Can anyone advise on reciprocal healthcare (EHIC) etc post Brexit ?

[Monapaloma]

Does anybody understand/ know/ want to take a wild guess about how things like EHIC would work post Brexit, and when would the new situation come into play?

Could I give this example...
A father is employed by a uk company but works and lives in Germany with wife and kids. They all have German government health insurance. Remember they live in Germany, so if they have an EHIC it's a German issued one, (because as I understand our EHIC is no longer valid when no longer resident in Uk). So then post Brexit, may the family have to take out a private Italian insurance at a
Much higher cost? How will it all work?

I live in Germany, it's not as complicated as it sounds like you think it is, but you're mixing up two different concepts.

Anyone who is employed and earning less than a certain amount a year (I can't remember the cut off, I think €60k?) gets state health insurance. It doesn't matter if you're German, European, American, all that matters is that you have a job which pays more than €450 a month. (Anything less is counted as a mini-job). Your employer will sort out this insurance for you. AOK is one of the companies offering state insurance. I'm with TK. Through this employer-subsidised insurance, any dependants, so children, adolescents in education and non-working spouses, are covered. Again, it matters not a jot where you are from. State insurance is always 14% of your wage no matter how many people are included on it, and it covers any normal healthcare, whether that's emergency or routine or elective.

The only time you get into NI contributions etc is when you're NOT employed and NOT married to somebody who is employed. I had this problem when we first moved because I'd been studying and working part time so I didn't have NI contributions except for as receiving child benefit and I can't remember exactly why but anyway I wasn't covered by the reciprocal arrangement. I was advised by somebody to get travel health insurance, as I was planning to get a job ASAP. You can only exist on travel health insurance for about 6 months IIRC but it fills a gap.

The EHIC is a totally separate thing and simply covers emergency health care if you happen to be visiting another European country, whether that's a holiday or a hop across the border or you work in the second country. In Germany your EHIC is printed on the back of your health insurance card, in the UK of course you have to apply for one, because there is no NHS card.

After Brexit the first part, state health insurance will stay the same since they don't look at previous healthcare or any contributions, it's the same for anybody living and working in Germany and only based on employment status (or eligibility for unemployment insurance). It might be more difficult if you're self employed or unemployed and not married to somebody who is employed, but we don't yet know how this will work out. It's fairly likely that it would revert to whatever status immigrants from outside the EU have now. I believe people in this position have a harder time working as self employed but most companies are understanding of this and will just offer you a contract with visa, it's easier for them anyway.

As for your EHIC that will be affected but again we don't know exactly how. I think it's likely that it will just cease to exist from the UK meaning that if you want to travel to an EU country you'll need travel health insurance just like you would when you travel somewhere outside of the EU. But if you move to Germany then you'll get a German EHIC which you can use in France, Italy, etc - and you'll need travel health insurance when you visit the UK.

@Mentounasc very helpful. is this true that government health insurance is simply for everyone who is employed in the eu? Why is is then that gesetzliche krankenkasse request e109 s1 from the uk for dependants, rather than simply accepting employment contracts or similar?
Say I was the employed in England and my child was at uni in Germany. They can enter the gesetzliche krankenkasse because I'm employed here? Regardless of how much I earn or indeed how long I've been in employment?

No - government health insurance is for everyone who is employed in Germant, it's a German policy, not an EU one.

I don't know what that form is, though - is that when you're resident elsewhere but living in Germany? Because we were just able to add DS to my insurance based on the fact all three of us are registered as living in Germany.

@BertieBotts thanks. And as I understand it, it's reciprocal agreements between the two countries that allow eu residents to access it under certain circumstances?

@bertiebotts.
The form is if say, you're a uk taxpayer but have a dependent resident in Germany for necessary reasons, eg education

In what situation? Do you mean when you move country to live and work, or are simply visiting?

This is what I found about the S1 (formerly E109)

S1 forms are issued to people who live in one EEA country, but have their healthcare costs covered by another EEA country. It also includes people who have been posted to work in another country (once they have lived there for 2 years) and frontier workers (people who commute across a border to get to work). Family members are also covered by the S1 form.

Worth noting this is the EEA rather than EU which means we may well stay in it but who knows.

Ah right, OK. Is that what you're looking at doing? It sounds like that would be a more complicated situation. I thought in the OP you were looking at the scenario of an entire family moving to Germany but only one parent being employed.

I believe it's to do with where you're resident, rather than where you pay tax, but I'm not 100% sure.

I would look up how it works for someone outside the EEA. US citizens would be the best one to look up since there is no Commonwealth connection and the info would be in English.

Thanks Bertie, I'm tying myself in knots with my hypothetical situation that is intended to be non specific!
But thanks for your help

Perhaps this helps?

www.thelocal.de/20160616/health-insurance-for-expats-in-germany-a-quick-guide-mawista-tlccu

Doh - sorry didn't notice that was essentially a giant advert.

@bertiebotts sorry I just saw your first post which is so helpful. So massive thanks.

I think for permenant residents they would continue the same way they do now, use German insurance.

In the UK foreign (non UK) students are issued a visa that allows them to access the NHS so I imagine that will be similar for EU nationals living here.

However the EHIC that allows you to go on holiday and access health care in the EU as a local, no one knows.

And that's really sad, it doesn't make much difference if you are having 2 weeks in Spain and you take out insurance, the people it will hit hardest are people who know they are going to access healthcare eg dialysis patients.

At the moment if you need dialysis once or twice a week you can go to an EU country and receive dialysis as a local.

The other group who are potentially hit badly depending on the Brexit agreement will be those needing organ transplants. At the moment organs are transported within the EU, no one knows if that will continue.

@sashh that is sad.

Bertie explained the situation fairly well. As far as living in the U.K. but having a dependent DC studying in Germany is concerned, I believe they would have to get their own student insurance, which is much cheaper than that for an employee. I was insured as a student in the 90s and it was less than 100 marks (50 euros) per month. And I would agree with Bertie that what's important is being permanently resident in Germany, not whether you're a taxpayer or not. You can only use your EHIC for temporary stays and only for emergency treatment (ie no dental check-ups etc).