More people are again travelling abroad following the lifting of COVID-19 restrictions. Access to healthcare in Europe has changed since we exited the EU, so what happens if you’re sick or injured while on holiday? And with long waiting lists for NHS treatment, can UK residents get the treatment they need in another country?
Our article describes the arrangements for UK residents to access healthcare overseas.
Travel to an EU country: Unplanned treatment
The UK Global Health Insurance Card (GHIC) gives UK residents access to medically necessary, state-provided healthcare when visiting an EU country or Switzerland. GHIC replaces the European Health Insurance Card (EHIC) for most new applications. Some people will be able to apply for a new UK EHIC if they have rights under the Withdrawal Agreement, which will also be valid in Norway, Iceland and Liechtenstein.
You can apply for a GHIC free of charge via the NHS Business Services Authority website. People who have an existing EHIC can continue to use this until it expires.
A GHIC/EHIC covers necessary treatment that can’t wait until you’ve returned home. This includes treatment for chronic or pre-existing medical conditions and also routine maternity care (unplanned childbirth would be covered, but not someone planning to give birth abroad). Some treatments would need to be pre-arranged, for example, kidney dialysis or chemotherapy.
The GHIC/EHIC scheme is not an alternative to travel insurance – it will not, for example, cover rescue and repatriation costs following an accident. All UK travellers are advised to take out adequate travel insurance to cover their trip.
The UK Government is seeking to extend the use of GHIC in the future to Norway, Iceland, and Liechtenstein.
What about travelling for planned treatment?
UK residents may be entitled to NHS funding for planned treatment for a specific condition within the EU and Switzerland via the S2 funding route. Certain criteria apply; key points include:
- Prior approval must be sought from the NHS (in Wales, from the patient’s local health board).
- The requested treatment must be one that would normally be provided on the NHS to a patient in their particular circumstances.
- The NHS must confirm that it cannot provide the treatment or equivalent in a medically acceptable timeframe for the patient’s condition/diagnosis (referred to as ‘undue delay’). This is not based on general NHS target timeframes for treatment, but on a clinical assessment of the patient and their individual circumstances.
- The treatment ‘provider’ must be in the EU or Switzerland, and the treatment must be available within the providing country’s state healthcare system. Treatment will be provided under the same conditions that would apply to residents of that country. This may mean that the patient has to contribute a certain amount towards the costs themselves, known as a co-payment charge (e.g. in countries where patients have to pay a percentage of the costs of their state-provided treatment). The patient may be able to claim back some or all of their contribution on return to the UK.
Under EU rules on patients’ rights in cross-border healthcare, UK patients were able to purchase state or private healthcare in another European Economic Area country (EU countries plus Norway, Iceland and Liechtenstein) and seek reimbursement from the NHS. This route can no longer be used by UK residents following the UK’s exit from the EU, unless an application was in progress on 31 December 2020, or treatment was accessed before 11pm on 31 December 2020.
Specific arrangements for Ireland
The Irish and UK Governments have committed to maintaining, as far as possible, the healthcare arrangements under the Common Travel Area (CTA). Under the CTA, Irish and UK residents who live in, work in, or visit the other state have the right to access healthcare there, on the same basis as residents of that state.
Accessing healthcare in non-EU countries
The UK has reciprocal healthcare agreements with a number of individual countries outside the EU, including Australia and New Zealand. The level of treatment provided free of charge to visitors varies, but in general the agreements only cover immediate medical treatment that will allow you to return home. The agreements won’t cover the cost of returning you to the UK (repatriation). Travellers are advised to take out adequate insurance to cover their stay abroad.
The UK Government has published individual country guides on accessing healthcare for UK nationals living in EU countries, plus Norway, Iceland, Liechtenstein, and Switzerland. This includes UK workers who are temporarily ‘posted’ to one of these countries.
The Foreign, Commonwealth and Development Office (FCDO) has also published advice for UK nationals living abroad, including information on healthcare access. There are guides for individual countries around the world.
Contacts and further information
If you’re unsure about what you need to do or are considering travelling abroad for treatment, speak to your local health board. The contact details for local health board teams dealing with overseas travel healthcare requests are:
Aneurin Bevan University Health Board
Tel: 01633 623432
Betsi Cadwaladr University Health Board
Tel: 03000 855145
Cardiff and Vale University Health Board
Tel: 02921 836535
Cwm Taf Morgannwg University Health Board
Tel: 01443 744800
Hywel Dda University Health Board
Tel: 01437 834485
Powys Teaching Health Board
Tel: 01874 712694
Swansea Bay University Health Board
Tel: 01639 683615 or 01639 683389
Article by Philippa Watkins, Senedd Research, Welsh Parliament