# Private Health Insurance to Satisfy Residency Requirements



## Dmoesq (Apr 3, 2015)

Hello all!

As I noted in my earlier post ("Importing Car Into Italy"), my family and I are planning to move from the U.S. to Firenze in July. I, as well as my minor children, are dual E.U./U.S. citizens (not Italian). My wife is a U.S. citizen. I will be self-employed in Italy. We have never lived in the E.U.

We are looking into "Schengen" health insurance that will satisfy the registration requirements (at the Anagrafe office). We are not sure, however, as to the length of the policy that will be needed (i.e., 1 month, 3 months, 6 months, etc.). We intend to sign up for the Italian public healthcare system (Servizio Sanitario Nazionale) once our residency is established. I would obviously like to purchase the Schengen health insurance for the shortest period necessary. Of course, any recommendations for companies that sell this type of insurance is appreciated.

In addition, I understand that the Italian healthcare "buy in" is based on an annual calendar year system. Since this is our first time "buying in" and we assume will not have earned any money in Italy by the time of the "buy in", will we be subject to the minimum amount (387.34 euro?) or will the percentage be of my prior year's U.S. income?

I thank everyone in advance for all your help and if anyone has any information on my other post, it would be gladly appreciated.

All the best!

Don


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## BBCWatcher (Dec 28, 2012)

My understanding is that the medical insurance has to cover the period of intended residence or one year, whichever is less. So the answer would be one year. _However_, that's not a problem if you get a policy that can be cancelled with a pro-rated refund and little or no penalty, and that shouldn't be hard to do.

A couple points, though:

1. Schengen minimum medical insurance isn't really insurance from your point of view. All it does is make sure the government isn't stuck with the entire bill if you get sick or injured. It's probably not the sort of insurance that would actually meet your needs or offer adequate financial protection and treatment assurance. The easiest way to make sure you've got something that actually meets your needs is (probably) to keep whatever U.S. coverage you have now also in force at least until you're well established in Italy. Most U.S. medical insurance covers emergency and urgent treatment overseas for some period of time.

2. When you cancel your Schengen minimum insurance that cancellation is likely to be reported. (Yes, they thought of that.) So don't cancel until the need to maintain it has passed, i.e. until you're enrolled in the Italian public system.

3. Given #1, and given the fact that Schengen minimum medical insurance is not rigidly enforced when you apply for residence (it is more vigorously enforced when applying for a visa, something you don't actually have to do), I'd recommend just researching that insurance (in case you need it once you land) but not actually buying it unless and until needed, and assuming of course you've got adequate coverage from your U.S. carrier during the transition phase. You might also be able to get away with a shorter insurance term than one year once you land, for example. So "line it up," as it were, but pull the trigger only if you're finding it difficult to get registered as a resident -- assuming you've got good U.S. coverage that's the "real" insurance that you need anyway during your settlement phase.

You seem to be under the impression that you and your family will be in the "voluntary registration" category for enrollment in the Italian public medical system. Actually no, you can qualify for the "obligatory registration" (iscrizione obbligatoria) category, meaning there's no enrollment fee. Since you'll be self-employed you'll need -- and I'll just quote the Italian language requirements:

_Certificato di iscrizione alla Camera di Commercio o ad un albo o ordine professionale
Attestazione di apertura partita IVA o apertura posizione INPS_

To boil it down, you'll need some "Italian" evidence that you actually have a sole proprietorship in Italy -- a VAT registration, for example. Any of those pieces of evidence will do. Submit that evidence when you and your dependents enroll at the local ASL office, and you've got free enrollment.


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## BBCWatcher (Dec 28, 2012)

One more point. If for some reason you end up in the voluntary registration category:

(a) Dependents should be no additional charge.

(b) Yes, they're supposed to ask about your worldwide income for the previous year in order to settle on the enrollment fee. Just tell the truth if asked, and it is what it is.

(c) One reason to acquire Italian citizenship -- with another EU citizenship you would be eligible as soon as you reach the 4 year mark of continuous legal residence -- is to switch from the voluntary to the obligatory registration category for medical insurance.


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## Dmoesq (Apr 3, 2015)

BBCWatcher-

Thank you for that thorough reply!!! It is greatly appreciated and very helpful. I am still absorbing it and will let you know if I have any follow ups.

All the best!

Don


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## Donutz2 (Apr 14, 2014)

For EU nationals and their non-EU family members there is no medical-travel insurance requirement for temporary stay (up to 3 months). You may wish to get insurance regardless though. I don't know how (public) healthcare is organized in Italy but it should be possible to get travelinsurance with a company that will pay back (minus some administration costs) the days that you have been double insured (covered by the healthcare system and the travel insurance). That atleast the case elsewhere in the EU but I'd expect that this policy applies to all proper Schengen travel insurance policies out there.


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## Dmoesq (Apr 3, 2015)

Thank you Donutz2!

All the best!

Don


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## BBCWatcher (Dec 28, 2012)

Donutz2 said:


> For EU nationals and their non-EU family members there is no medical-travel insurance requirement for temporary stay (up to 3 months).


That true but not terribly relevant in these circumstances. The original poster is going to be registering as a resident, not just popping over for a short stay, so long-term residence procedures apply.

I certainly agree, though, that there's a difference between what's required and what's a really, really good idea. Whether required or not, having adequate medical insurance is a really, really good idea, whether you're staying for one hour or one hundred years.


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## Dmoesq (Apr 3, 2015)

Agreed!


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## BBCWatcher (Dec 28, 2012)

Another thing you could try -- it doesn't hurt to try -- is to present evidence of the medical insurance you do have when you register as a resident. If that insurance adequately covers care in Italy (at least for emergency and urgent care), great. Whoever is processing your residence registration just might rubber stamp that, even though it may not technically be "Schengen" insurance.

Anyway, to net it out, I think Donutz2 and I are agreeing that it's a very good idea to have adequate medical insurance in general. You can research "Schengen compliant" insurance before you go, but you don't actually have to sign up. Try to register as residents and see how it goes. _If_ you get a proof of insurance request, provide evidence of the adequate insurance (U.S. policy presumably) you do have ("Schengen" or not). If that doesn't work, then go ahead and get that minimum Schengen stuff as a relatively inexpensive supplement to clear the bureaucratic hurdle.

After you're registered as residents, enroll in the Italian public medical system, preferably under the _obbligatoria_ (free) category if you can manage it. Once you're enrolled in ASL, cancel your other insurance if you no longer need it.


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## yosheryosh (Mar 4, 2013)

what brings you to firenze?


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## Dmoesq (Apr 3, 2015)

yosheryosh - 

1. Current client matters and expansion within the E.U. of my Customs, international trade and federal regulatory compliance practice (I assist foreign companies with the movement of goods and services throughout the world and particularly with duty savings/import requirements for products intended for the U.S.); 2. Familiarity; and, most importantly, 3. Consensus of my family.


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## yosheryosh (Mar 4, 2013)

sounds like a great adventure


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## Dmoesq (Apr 3, 2015)

I definitely expect it to be one for us all!


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