DO S1 HOLDERS HAVE TO TAKE ANY FURTHER STEPS BEFORE BREXIT TO PRESEVE THEIR RIGHT TO HEALTHCARE?

  • We are working hard to secure an arrangement with Italy to continue current healthcare arrangements for S1 holders until 31 December 2020.

If this is agreed, this would mean that, for those people whose healthcare the UK Government currently funds (including S1 holders), the UK would continue to pay their healthcare costs as now until 31 December 2020.

  • The main step S1 holders need to take now is to make sure that they have registered their residence with the anagrafe and ensure that their S1 form is registered with their local health authority (ASL).

 

  • If it is not possible to secure an arrangement with Italy to reimburse costs for S1 holders living in Italy before Exit day, the UK Government will, for six-months after Exit day (from 1 November 2019 until 30 April 2020), reimburse healthcare costs or pay providers directly where necessary. This is a bridging measure to ensure that people don’t experience gaps in healthcare coverage and potentially high costs while they register for healthcare under their local scheme. To be eligible for this support, people must apply no later than six months after Exit da

 

  • People should be ready for possible permanent changes to how they access healthcare, if there is a no-deal exit. Everyone living in the EU is strongly encouraged to think about their own healthcare needs and circumstances, and consider the steps they might need to take to be assured of continued healthcare coverage in the event of a No Deal Exit. We encourage S1 holders to check now with their local ASL about how they can register with the ASL in the event the S1 becomes invalid. If someone is not eligible to join the local healthcare scheme for free, they should consider whether to join the voluntary scheme by paying into the system or buy comprehensive private health insurance

 

  • After Exit day, if you have an S1 form, you will still be able to access free NHS care when temporarily visiting England, Scotland and Wales. To access NHS services, you will need to present a copy of your S1 form.

DO S1 HOLDERS HAVE TO TAKE ANY SUCH STEPS, OTHER THAN REGISTRATION WITH ASL AS AN EU CITIZEN, IF THEY HAVE NOT ALREADY DONE SO?

  • According to the Italian No Deal legislation those legally resident in Italy on or before 31 October, who are registered with ASL by paying social security contributions into the public health care system, (registrazione obbligatoria scheme), or through voluntary contribution into the healthcare system (registrazione volontaria) will continue to have access to healthcare as they do now.

IF THEY ARE REGISTERED AS S1 HOLDERS, CAN THEY REGISTER IN ANY OTHER CAPACITY? IN PARTICULAR CAN THOSE WHO HAVE PERMANENT RESIDENCE RE-REGISTER AS SUCH (RATHER THAN AS S1 HOLDERS) IN ORDER TO OBTAIN ANY CONTINUING RIGHT TO HEALTHCARE POST-BREXIT EITHER FOR THE GRACE PERIOD OR LONGER?

  • We are seeking confirmation from the Italian government about whether permanent residents – whose access to healthcare was based on their S1 form- will be given continued access to healthcare on the basis of their permanent residency. An alternative option is the voluntary registration scheme.

 HOW ARE BRITISH CITIZENS IN ITALY WHO ARE ENTITLED TO THE BENEFIT OF EITHER THE MARCH ANNOUNCEMENT (UK FUNDING HEALTHCARE FOR UP TO 1 YEAR FOR THOSE WHO ARE RECEIVING OR WHO HAVE APPLIED FOR TREATMENT AT THE DATE OF BREXIT) OR THIS NEW ANNOUNCEMENT (6 MONTHS HEALTHCARE FROM BREXIT) GOING TO ESTABLISH THEIR RIGHT TO FREE HEALTHCARE FOR THOSE PERIODS WITH THE ITALIAN HEALTH AUTHORITIES?  WILL THEY SIMPLY BE BILLED AND HAVE TO CLAIM BACK FROM THE UK LATER?  HOW DOES THIS FIT WITH ART. 17 COMMA 1 OF THE DECRETO BREXIT WHICH EXTENDS THE S1, S2 AND EHIC SCHEMES UNTIL THE END OF 2020 FOR THOSE ELIGIBLE?

  • For S1 holders living in Italy before Exit day, in the absence of an arrangement with Italy on continuation of reciprocal healthcare (as per art. 17 of the decreto), the UK Government will, for six-months after Exit day (from 1 November 2019 until 30 April 2020), reimburse healthcare costs or pay providers directly where necessary. This is to ensure people are not exposed to gaps in healthcare coverage and potentially high costs while they re-register for healthcare under the local scheme (if their access on the S1 form will no longer be valid). To be eligible for this support, people must apply no later than six months after Exit and the UK will pay the healthcare provider directly.

 

  • Operationally, making payments to healthcare providers and individuals outside of the UK can be complex and time consuming. It is for this reason the UK will in the first instance seek to continue making payments at country-to-country (UK to Italy in our case) level as we do now. If a Member State does not agree to this then the UK Government will step in to pay healthcare providers in the EU directly. To organise a payment, people will need to contact +44 (0)191 218 1999 (Overseas Healthcare Service) and provide the details of the healthcare provider in Italy.

 

WHAT DOES SOMEONE ENTITLED TO FREE CARE UNDER THE MARCH ANNOUNCEMENT FOR ONE EXISTING CONDITION DO TO PROTECT THEIR RIGHT TO HEALTHCARE FOR ANY OTHER CONDITION THAT MIGHT STRIKE THEM AFTER BREXIT?

  • The UK Government has already said that if we currently fund someone’s healthcare and they start a course of healthcare treatment before the UK leaves the EU and the treatment continues after Exit, we will pay for this treatment for up to 1 year.
  • As a further measure to support UK-insured persons (S1, EHIC holders) living in the EU before Exit day, the UK Government will, for six-months after Exit day (from 1 November 2019 until 30 April 2020), reimburse healthcare costs or pay providers directly where necessary. This is to ensure people are not exposed to gaps in healthcare coverage and potentially high costs while they register for healthcare locally. To be eligible for this support, people must apply no later than six months after Exit.
  • People should be ready for possible permanent changes to how they access healthcare, if there is a no-deal exit. In the absence of an arrangement with Italy, if someone is not eligible to join the local healthcare scheme for free, they should consider whether to join the voluntary scheme by paying into the system or buy comprehensive private health insurance, or if they need to return to the UK for healthcare treatment. After Exit day, if you have an S1 form, you will still be able to access free NHS care when temporarily visiting England, Scotland and Wales. To access NHS services, you will need to present a copy of your S1 form.

AND, OUR OLD CHESTNUTS:

WHAT WILL BE THE RIGHTS TO HEALTHCARE OF S1 HOLDERS WHEN THESE TEMPORARY ARRANGEMENTS EXPIRE?

  • These measures are being put in place to allow UK insured-persons (S1 holders) living in the EU time to make arrangements for the future of their healthcare. Most people should be able to do this within the six-month period.
  • However, after the six-months is over, the UK Government will continue to support people during the registration process where the registration period is longer than six months (which is normally not the case for Italy) and the Member State does not cover them.
  • This will ensure there is appropriate healthcare coverage should there be delays or overly lengthy registration processes. To be eligible for this protection individuals must have applied within local timeframes or no later than six months after Exit, whichever is shortest.
  • As explained above, people should be ready for possible permanent changes to how they access healthcare, if there is a no-deal exit. In the absence of an arrangement with Italy, if someone is not eligible to join the local healthcare scheme for free, they should consider whether to join the voluntary scheme by paying into the system or buy comprehensive private health insurance, or if they need to return to the UK for healthcare treatment.

 

WHAT WILL BE THE RIGHTS TO HEALTHCARE OF NON-S1 HOLDERS RESIDENT IN ITALY (A) IN THE ITALIAN GRACE PERIOD AND (B) AFTER 2020, AND HOW WILL THESE BE DIFFERENT IF (A) THEY HAVE THE NEW THIRD COUNTRY NATIONAL LONG-TERM RESIDENCE AND (B) THEY HAVE THE NEW PERMESSO DI SOGGIORNO “PER RESIDENZA”?

  • As explained in the second question, according to the Italian No Deal legislation, those legally resident in Italy on or before 31 October, who are registered with ASL  by paying social security contributions into the public health care system (registrazione obbligatoria scheme), or through voluntary contribution into the healthcare system (registrazione volontaria) will continue to have access to healthcare as they do now after Brexit. Our understanding is that third country nationals registered for healthcare in Italy under the obligatory or voluntary schemes have the same access to healthcare as EU nationals. We will continue to seek the advice of the Italian authorities.