It was expected that Brexit would be a reality by now, but it is still far from clear what that reality will look like.
This is particularly true from a healthcare perspective.
One thing that is becoming increasingly clear is that the onus is on each one of us to put in place measures to protect ourselves in preparation for a hard Brexit.
The prospect of the UK leaving the EU with no deal remains and that potentially means very real consequences in terms of accessing healthcare for approximately 1.3m British people living on the continent, and millions who travel across the region every year.
Up until now, the 2006 European Court of Justice ruling that healthcare is a service that EU citizens must be given the right to receive has meant co-operation on healthcare delivery across the region.
As it stands, the S1 certificate helps Britons living in EU/European Economic Area countries to access medical treatment for both themselves and their dependants, while the European Health Insurance Card (EHIC) enables access to healthcare for British people who are visiting countries within the EU/EEA and vice versa.
However, the EHIC is currently only valid until April 12 for UK citizens, according to guidance from the NHS, while the future of the S1 certificate is also unclear.
The UK government has proposed maintaining the existing healthcare arrangements with EU member states in a no-deal scenario, but there is no guarantee that those countries will agree to extending those arrangements.
This leaves us in a situation where, in the event of no deal, the reality is that continued free access to medically necessary treatment will not be guaranteed for British citizens living on mainland Europe and they will only be entitled to free healthcare in the UK if they return permanently, because the NHS is a residence-based healthcare system.
Similarly, British people will not be entitled to access emergency care while on holiday within the EU, while the same may apply to European tourists in the UK.
The future is equally uncertain for those who do not have private health insurance but are planning to travel for an elective surgery at a hospital abroad, or treatment for a rare disease at a specialist centre in a different country, on the basis that they will be reimbursed for the costs incurred.
If there is no deal, then reimbursement for such treatments will not be guaranteed.
The UK government has publicly called on its citizens to take out travel insurance, in order to ensure they are covered while travelling throughout Europe.
The same logic applies to UK citizens working and living on the continent or those traveling regularly for work, who may benefit from an international health insurance policy to safeguard their health and ensure they are covered, whether they are here in Britain or on the continent.
