Italian Health coverage – a new year

Here, in our part of Umbria, we are required to obtain our social security statements from the US Embassy in Rome to obtain our enrollment in the National Health system. This statement must be stamped and signed by the American Embassy in Rome. This is ONLY a requirement in this part of Umbria. How and why this came about I do not know. When we first moved here, we self declared our income. After a couple years they decided we needed this statement. It really threw a monkey wrench into the works that year for all of us! We eventually got used to it and just go with the flow, requesting the statement from the Embassy.

I always send off two emails, one for me, and one for Luther to the Social Security office in Rome asking for this statement to be sent. Usually I do this in mid-December so I can get them by January 1. I complain, and everyone does, about Italian bureaucrats. Now, in this case they work at the American Embassy which is almost entirely staffed by Italians. I got a nice reply from a woman to me that she was sending out my statement right away. But I also got a reply from a man to Luther that he would have to ask again after the first of the year. 😡 Annoyed I shot back an email that said essentially “my wife can get hers now why not me?” He replied that he “normally” waits until the year is done to send it, but would send it now. Think about it, this is our Social Security benefit for the year 2022. It is not like this will change in the next two weeks! Geesh. Dealing with bureaucrats can be exhausting.

When we receive the statements from the Embassy we will go to the USL which is the agency of health and re-up for our annual payment and enrollment for 2023. It is 7.5% of our social security benefits. It is paid annually in January. We are usually out of the system for a week or two while completing the payment and application. Once we sign up, most things are free. Co-pays are small and linked to your income on a sliding scale. For Italian citizens and workers they are automatically enrolled. I am happy with our care here. It is a good system.

12 thoughts on “Italian Health coverage – a new year

  1. Nancy Hampton Post author

    Hi Carla, being stranieri, when our card expires we cannot access the system. In fact, I tested it once, and my doctor could no longer give me my prescriptions. But our pharmacy knows me and allows me to renew but I have to pay full price…which is small. As I mentioned to another commenter, I can always pay private during the gap. And emergency care is always available to anyone.

  2. Carla Fiorina

    Actually Nancy, you don’t go out of the SSN system, as far as I know. Pending your documented renewal, you can get meds and assistance.

  3. Nancy Hampton Post author

    Hi Nancy, as I mentioned in the post it is different in every region, and even every ASL office (Agenzia Sanitaria Locale). But the “official” amount is 7.5% of your income. Our ASL just wants to see social security. And they charge on the net amount. The ASL in Paciano (near lake Trasimeno) wants to see your 1040. Then there are other regions where they can’t be bothered and charge the minimum amount of about €400 a year. It is crazy.

    As for the gap. It isn’t as scary here as it is in the US. First emergency care is available to everyone. Doesn’t matter who, can be a tourist, immigrant, anyone. And it is usually free. Second if you want to see a doctor for an issue, non emergency, during the gap it is ridiculously cheap here to see a doctor and get treatment. There is really no fear.

  4. Nancy Hampton Post author

    Hi Karen, yes, these are the mundane things that must be addressed when you move here. Not the dolce vita that people dream of, but necessarily a part of living in Italy full time as a resident.

  5. Nancy

    This is good info. Thank you! Peter and I will also keep our Medigap coverage when we move to IT, which will be removed from our social security before we get it. I would suppose the 7.5% if from gross, not net. I am also wondering what you do for coverage during that Insurance gap each year. It’s a bit scary to me, as we’ve had so many “surprises” through the year medically that I just dont think we could have a gap in insurances even for a couple of week. Thanks, as always, for your willingness to share with us!

  6. Karen Pace

    All very good to know, and appreciated, for when I make the same move, Nancy. Thanks, as always, for your insight into the wheels and gears and cogs that make ex-pat life work in Italy!
    Buon Natale and Happy New Year! =)

  7. Nancy Hampton Post author

    Hi Sally, oh, well, don’t tell the Italians that! They will close too if they hear!

  8. Nancy Hampton Post author

    Hi Elizabeth. Yes, that is what we pay. Once paid everything is (mostly) free. Sometimes a small copay. Every region handles health care separately so it depends where you live. Some charge less than we pay. No predicting your personal results.

  9. Nancy Hampton Post author

    Hi LeeRyan, the system is not perfect by any means. But it is very affordable, unlike the US system. Everyone gets healthcare here, unlike the US. The care is good. It is no frills. It is also health focused, not bottom line focused like in the US. We are quite happy with it.

  10. Elizabeth Milne Baum

    Does this mean you pay 7.5% of your social security income for your medical coverage? I’m trying to get a sense for what I would pay in Italy. Thank you.

  11. LeeRyan Coston

    Good to hear that you feel it’s a good system. I have heard mixed reviews from both Italians and American expats.

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