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I know questions like this one have been asked before, but my question is specifically in regards to healthcare.

My wife is a Swedish citizen. She has also acquired permanent residency in the UK by having lived there for 10 years. She and I are moving to Berlin, and will be registering ourselves there, however we're also trying to get pregnant. For both legal and personal reasons, we would like to come back to the UK to give birth when the time comes.

My question is, when we go to Berlin, register our home and get health insurance, will that automatically unregister her with the local GP? Is there any reason (both practical or legal) she wouldn't be able to come back and use the healthcare system as if she never left?

Also, I don't think it matters, but assume we give birth before the UK leaves the EU.

  • Brexit will make no difference. The registration itself would automatically cancel. But your intentions might. If you are leaving the UK permanently, then you are no longer a permanent resident. I think that is the bigger issue. – ouflak Sep 22 '16 at 12:19
  • An actual "permanent resident" is an objective term and is different than holding "permanent resident" legal status. In one of the links mentioned by Gala in the answer below states an EU citizen who has acquired that status can lose it after spending two years outside of the country. We've never thought of Germany as a permanent move. It's just a cheaper base after having been married and done some globetrotting. Our current contract in Berlin ends after about 6 months. We may just move to the UK after that because it is how we see our long-term future. – Christian Sep 22 '16 at 13:13
  • Formally, I think there are at least two distinct permanent statuses for non-nationals. The Indefinite Leave to Remain and "Permanent Residence" for EU citizens under directive 2004/38/EC. Intent is definitely relevant for the former but I was surprised to find that the directive unambiguously states that losing the latter can only result from two years of absence from the country. If the transcription in UK law is similar and this interpretation is correct, it would mean that you would not immediately lose that status even if your situation shows that you intend to leave the UK for good. – Gala Sep 23 '16 at 11:36
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    In any case, how much this matters under UK law is definitely the bigger issue (as opposed to your status in Germany). – Gala Sep 23 '16 at 11:38
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There is no unified concept of residence for all purposes (immigration, taxes, healthcare) and no harmonization or coordination at the EU level. This means that registering in Germany or getting insurance there doesn't per se mean that you cannot be considered a resident elsewhere for some purpose. The UK authorities or the NHS won't be notified of it. In that sense, an EU national could theoretically be a resident in two EU countries, at least for some time and some purpose.

On the other hand, as soon as you move somewhere else with the intention of spending most of your time and living there permanently, you are probably not considered a resident in the UK for most purposes anymore. The relevant fact here is not so much that you would be registered in Germany and considered a resident there but simply that the center of your interests (job, main home, etc.) are materially outside the UK. It doesn't really matter what else you are doing, that Germany is in the EU, etc. if you don't live in the UK, you don't live in the UK and that's usually the relevant test for the NHS.

Incidentally, if you get German statutory insurance (Gesetzliche Krankenversicherung - but not private insurance), you will also get a European Health Insurance Card (EHIC), which you can use to get access to the NHS during a visit to the UK (even people who have no special link with UK/have never lived there can). It does cover routine maternity care but explicitly would not cover you if you go to the UK specifically to get treatment or give birth so it would not solve your problem.

I think that immigration law is somewhat different in that you wouldn't lose the right of permanent residence as an EU citizen immediately but only after two years of absence from the country. My understanding is that during those two years you should be able to return to the UK and register yourself with the NHS again, no questions asked. After that, you would need a job or some other legal basis to become a (regular) resident again.

In practice, the NHS might not notice immediately but you are supposed to let your GP know. If you can make a good case that it's temporary (e.g. you're a student or you will work on a specific project for your UK-based employer), you may be able to argue that the move is not permanent and stay registered but otherwise, you will have to leave the NHS. Apparently, there is also a special rule for people who have lived at least 10 years in the UK that lets you resume coverage if you have worked less than 5 years abroad and could provide you a bit of leeway. That's probably your best shot but apart from that, the NHS is a residence-based system and residence is determined by your material situation so it's difficult to see how your could live in Berlin and legally benefit from it without misrepresenting your situation.

  • We've never thought of our move to Germany as permanent, more a way for us to settle down a bit cheaper after marrying and a bit of globetrotting. Our current contract in Berlin expires after 6 months. We may just come back to the UK after that. I love that the possibilities are so endless, but it really does get confusing trying to figure out what's allowed and what's not! Me being non-European adds another level to it too. Thanks for this wealth of information! – Christian Sep 22 '16 at 12:50

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