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According to current information, the United Kingdom is to leave the European Union on 31.10.2019. Given the variability of the situation, it is still uncertain how exactly Brexit will happen. There are still three scenarios for health insurance, each affecting health insurance and the provision of health services to Czech insured persons in the UK and UK insured persons in the Czech Republic in a different way. The information will change over time, so please check the current situation.

 

Scenario No 1 – Brexit at a later date

Due to previous postponements, further postponement cannot be excluded. Should Brexit be postponed until a later date, the existing rules (Regulations on the coordination of social security systems Nos 883/2004 and 987/2009) would continue to apply until the new Brexit date.

Scenario No 2 – Brexit with Withdrawal Agreement

If the Withdrawal Agreement is finally approved, all existing rules will continue to apply until the end of 2020. The principle of a single insurance would continue to apply (ie. one cannot be insured at the same time in the UK and the Czech Republic), the necessary healthcare can be provided based on European Health Insurance Card, entitlement documents for full healthcare (S1, E106, E109, E121) as well as planned healthcare provision (S2, E112) would apply.

Scenario No 3 – No Deal Brexit

This scenario would have the greatest and immediate impact on health insurance. The existing EU social security/health insurance rules would cease to apply on the date of Brexit and the United Kingdom will find itself in a third country position with certain advantages for persons who were in a cross-border situation before the Brexit date thanks to Regulation (EU) No 2019/500 establishing contingency measures in the field of social security coordination following the withdrawal of the United Kingdom from the Union. This new regulation contains a rule on equal treatment, the principle of assimilation of facts and addition of periods of insurance. The Regulation is to take effect from the date of Brexit. Otherwise, the Czech Public Health Insurance Act will apply.

It will no longer be possible to use the European Health Insurance Card and all forms (S1, S2, etc.) will no longer be valid. Healthcare will be covered by health insurance only if the conditions of national legislation in combination with Regulation 2019/500 are met. For the Czech Republic, we can generally say that a person who is insured in the Czech Republic (not only registered with UK forms) will continue to be insured in the Czech Republic. Furthermore, all those who have permanent residence in the Czech Republic will be newly insured.

In this scenario, unfortunately, it is not yet clear what the solution will be for a group of British insured persons resident and registered in the Czech Republic on the basis of the S1 form (or E106, E109, E121) who do not have permanent residence in the Czech Republic. As soon as the Health Insurance Bureau knows the final decision, we will inform you.

 

Below you will find typical life situations and the related changes in more detail:

 

 A) CZECH CITIZENS

a. Czech citizens, employed or self-employed in the UK before the date of Brexit

With regards to health insurance in the UK, the situation will be subject to the British legislation. Although Great Britain has declared its positive attitude towards EU citizens living in the UK, some changes may occur. Further details can be obtained from the UK authorities.

With regards to health insurance in the CR, it is especially important to note, that the rules to prevent double insurance (laid down by the European regulations) will no longer apply. The persons concerned will become subject to Czech health insurance legislation. Therefore, persons with permanent residence (“trvalý pobyt”) in CR should be generally insured in CR, even if they are employed, self-employed or have residence in the UK. Pursuant to §8 art. 4 and 6 of Public Health Insurance Act No. 48/1997 Coll., , persons can be excluded from the health insurance system in the CR, if they submit Declaration of Long-term residence in another country to their health insurance fund. Having regard to the unusual situation of Brexit and the need to maintain the legal certainty of the citizens, it has been decided, that persons, who were employed or self-employed in the UK and therefore were exclusively insured there, will not be required to submit aforementioned Declaration upon their return. This means, that if a person concerned became subject to British legislation before the date of Brexit, they will not be required to personally cancel their insurance in CR again. However, upon their return to CR, they will be required to provide proof of insurance periods in the UK in accordance with the law. The aggregate of these periods must be at least 6 months in accordance with the Czech legislation. If the length of insurance in the UK constitutes less than 6 months, the persons concerned will have to retroactively pay their health insurance fees in CR for the period after Brexit.

Example:

Czech citizen has been employed in the UK since 1.1.2019. Pursuant to the European Regulations, they are exclusively subject to the British legislation on social security and health insurance. They are automatically excluded from the health insurance system in the CR. On 30.11.2019, they terminate their employment in the UK and return to the CR. They apply for admission into the Czech public health insurance system. Czech health insurance fund verifies the period of insurance in the UK. Since the length of insurance in the UK constitutes more than 6 months, the whole period is then viewed as if the person had previously submitted their Declaration of Long-term residence in another country and their insurance in CR was canceled in accordance with the law. The person concerned will not have to retroactively pay their health insurance fees in CR for the period after Brexit (i.e. from 1.11.2019).

 b. Czech insured persons/citizens, registered in the UK and having residence there

(Czech solo-pensioners, Czech long-term posted workers, diplomats, dependent family members of persons, who are employed in the CR, etc.)

Czech insured persons, registered in the UK, lose all entitlement to full health care based on entitlement documents S1, E106, E109 and E121, because after the date of Brexit, these documents cease to be valid in relation to the UK.

In case of economically inactive persons, who do not have permanent residence in the CR, the health insurance in the CR will be terminated.

Example: Wife of a worker employed in the CR lives in the UK. She is registered in the CR on the basis of Czech entitlement document S1. Her registration ceases to be valid on the date of Brexit. Czech health insurance fund will no longer reimburse the costs for benefits in kind provided in the UK. She will be entitled to healthcare at expenses of the British system (NHS) if she meets the criteria for admission into it. If she does not have permanent residence in the CR, her Czech health insurance will be canceled.

c. Czech insured persons, traveling to Britain for a short term stay

(For example: tourists, Czech short-term posted workers, course students etc.)

Czech insured persons lose entitlement to reimbursement of costs for medically necessary care on the basis of European health insurance card. We recommend purchasing travel insurance when traveling to the UK.


 

B) BRITISH CITIZENS

Health insurance will be subject not only to the Czech legislation on health insurance (especially Act No. 48/1997 Coll., Public Health Insurance Act, and Act No. 592/1992 Coll., on premiums for general health insurance, as last amended), but also to the aforementioned minimalist contingency regulation of the European Parliament and of the Council on the coordination of social security systems. Said Regulation will guarantee equal treatment to the persons, who were in a cross-border situation before the date of Brexit

a. British self-employed persons with health insurance in the CR

Since the principle of equal treatment continues to apply, the British self-employed persons will not be required to have permanent residence in the CR in order to participate in Czech public health insurance system. This means, that if these persons were insured in the CR before the date of Brexit, they will continue to be insured, even if they do not have permanent residence in the CR.

 b. British citizens without permanent residence in the CR, who are not economically active and reside in the CR

(for example: dependent family members of British nationals, who are employed in the CR, or persons with the permanent residence in the CR)

British non-active citizens, who were insured in the CR before the date of Brexit, will continue to be insured on the basis of the principle of equal treatment, no matter whether they have permanent residence in the CR or not. Their habitual residence in the CR is the determinative factor.

Example:

Dependent family members of a British national, who is employed in the CR, live in the CR. Since the principle of equal treatment continues to apply, they will be insured even after the date of Brexit, no matter whether they have permanent residence in the CR or not.

c. British citizens, employed by a company, that has its headquarters in the CR or other Member state (not UK), who work in the CR

British employees will continue to be insured in the CR.

d. British insured persons, traveling to the CR for a short-term stay

British insured persons lose entitlement to reimbursement of costs for medically necessary care on the basis of European health insurance card (EHIC). EHIC will not be accepted on the territory of the CR. The costs cannot be invoiced to Czech health insurance funds anymore. Czech health insurance funds will not be able to process any registration on the basis of EHIC and all existing registrations will cease to be valid on the date of Brexit. We recommend purchasing travel insurance when traveling to the CR.

e. British insured persons/citizens, registered in the CR and residing here

On the date of Brexit, the British S1, E106, E109, E121 entitlement documents are no longer valid in the Czech Republic. Their holders may either become Czech insured persons (persons with permanent residence in the Czech Republic) under specified conditions, or they may have to bear the costs of healthcare themselves (persons without permanent residence in the Czech Republic). The solution for this group of people may still change. As soon as the Health Insurance Bureau knows the final decision, we will inform you.

 

C) PLANNED HEALTHCARE

Change occurs also in the field of planned healthcare – the S2 form (or E112) confirming an entitlement to planned healthcare in another EU member state at expense of the competent institution (issued either by the CZ or the UK institution) cease to be valid after the Brexit.

If a Czech insured person travelled to the UK for a planned healthcare without a consent of his health insurance fund in accordance with the Patients’ Rights Directive (or the §14/3 of the Public Health Insurance Act No. 48/1997 Coll.), the reimbursement of expenses can be made by the health insurance fund only for a treatment provided before the date of Brexit.

 

 

D) POSTED WORKERS, CONCURRENCE OF EMPLOYMENT/SELF-EMPLOYMENT, EXCEPTIONS AND SO ON (form A1)

On the date of Brexit, all issued forms A1 (the A1 form certifies which social security legislation applies to the holder of the form.) cease to be valid. Life situations will have to be reexamined through the optics of the Czech and British legislation. Only if the situation concerns also another Member state, then the application of EU Regulations will continue.

a. British workers posted to the CR, persons excluded from the health insurance system in the CR (A1 issued in the UK)

If a British citizen who has an employment relationship with a Czech employer is working in the Czech Republic at the time of Brexit, the employer must be registered for insurance in the Czech Republic, even if he / she has the received A1 confirmation determining the UK legislation as applicable.

If a British citizen who does not have an employment relationship with a Czech employer is working in the Czech Republic at the time of Brexit, he will have to obtain comprehensive commercial health insurance in case of a long-term stay in the Czech Republic.

The situation of the so called “contractual workers” from the UK will be dealt in accordance with the Czech legislation after the Brexit  (i.e. they will usually have to be registered by their Czech “economic” employer for Czech insurance).

British citizen who works for a Czech employer at the time of Brexit has to participate in the Czech public health insurance system after the Brexit even if an A1 form was issued to him certifying that UK legislation is applicable. The employer is responsible for the proper registration

b. Czech workers posted to the UK, persons excluded from the health insurance system in the UK (A1 issued in the CR)

The situation of the Czech workers posted to the UK or the workers with the exception, who work on the territory of the UK after Brexit, will have to be consulted with the British authorities. However, it is quite likely, that the persons concerned will have to participate in the British public health insurance/social security system and pay their insurance fees there.

If you have questions regarding more complicated situations (two or more sources of income at the same time, the involvement of other states and so on), we recommend contacting competent representatives of ČSSZ (Czech Social Security Administration, www.cssz.cz) and asking them for consultation.


 

E) SITUATIONS, THAT ARISE AFTER BREXIT

All situations of British citizens, that arise after the date of Brexit, will be strictly subject to the Czech legislation. The persons concerned will be considered nationals of third country. These persons will be able to participate in the Czech public health insurance system either through employment in the CR, or if they obtain permanent residence (“trvalý pobyt”) in the CR. This means, that permanent residence in the CR will be mandatory for self-employed persons, if they want to participate in the Czech public health insurance system.

For situations, that also relate to another Member State, the application of Regulation (EU) No 1231/2010 of the European Parliament and of the Council of 24 November 2010 extending Regulation (EC) No 883/2004 and Regulation (EC) No 987/2009 to nationals of third countries who are not already covered by these Regulations solely on the ground of their nationality will continue unchanged. 

Although we aim to provide you with the most comprehensive and detailed information, it is more than likely, that all of the above does not cover all possible life situations. It is also possible, that the ever-changing development on the political scene may introduce new alterations to the situation. Should any such alteration or change occur, we will inform you immediately. Please, watch the development of the situation.

Should you require any assistance, do not hesitate to contact us via e-mail This email address is being protected from spambots. You need JavaScript enabled to view it., or phone no.: +420 236 033 411. We are at your disposal.

 

Prague, 29.8.2019

JUDr. Ladislav Švec, director

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