S1 healthcare for pensioners - default position.

In a little-publicised Brexit no-deal technical notice published this week, the UK government said: “An S1 certificate helps you and your dependents access healthcare in the EU/EEA country where you live. If you have an S1 certificate, it will be valid until 29 March 2019. After this date, the certificate may not be valid, depending on decisions by member states.”

Sue Wilson, who chairs the Bremain in Spain campaign group, said the change could be devastating. “All along we’ve been told our healthcare is protected. This is a big shock to everyone and our members are really, really scared,” she said.

The Department of Health said it was “working closely with countries, including Spain and France, to make sure patients can continue to access healthcare, whatever the outcome”.

In the event of the expected no-deal Brexit existing pensioners in Spain will rely of the Spanish government to agree a bilateral treaty with Britain to continue health care provision.

If the S1 cover ceases,  then all of those currently enjoying that cover would be covered by the free medical cover provided by the Spanish government.  

New comers would also be covered once they were considered as ‘ living in Spain’.  

Johnzx, if S1 ceases, what is  considered as ‘ living in Spain’? When will residency stop asking Brits for proof of medical insurance? 

It is impossible to obtain private health insurance in Spain over 65 and for pre-existing conditions. Unless a bilateral treaty is agreed between the UK and Spain to continue the S1 system, remaining living in Spain for most pensioners will be untenable post no-deal Brexit. 

I do know several UK Spanish residents who are unregistered and who commute to the UK for healthcare. Usually they own two properties that allows them to do it.

I have two residencies in the Eurozone but the same situation applies to France. Accept in France there are no age limits for private healthcare cover or restrictions on pre-existing condition questions. However it is relatively expensive but cheaper than BUPA.

I believe the chances of Spain and France agreeing a bilateral agreement with the UK are good. Based on the fact that an estimated 70,000 pensioners are registered in Spain on the S1 system at €3,500 per head per annum, paid by the NHS into the Spanish coffers. In France it is much more.

The press has reported the free cover is provided for all those living in Spain, including those who are illegally here.   So I guess if, as determined by the requirement to register on the EU Citizens Register, one must register, or must register on the padron, then they are covered.  I think living in spain means what one would understand by that. 

I understand that under the facilty to voluntarily pay into the health system, the payments stopped being collected as everyone on that system automatically qualified for the free cover.   Those authorities who did collect payments after a certain date paid it back

Read about the "reciprocal health agreement" bill going through parliament at the moment. This is to ensure UK citizens continue to receive healthcare funding if there is no deal on leaving the EU. 

Healthcare After Brexit

If there is an agreement then nothing will change.

At one meeting we attended, it was explained that they required proof of healthcare cover for the first year when applying for residency to stop the health tourists just coming in for treatment. The Convenio Especial (the bit where you pay monthly for health cover) is being phased out and I think Andalusia has already cancelled it but not sure on that.

Spain, France and the Netherlands have said they will continue to provide healthcare cover to UK citizens in the event of a no deal if UK does the same for its nationals living in UK which is covered in the bill going through parliament and has been promised several times by the UK government.

Portugal has said that health cover for Brits will continue even in the event of a no deal and have also stated there will be no visa requirements for up to 90 day visits.

Thanks mariedav. The link you posted is the UK part of what will be the legal basis for any bilateral treaties in future. Each member states will have to do likewise. Verbal promises to the media they will are not the same thing. In this fluid political situation anything is possible. Politicians create arbitrary default cut off dates then try and negotiate backwards.

If healthcare in Spain is now free to everyone why do I have to prove my entitlement every time I need something?

Micky.  ‘If healthcare in Spain is now free to everyone why do I have to prove my entitlement every time I need something,’

i Understand that if a state retired U.K. national wants to get the fee cover,  the social Seguridad require a letter from DWP to the effect that they will not provide cover. With that no problem.   However like probably most U.K. retirees I have the cover under an S1, so I need not test the new law.  

Hopefully someone who has obtained it will let us know how it went for them.

A bit confusing johnzx. Why would the UK want to continue paying Spain €3,500 per head per annum

If

FREE and universal State healthcare for everyone in Spain has now been officially restored after years of undocumented migrants being denied all bar emergency treatment.

https://www.thinkspain.com/news-spain/30942/healthcare-in-spain-free-and-universal-to-all-residents-legal-or-not

Surely, Kavanagh, this is to do with the agreement between the countries. UK pays Spain about €3.500 a year (the actual figures state an  average cost of £2300 per pensioner) and UK charges Spain around £5,000 a year for each of its citizens. Healthcare in UK is also free to everyone but they still bill each individual country for their citizens under the S1 agreement.

Ireland, apparently, works out most expensive and they charge the UK government around €7,500 a year to provide treatment (I can't find out how much UK charges Ireland for its citizens). 

I was trying to point out we shouldn't start panicking yet. 

And I'm pretty sure that the link you posted about free healthcare doesn't apply to EU citizens as that is covered under a different agreement. That was in reference to the illegals in Spain who were denied health cover under the previous government. In fact, I seem to recall the original article on this did state it would not affect those covered under different arrangements such as the S1 for those eligible and only applied to those who had no access to health cover under different means.

But marie the whole thing becomes nothing but bureaucracy, shuffling money from one country to another, a job creation scheme for expensive pen pushers including office, company car, pension. What right minded commercial company would get involved in this sort of nonsense?

I recently attended a presentation by the British Consul and someone from  DWP. 

After explaining that the S1 might cease I asked about the free cover available in Spain. 

They agreed that free cover would be available to UK citizens if the S1 agreement could not continue,

Just to clarify the amouts DWP pays.:--

‘Free Health Cover’

The so-called free medical cover UK nationals who have retired to Spain enjoy by means of a form S1 from DWP is not free.  For each person qualified the DWP currently pays a flat rate of £4,172.59 (4,700€) a year.  They also pay a flat rate for each qualified person’s  dependants according to age:-   For those under 19 years old it is  £585 p.a. ;   Aged 20 to 64 £802; over 65 (who do not qualify in their own right) £1,100.  The amounts are paid each year irrespective how much or little use is made of the service. 

I was urged to get the exact figures when a few Spaniards in the health system told me they understood we paid nothing, believing the cost was covered by Spanish workers social security payments. I wanted to be able to assure them we Brits are not parasites.

Re  EHIC treatment.  

When used, the Spanish health authority bill UK for the actual cost  involved.   Unfortunately the refunds must be sent to Madrid, from where they are distributed to the various health authorities.   I understand it is not done on a basis of treatments provided, thus the main tourist areas, which treat many more patients, are not compensated pro rata,  inevitably loosing out.

Best case scenario. I think basically on 29 March 2019 the S1 system ends. A new bilateral agreement then replaces it. Those already registered will be automatically moved to the new arrangement.

Worse case. Uk pensioners revert to the free system in Spain designed for illegal immigrants which may have restrictions on costs and benefit 

The situation is quite simple; each country that is prepared to let in foreigners is responsible for their healthcare. If they don’t like it, don’t let them in. Stop making job creation schemes for non productive parasites to shuffle wooden dollars around.

If the world stopped messing about with non productive bureaucrats it would not have the hunger and starvation.  

Any state healthcare system requires administration to ensure it runs smoothly. It is a little over the top with bureaucrats in France I agree. Macron is trying to change that. I believe the Civil Service in Britain do a great job, elsewhere and in Spain perhaps not.

A DHSC spokeswoman ( bureaucrat) said yesterday that British nationals should not be concerned about health cover: Quote: “Our priority is to ensure UK nationals living or working in the EU can continue to access the healthcare they need as we exit the EU.”

The department also pointed out that France’s national assembly had voted through a bill that allows the government to take emergency measures to deal with a no-deal Brexit, including protecting the lives of Britons living and working in France, and that Spain was bringing forward a law giving the Spanish prime minister the power to allow British nationals access to healthcare under the current system in the event of a no deal – providing there was a reciprocal agreement in the UK based on current access.

** EDITED - Against forum rules **

This message was last edited by Liliat on 19/03/2019.