# Advice needed re medical



## jacky mclean (Feb 27, 2013)

I am a new resident (with residency) in Umbria and because my husband still commutes to UK for work he is not classified as a resident. We are not retired (therefore no pension) however he obviously provides my financial support.

The S1 form that was once provided from UK tax office giving expats like for like medical benefits in Italy has now been stopped. Therefore I am not entitled to free health in Italy. (until we are retired and he is able to become a resident)

Can someone advise me if private medical insurance can be taken out and what is the procedure then for going to the doctor in Italy? i.e....doctors write a bill?

The UZL/ASL departments do not seem to know anything!

Hope you can help....:fingerscrossed:


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## accbgb (Sep 23, 2009)

Forgive me for side-stepping your question, but I was wondering: why isn't your husband "able to become a resident" now? Is Italy your primary place of residence, or is it not?

I am not aware of any rule which says your husband cannot be resident in Italy but earn his income in the UK...


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## jacky mclean (Feb 27, 2013)

Because he is not in the country long enough....you have to be in a country for more than 180 days to be a resident.


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## accbgb (Sep 23, 2009)

Well, first of all, I am not absolutely certain that your husband must be physically present in Italy for 180 days of the year in order to obtain residenza. In fact, you can apply for residenza within days of arriving in Italy.


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## accbgb (Sep 23, 2009)

Also, have you reviewed the info available here? Healthcare in Italy - Healthcare abroad - NHS Choices


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## BBCWatcher (Dec 28, 2012)

Jacky, I share Accbgb's confusion. If you're a U.K. citizen then to stay in Italy you'd need to be exercising an EU treaty right: working (employed or self-employed), jobseeking (with some limits), studying (with satisfactory progress toward a degree), or retired with a pension. Whereupon you'd be able enroll in ASL, either for a fee or without a fee. This stuff all fits together, really.

It sure sounds like you're retired, with "independent resources" (a portion of your husband's income). Have you tried registering as a resident yet? To do that you'll need (among a few other things) proof of medical insurance and proof of those financial resources, but that medical insurance can be so-called "Schengen minimum" insurance for these purposes. (That's not great insurance, though.) Once you have a receipt for your residence permit in hand, you can then stop at the ASL office to enrolled in the public medical system, perhaps for a fee. It's a calendar year fee, so it's better to enroll earlier in the year rather than later.

Or are we just confused and you only plan to be in Italy less than 3 months...and you simply need short-term medical insurance coverage there?


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## jacky mclean (Feb 27, 2013)

I am already a resident - I was able to achieve this because he is my sponsor. I am not classified as retired. It was very easy to get my residency. My husband pays UK tax - if he was a resident he would have to pay Italian tax aswell (obviously) - but he is not in the country more than 180 days. Are you aware of the S1 form from the UK tax office? We are not eligible for this anymore. This is required from the ASL office to get free health. I am not trying to get free health....I am trying to find out how to go to a doctor and pay! And if it is worth taking out medical insurance.


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## NickZ (Jun 26, 2009)

Tell them you want to register voluntarily 

ASL TO1 - Assistenza sanitaria agli stranieri



> L'iscrizione volontaria è una forma di assicurazione pubblica che prevede il versamento di un importo determinato in base al reddito complessivo conseguito l'anno precedente (si calcola il 7,50% del reddito fino ad un ammontare di reddito pari a 20.658,28 €; se il reddito complessivo dichiarato supera tale importo, sulla parte eccedente si calcola un ulteriore contributo pari al 4% fino al limite di 51.645,69 € annui).
> 
> In ogni caso il contributo minimo da pagare non può essere inferiore a 387,34 €.


That's what you want. Print it out and bring it with you. Hopefully they know about it. You'll need to fill out a F24 to pay the amount


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## BBCWatcher (Dec 28, 2012)

OK, excellent. Then why don't you enroll with ASL under the voluntary registration program (iscrizione volontaria), meaning fee-based? They offer that, too. (On edit: I see NickZ had the same suggestion.)

FYI, that tax avoidance approach you describe only partially works in Italy. Italy has a foreign wealth tax (actually a pair of them: IVAFE and IVIE), and marital/household assets are generally treated as 50% yours. Welcome to Italy.


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## jacky mclean (Feb 27, 2013)

So that I understand.....I go to ASL and say I want to register voluntarily? I pay the fee (387.34), then I can go to the doctor without an issue?
Is it an annual fee? 
Why haven't they (ASL) told me about this?


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## NickZ (Jun 26, 2009)

It's at least that amount per solar year. So Jan 1st to Dec 31st. No discount for the months already passed.

You then get a health card and to everybody in the system you look no different then anybody else.

Depending on your area the ASL may never of done this. It doesn't apply to that many people.


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## jacky mclean (Feb 27, 2013)

Seems easy!! What documents do I need to take?


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## NickZ (Jun 26, 2009)

Best to ask them


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## jacky mclean (Feb 27, 2013)

Thanks....at least I feel I am getting somewhere now.


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## Arturo.c (Aug 15, 2010)

jacky mclean said:


> Seems easy!! What documents do I need to take?


Your current photo ID (passport or "carta di identità") and your "codice fiscale" should suffice...


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## Amblepup (May 3, 2016)

I was unaware the like for like has been stopped, we are still in the EU. Have you spoken to the consulate? Before you pay for medical insurance ensure you have the correct information. Also re your husband still commuting, if he spends time with you due to commuting, he may still be able to get residency. I say this because communes differ where residency rules exist. I was asked by my local health practice here in Abruzzo a few weeks ago for my S1 as I had moved from another region, spoke to uk pensions and no mention of this stopping, but just told they only issue it once, but valid all over Italy.


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## Amblepup (May 3, 2016)

Just read through some responses, after my original response, sorry I am new to the forum! As a Uk citizen, you DO NOT pay for healthcare (although some things are charged ie blood tests if under 65) take your residency card to your local Asl, get your health card, no cost, find out where your local docs are, walk in to the waiting room. Wait your turn and just see the doc, simple! No receptionist at GP practices. Secondly, your husband IS entitled to be a resident. There is a NO double tax rule, you either pay in the Uk or here in Italy. However, when asking if I have to pay tax here on my pension, the U.K. Take my tax. I have had that told to me by the tax office. So I hope when the financial police come knocking ha ha, they are right and the system understands that here,


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## Arturo.c (Aug 15, 2010)

It would also be useful to check the relevant HMRC website.


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