1. Brexit with withdrawal agreement
Should the withdrawal agreement negotiated between the EU and the United Kingdom enter into force, comprehensive protection for the citizens concerned and their family members would be ensured during the transitional phase (end of 2020, renewable once to a maximum of 2022). During the transition phase, the current EU rules will continue to apply. In this time, there will therefore be no changes with regard to health and long-term care insurance cover. In addition, the negotiated withdrawal agreement ensures that persons who have already started planned medical care in the UK or Germany before the end of the transitional period will continue to have the right to pursue this treatment. In addition, during the transitional period, benefits based on the European Health Insurance Card (EHIC) or the Provisional Replacement Certificate (PEB) may be used.
2. Brexit without withdrawal agreement
In the event of an unregulated brexit, the Social Security Agreement of 20 April 1960 between the Federal Republic of Germany and the UK would possibly be applicable again from the day after withdrawal. This legal issue has not yet been conclusively clarified. If the Social Security Agreement is not applicable, the UK must be regarded as a non-contractual foreign country with which there is no Social Security Agreement.
The Social Security Agreement is not congruent with the mentioned European regulations in its scope of application. For example, long-term care insurance is not covered. In order to avoid such contractual gaps, the German federal legislator has passed a law on the coordination of social security (health, long-term care, accident, pension and unemployment insurance), which was published in the German Federal Law Gazette on 11 April 2019. Through this law unreasonable hardships for the insurant, which would arise because of the abolition of EU regulations, will be cushioned. It creates short-term legal certainty with regard to insurance status, claims and benefits.
In addition, British citizens resident in Germany who are currently covered by the NHS can join the statutory health insurance in Germany as a voluntary member. Membership must be declared in writing within three months of the date of resignation to a health insurance that can be chosen at the place of residence and employment and is retroactive to the day after withdrawal. It is recommended to declare membership as early as possible so that the health insurance cover can be made available in time by the statutory health insurance. This also prevents those affected from receiving a private bill from the doctor in the case of treatment because they have not yet been able to prove health insurance cover with a statutory health insurance at the time of treatment. Once the three-month accession period has expired, the right of access to statutory health insurance can no longer be guaranteed. In these cases, private health insurance may also be considered under certain circumstances.
British citizens temporarily staying in Germany are no longer entitled to benefits based on EHIC or PEB in the case of an unregulated Brexit. You will receive a private invoice for medical services provided, which you must submit to your UK health insurer for reimbursement.
Even a prescription which a NHS insured Briton has received, loses its validity in Germany from the date of withdrawal. The pharmacy can no longer settle this prescription with the German health insurance after the withdrawal date. In this case, a private prescription must be obtained in order to receive the medication, which must be paid for by the patient. A possible claim for reimbursement must be clarified with the competent health insurance institution in the United Kingdom.
After the Brexit, the cases and questions regarding health and long-term care insurance for Britons living in Hamburg can be very diverse. We therefore recommend to contact your health insurance directly with your respective requests.