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Health Insurance After Brexit: A Roadmap For Britons Living In Germany

Brexit has undoubtedly created a significant shift in various aspects of life for British citizens living across the European Union. One crucial area affected is health insurance for British expats residing in Germany. The transition from EU member state to third country status for the United Kingdom has brought with it a re-evaluation of existing regulations, rights, and privileges.

EHIC and S1 Form Before Brexit

Before Brexit, British citizens living, working, or traveling in Germany had access to the German healthcare system through two key mechanisms: the European Health Insurance Card (EHIC) and the S1 form.

The EHIC was instrumental in ensuring healthcare access for British citizens within the EU. It allowed for treatment under the same conditions and at the same cost as nationals in the country being visited. In Germany, this meant that emergency treatment, necessary medical care during a temporary stay, and even some chronic or pre-existing conditions were covered. The card was free of charge and was an essential item for travelers and expats alike. While it wasn’t a replacement for travel insurance, it did provide a vital safety net for medical care. The EHIC was, however, not valid for private healthcare or intended to cover medical tourism where individuals traveled explicitly for treatment.

The S1 form played a specific role for British expats living in Germany, especially those who were retired or receiving certain UK benefits. The S1 form enabled them to register for healthcare in Germany, funded by the UK. It provided comprehensive coverage and was particularly vital for pensioners and individuals receiving certain social security benefits.

Here’s how the S1 form functioned:

  • Eligibility: British citizens receiving a State Pension or certain other benefits were eligible for an S1 form.
  • Comprehensive Coverage: The S1 form gave the holder and their dependents the same access to healthcare as German nationals.
  • Link to UK System: The healthcare costs were generally covered by the UK, linking the expat’s healthcare rights to their UK social security contributions.

The S1 form was an essential part of the healthcare system for many British expats in Germany, ensuring uninterrupted access to medical services.


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Both the EHIC and S1 form created a framework that allowed British citizens to seamlessly access healthcare in Germany. However, Brexit has led to a reassessment of these privileges, necessitating a careful review of healthcare rights and planning for British expats.

Post-Brexit Changes

With Brexit, the usage of the European Health Insurance Card (EHIC) has become more restricted for British citizens. Those who were residents in Germany before December 31, 2020, may still use their EHIC cards. This continuation has been facilitated by the Withdrawal Agreement, enabling pre-existing residents to continue accessing necessary healthcare treatments as before. However, new arrivals in Germany after this date will not have the same privileges. This change has meant that British expats must seek alternative health insurance options, making a once straightforward process now more complex.

It’s important for both existing residents and those planning to move to Germany to be aware of their current rights under the EHIC system and the new restrictions. The UK government’s official page here provides detailed information on residency rights and healthcare, and should be consulted regularly for updates.

New Health Insurance Requirements

Post-Brexit, British expats may need to explore private health insurance options or specialized travel insurance policies with health coverage. Here are some aspects to consider:

  • Selection of Private Health Insurance: The selection of private health insurance requires careful assessment to ensure that policies provide adequate protection. Factors such as coverage for pre-existing conditions, maternity care, and emergency services must be taken into account.
  • Utilizing Expat Resources: Websites like Toytown Germany offer forums and resources for expats looking to understand the local health insurance landscape. Connecting with other expats who have navigated these changes can provide invaluable insights.
  • Impact on Short-term Travelers: For short-term travelers, comprehensive travel insurance that includes health coverage has become more essential. It’s crucial to assess the level of coverage in the context of the new regulations.

Impact on Pensioners

Pensioners who have retired to Germany face specific changes related to healthcare access. The S1 form previously allowed pensioners to access healthcare in Germany with the costs covered by the UK. Post-Brexit, the rights of pensioners depend on individual circumstances and bilateral agreements, adding a layer of complexity to what was previously a clear-cut procedure.

Understanding personal eligibility and rights is now vital, and pensioners should consult the UK Government’s guidance for pensioners living in Germany here. Some pensioners may need to explore private health insurance or additional coverages to fill gaps left by changes in the S1 form regulations. Other things to consider include:

  • Understanding Regional Differences: Germany’s healthcare regulations can vary by region, so it is essential to understand the specific rules that apply in the particular area of residence.
  • Consider Private Health Insurance: With the loss of S1 form benefits, private health insurance may become necessary. Pensioners must look into plans that cover their specific medical needs, including chronic conditions, medications, and specialized care.
  • Consult Local Authorities: Engaging with local German health authorities can provide information about enrolling in the German healthcare system, if applicable.
  • Utilize British Embassy and Consulates: The British Embassy and consulates in Germany can provide consular support and guidance on legal and administrative matters specific to British nationals.
  • Create a Healthcare Strategy: Develop a long-term healthcare strategy that considers potential future healthcare requirements. This strategy should align with both immediate medical needs and long-term considerations such as aging and long-term care.

Implications for Travel Insurance

Travel insurance has taken on renewed importance for British citizens visiting or residing in Germany post-Brexit. While travel insurance with health coverage was always recommended, it has become essential now. The need to ensure that chosen policies cover not only general medical expenses but also pre-existing conditions and other specific needs has become more pressing.

Comparison sites like MoneySuperMarket can assist in finding suitable travel insurance policies tailored to individual needs. Factors to consider may include:

  • Emergency Medical Expenses: Cover for unexpected medical costs.
  • Pre-existing Conditions: Adequate coverage for any known medical conditions.
  • Repatriation Costs: The cost of returning home if medical treatment is required.
  • Legal Assistance: Some policies provide support for legal matters while abroad.

With the change in regulations, some existing travel insurance policies might not offer sufficient coverage post-Brexit. It is advisable to review and possibly update existing policies.

What to Look for in a Policy

It’s important for British expats in Germany to think carefully about their healthcare options and plan ahead accordingly. If you are thinking of obtaining private health insurance, consider the following areas:

Comprehensive Coverage Options: Many German private health insurance providers offer comprehensive coverage options, including outpatient, inpatient, dental care, and even alternative treatments. Allianz, AXA, and BUPA Global have specialized expat-oriented policies, with tiered plans that cater to various needs and budgets. They often offer add-ons for vision care, mental health services, and preventive screenings. Cigna Global, another significant player, provides personalized plans that can include a combination of these benefits, allowing clients to tailor coverage according to individual and family healthcare requirements.

Coverage for Pre-existing Conditions: Policies that cover pre-existing medical conditions can be vital for many expats. While some insurers may exclude these or charge higher premiums, others specialize in offering coverage for specific health issues. It is essential to carefully review policy terms and consult with insurance brokers to find a policy that won’t leave you without necessary care.

Family Plans: Providers like Cigna Global and Allianz offer family plans tailored to the diverse needs of families, such as maternity care, child wellness services, and vaccinations. Cigna, in particular, provides flexible family packages that can be adjusted based on the number of family members and specific healthcare needs, offering both convenience and cost-saving options.

Language Support: English-speaking support is often crucial for British expats. Providers understand the communication needs of expats and offer English-language customer service, documentation, and even a network of English-speaking doctors, making it easier for British citizens to navigate the healthcare system.

Network of Medical Providers: Checking the insurer’s network of doctors and hospitals is vital. While living in Germany it’s important to think about your access to a wider international network, giving you the flexibility to choose the right healthcare providers. Other insurers may restrict you to specific networks, which could limit choices but might also lead to cost savings.

Legal Compliance: Ensuring compliance with German legal requirements is essential, especially when seeking a residence permit. The right private health insurance policy must meet specific criteria laid out by the German government, and a professional broker can guide you through these requirements.

Price Range and Deductibles: With policies varying widely in price based on coverage, age, health conditions, and deductibles, a careful comparison is essential. Platforms that provide quotes from multiple insurers, including major providers like Cigna Global, can offer a snapshot of available options and help in making an informed decision.

Brexit has brought about profound changes in the way British expats in Germany must approach health insurance. The previously seamless access to healthcare, comparable to that enjoyed by German citizens, has become more complex. Careful consideration, planning, and awareness of both current regulations and potential future changes are vital for British expats in Germany.

By actively seeking information from reliable sources and potentially consulting with professional insurance experts, British expats can navigate these changes successfully, ensuring uninterrupted access to the high-quality healthcare system in Germany.

For further guidance, expats can refer to the UK government’s official guide for living in Germany, available here, or the German Federal Ministry of Health’s English-language


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