lifetimes. 
Future arrangements for UK citizens  travelling to the EU (or vice-versa) after 31 December 2020 are subject to the current negotiations on the future UK-EU relationship.

On 31st January, updates to all 31 country guides and Healthcare after Brexit: visiting the EU, Norway, Iceland, Liechtenstein and Switzerland on GOV.UK were made.  Of these, seven country guides (Poland, Italy, Spain, Switzerland, Austria, France, Ireland) contain new information. 

Brexit Health Alliance

The Brexit Health Alliance is campaigning for continued access to reciprocal healthcare rights post-Dec 2020

This paper from the Alliance issued in 2018 outlines how the current reciprocal arrangements work and the implications of a possible no-deal or bad deal for both patients and healthcare providers.

Niall Dickson, chief executive of the NHS Confederation and co-chair of the Brexit Health Alliance, gave evidence to the EU Home Affairs Sub-Committee on Brexit, highlighting how both the Confederation and the Alliance is keen on maintaining EU-UK reciprocal healthcare arrangements post-EU exit. Watch a video recording of his evidence.

Blog posts

In October 2017, we published a series of blog posts in which patients and clinicians related their experience of how current reciprocal healthcare arrangements work for them and what the possible consequences might be should these arrangements no longer be in place post-Brexit.

  • The first of our blogs is from dialysis patient Nicola Hawkins, who describes how the right to access state-provided healthcare across the EU via the European Health Insurance Card (EHIC) has given her a better quality of life, as it allows her to travel on holiday to other parts of Europe, knowing that her dialysis healthcare is covered.
  • In this blog, Professor Chris Chapple, consultant urologist at Sheffield Teaching Hospitals and coordinator of eUROGEN, a European Reference Network for rare urogenital diseases, outlines why the UK's decision to leave the EU must not jeopardise patients' access to the best possible care, regardless of where they happen to live.
  • Rob Johnson was diagnosed with motor neurone disease in 2011. He and his family reside in France and in this blog, Chris James, director for external affairs at the MND Association, explains how Rob's healthcare needs are catered for by the French healthcare system and how his family is concerned that a no-deal outcome in the Brexit negotiations will be detrimental to his quality of life.
  • Professor Helen Cross, coordinator of EpiCARE, a European Reference Network for rare and complex epilepsies, writes about the innovative work being done by the network and her concern that patients with rare and complex epilepsies will be denied access to European expertise and new treatments, should the UK no longer be able to participate in European Reference Networks post-Brexit.
  • In their joint blog, dialysis patient Amanda and her partner Stephen explain how the European Health Insurance Card has helped Amanda feel less trapped by her treatment, by allowing her to dialyse while abroad and that were the EHIC to be discontined post-Brexit, the psychological effect on her would be detrimental.
  • In this post, Prof. Jill Clayton-Smith, a clinical geneticist, who collaborates with colleagues across the EU on the diagnosis, management and treatment of rare diseases, voices her concern that leaving the EU could jeopardise these collaborative working arrangements, which are not only useful for clinicians and researchers, but vital for patients.

Other resources

  • Kidney Care UK has produced a comprehensive factsheet on the vital importance of the European Health Insurance Card (EHIC) system to kidney dialysis patients and why the present EHIC system should be continued in its current form post-Brexit.
  • The European Commission has released a series of video testimonials where patients and clinicians explain how the newly established European Reference Networks will help to treat and manage rare or complex conditions. The NHS leads a quarter of these networks, which bring together leading providers from across Europe to tackle medical conditions that require highly specialised treatment and a concentration of knowledge and resources.


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