Dr Sarah Jarvis, MBE
Author: Dr Sarah Jarvis, MBE, General Practitioner (GP)

Dr Sarah Jarvis is the Clinical Director of the Patient Platform, an active medical writer, broadcaster, and the resident doctor for BBC Radio 2.

Originally posted: 7th Oct 2021

How will Brexit affect travel?

While all eyes were on COVID-19 over the last few years, Brexit hasn't gone away. The transition period with the EU officially ended on 31st December 2020, so now the UK is no longer part of the EU.

Brexit continues to take effect on every aspect of our lives, from supermarket shopping and undertaking business abroad to online ordering and import taxes. If you are planning to travel abroad, you can't afford to ignore the changes to travel insurance arrangements either.

For the millions of UK citizens wanting to get away, it's never too soon to consider your travel health cover and start to make plans to ensure it's in place.

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Launch of the GHIC

On 11th January 2021, the government announced that UK citizens would be able to apply for a Global Health Insurance Card, launched as part of a UK/EU deal.

This card will provide equivalent protection to the European Health Insurance Card (EHIC), which is being phased out, while on a temporary stay in the EU. This includes holiday, study and business travel.  A temporary stay is defined as a period during which you are staying in a place other than the one where you usually live, and you do not move your "centre of interest" there.

However, while the EHIC included Norway, Iceland, Liechtenstein and Switzerland, as well as EU countries, the GHIC only covers the EU. Existing EHIC cards will no longer cover Norway, Iceland, Liechtenstein and Switzerland either.

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What about other countries?

The government is currently negotiating reciprocal deals with the other European Free Trade Association states (Iceland, Liechtenstein, and Norway) as well as Switzerland.

In the short term, the government website notes that you can use a UK passport to get medically necessary healthcare in Norway (for example, emergency treatment, or to treat a pre-existing condition).

The UK also has reciprocal agreements with:

  • Australia

  • New Zealand

  • Some Crown Dependencies and overseas territories (such as the Isle of Man, Jersey, and Gibraltar)

  • Some Balkan states (Bosnia, Serbia, Montenegro, Kosovo)

However, these agreements involve different proofs of eligibility to travel in the EU. You can find out more on the relevant country page on the government's travel website.

What will the GHIC cover?

Under the new agreement, if you have a currently valid EHIC card, you can continue to use it until its expiry date – but from 1st January 2021, it is only valid in the EU.

The EHIC arrangements were designed to provide access for UK citizens to the same state medical treatment as a local in the EU and the countries no longer covered. However, this never meant treatment was automatically free, as it is on the NHS: in many countries, citizens must contribute to healthcare costs. The same will apply to GHIC arrangements.

The Government always advises that anyone travelling overseas, whether to the EU or elsewhere in the world, should take out comprehensive travel insurance.

As well as the cost of emergency care for a one-off medical problem, which is covered by most travel insurance policies, the EHIC covered and the GHIC will continue to cover:

  • Routine maternity care (except for people planning to have their baby while abroad)

  • Treatment of a chronic or pre-existing condition which becomes necessary while abroad

These conditions will still only be covered if you're treated by a state, rather than private, healthcare provider in the country you're visiting.

Under the new GHIC arrangements:

  • Dialysis for kidney failure will need to be organised through your NHS unit before you travel, to make sure it can be provided at your destination.

  • The same pre-arrangement will be necessary for chemotherapy.

The Brexit agreement says any specialised treatment (such as cancer treatment), "must be subject to a prior agreement between the insured person and the unit providing the treatment" to make sure the treatment is available.

How do you get a GHIC card?

You can find out more about the GHIC card requirements from the gov.uk website and apply for free through the NHS website. You'll need to provide your:

  • Full Name

  • Address

  • Date of Birth

  • National Insurance or NHS number (England and Wales)

  • CHI number (Scotland)

  • Health and Care number (Northern Ireland)

You'll need to apply at least two weeks before you plan to travel to ensure your card arrives on time. It makes sense to check your EHIC card now and apply for a GHIC card as soon as possible if your EHIC has expired.

If you do need medical care while you're in the EU and don't have an EHIC or GHIC, you can apply for a Provisional Replacement Certificate (PRC) which will provide the same cover. You can only request this at the point you need care; you are not allowed to request a PRC in advance of a trip.

If you're a UK national, you can contact NHSBSA at +44 (0)191 218 1999 if you need a PRC.

Amsterdam canal

How long does it take to get a GHIC card?

It usually takes between 10 and 14 days for a GHIC application to be processed; once the application has been processed and approved, your card should be in the post within 2-3 working days. It is always worth applying for a GHIC card at least 3 weeks before travelling to allow for any complications or delays in your application.

Can I get a new EHIC CARD post 31 December 2020?

The government has confirmed that the EHIC card will remain in place for EU travel until your current card runs out of date. Most people will be unable to apply for a new card when their existing one expires – they will need to replace it with a GHIC.

However, there are a couple of situations where you should be able to apply for a new UK-issued EHIC card, which will also cover Switzerland, Norway, Iceland and Liechtenstein. This will apply to people whose rights are guaranteed by the UK-EU withdrawal agreement, which is written into UK law. This applies to you if you are:

  • A UK state pensioner who has been living in the EU before the end of 2020. In some cases, this also applies if you are closely related to the pensioner.

  • A UK student who has started a course in Europe before the end of 2020 (this will only apply until when you finish your course).

  • A 'frontier worker' who lives in one state and works in another.

The government website is clear that from 1st January 2021, it will be essential to have travel insurance to cover your healthcare while you're away.

The website also makes the point that many people have been able to rely on EHIC for treatment of pre-existing medical conditions which became necessary while they're out of the UK. Many travel insurance policies do not cover pre-existing conditions, so government advice is that it's particularly important to get travel insurance with the right cover if you have any existing medical conditions.

What medical assistance will you be entitled to in other countries from 1st January 2021 onwards?

The government's advice, still says you should buy travel insurance with healthcare cover before you go on holiday.

Going forward, if people are to be entitled to any medical assistance in Norway, Iceland, Liechtenstein or Switzerland, the UK government would need to negotiate a new reciprocal arrangement with each individual country. That hasn't happened yet, and it's not clear whether any such arrangements will be negotiated.

The UK does have reciprocal health insurance arrangements with a few countries outside those currently covered by the EHIC. If there are individual arrangements with countries not covered by the GHIC in the future, they may follow the same principles.

Do I need a GHIC card or travel insurance with medical cover post 31 December 2020?

Even before the UK left the EU, it's always been important to have travel insurance with medical cover. Firstly, the EHIC/GHIC doesn't necessarily guarantee free treatment: you'll get medical care at the same cost a local would pay. In the UK, we take it for granted that we can get urgent medical care, free on the NHS when we need it. Many citizens of European countries have permanent medical insurance to cover the medical charges their local state provider makes for this sort of care.

Secondly, the EHIC doesn't cover the cost of being transported home to the UK if you're taken ill abroad and need special arrangements to get you back to the UK for care. It also doesn't cover the cost of the treatment you've undergone abroad specifically to get (this is unlikely to be covered by travel insurance either) or may not cover the cost of ambulances.

The EHIC and GHIC do cover the cost of some treatments for pre-existing medical conditions that come up while you're away. Standard travel insurance often excludes any cover for a pre-existing medical condition, and if you fail to declare your medical conditions, it may invalidate your insurance. Given the changes in regulations, it has never been more important to get specialist travel health insurance that will cover you if you do have any medical conditions.

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What do you need to look out for in a travel insurance policy now the UK has left the EU?

It will be more important than ever to make sure your travel insurance also provides medical cover, especially if you have any health conditions which you need to disclose. Healthcare costs can be eye-wateringly expensive in certain countries and having protection against these costs will be worth it in the long run.

You may also want to consider taking out a policy which includes Scheduled Airline Failure cover (sometimes known as SAFI) or Supplier Failure cover. These will help protect you should your airline, travel provider or accommodation provider get into difficulty and are no longer able to offer their services for your trip.

Will the rules change about which medicines you can and cannot bring into Europe?

The medicines you're allowed to bring into a given country depend on the laws of that individual country. This is unchanged by Brexit.

Each country makes its own rules about which medicines you can bring into the country and the maximum quantity you can carry. You can find out more about travelling with drugs to any country, including those in Europe, from our article and video on travelling with medication.

While the drugs most often prohibited are 'controlled drugs' such as powerful painkillers, there are some surprising exclusions. That's why it's always worth checking with the embassy of the country you're visiting before you travel if you're planning to take any medication with you.

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Will I need to show physical proof of travel insurance if I seek medical assistance while on holiday abroad post Brexit?

Whether you will be denied treatment if you don't have proof of travel insurance will depend on the treatment and the country you're visiting. The last thing you need, if you’re unwell, is to be fretting about whether you can get treatment.

So, you should always take a copy of your travel insurance with you when you travel. If possible, we recommend keeping a paper copy and a backup online copy in case your belongings are lost. We also advise them to keep a note of the emergency number of their travel insurer and to leave a copy with someone who isn't travelling in case they lose their records.

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If you don't travel much then a single trip cover is perfect as you can cover specific dates suited to your trip. If you have cancellation cover, you'll also benefit from this as soon as you buy your policy. If you travel 2 or more times a year, it may be cheaper for you to go for an annual trip cover. It's best to start your annual trip cover as soon as possible, as if you have cancellation cover, you'll only benefit from this from your policy start date.
It's really simple and quick to do! After you've told us about your trip details and answered some medical history questions you can add your pre-existing conditions, one by one, for each traveller. You'll only need to enter your details once, it's all online and there's no need to call, or provide details of your conditions in writing.
You will need to add each country that you are visiting. If you are on a flight stopover this will include any countries where you leave the airport. If you are on a cruise it includes any countries where your ship will be docking at.
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