# New to Liguria, Italian Health Insurance question



## spepper222 (Apr 18, 2019)

We made it! After retiring, helping my dad through the last phase of life, selling the house in Oregon, getting rid of 80% of our stuff, driving cross-country to Florida, packing up our remaining goods with a shipper in S Carolina, selling the car, buying international health insurance, and getting approval for the dog to fly in the cabin, we arrived in Albenga Italy to begin the next chapter. In the past few weeks we have learned tons of Italian, met wonderful people, and had much great food & drink. Now we have a permanent apartment in Bordighera which we occupy in 2 weeks. So we went to the Anagrafe in Bordighera the other day, with our rental documents in hand to apply for residency, and she told me that my Cigna Int'l Health plan is not acceptable as proof of insurance, and that I must obtain an Italian Health Insurance plan. I'm fine with buying a local plan and canceling the Cigna, it's pretty expensive, but my google searches on Italian Health Insurance companies have not yielded much useful information. Have others gone through this, and have any advice or recommendations? Thanks in advance. 

(Note: we came from US, and are both US citizens, but I am using my UK citizenship/passport obtained through my British parents, even though I've never lived in UK, to make the residency process easier. Hence, the authority expected me to have an English health card (S1?) which of course I don't have. She looked at the Cigna cover letter and cards and while it is not an issue for my wife, it is for me. Complicated...)


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## NickZ (Jun 26, 2009)

spepper222 said:


> (Note: we came from US, and are both US citizens, but I am using my UK citizenship/passport obtained through my British parents, even though I've never lived in UK, to make the residency process easier. Hence, the authority expected me to have an English health card (S1?) which of course I don't have. She looked at the Cigna cover letter and cards and while it is not an issue for my wife, it is for me. Complicated...)


Are you saying they accepted it for your wife? If so that sounds like some sort of miscommunication. It's either good enough for both or for neither.


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## spepper222 (Apr 18, 2019)

Thanks for the reply Nick. She either didn't care what health insurance my wife was covered by, or she assumed that whatever I purchased to cover my problem would cover her too. I was surprised that -- even though we're married -- she was being treated as an American and I was being treated as an EU National. Different requirements apply to each of us, e.g. she needs the Permesso and I do not, and that may be the simple explanation. Regardless, I'm most interested in finding a reputable Italian Health Insurance company that comes with expat recommendations...if you or others have had to purchase it. Thanks again! (Scott)


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## NickZ (Jun 26, 2009)

She is only an American until the point you get residence. At that point she becomes the spouse of an EU national resident.

Sorry no idea on insurance. 

assicurazione sanitaria residenza

Google that. Pick the cheapest and when you have residence register with the national health service. I know there are a few Americans occasionally reading here. Hopefully one will pop in.


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## spepper222 (Apr 18, 2019)

Interesting! Thanks again for the tips. Funny thing is, my wife's nonni were immigrants to US from Vieste (Puglia) back in the 30's, so she's got an attorney on the case and will probably be an Italian citizen within the year, instead of an "ex-American wife of EU National"


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## rsetzer99 (Feb 20, 2014)

The Italian Communes are consistently confused when Brits seek to interact with the health care system. You would only have an S1 if you are of UK retirement age. If such is the case, it is likely that you have presented them with a situation where they expected a specific set of documents and you have them confused now. Are you both seeking to reacquire citizenship, or just your wife? You come from the US, but your post does not indicate if you are here on an Elective Residence Visa or going through another process. The Cigna insurance, if it specifically says it is valid for coverage in Italy and covers you both, there should be no reason it should not be accepted. The guess is that presenting a British Passport has directed them into a - but you need a totally different set of documents as an EU citizen - situation.


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## spepper222 (Apr 18, 2019)

No doubt here that you have surmised the situation correctly; confusion. There really is no reason that the Cigna policy shouldn't be viewed as adequate. Yet I'm left with little choice other than (a) switch to a local insurance policy that's probably far cheaper anyway, or (b) hire a lawyer to "fight the anagrafe". To answer your question, no I'm not actively seeking citizenship, and my wife's request rests on a gray-area legal point which must be heard in court, so there is no using that information in the current, time-limited situation. Even though I've come from US, I'm using my British passport and identifying as a Brit, so to speak, only to ease the residency process; specifically, I don't need a visa as an EU National, and neither does she as the spouse of an EU Nat'l. (At least not until Brexit actually happens.) This is why I'm focused on finding a recommended Italian health insurance company...if possible.


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## KenzoXIV (Nov 13, 2013)

spepper222 said:


> No doubt here that you have surmised the situation correctly; confusion. There really is no reason that the Cigna policy shouldn't be viewed as adequate. Yet I'm left with little choice other than (a) switch to a local insurance policy that's probably far cheaper anyway, or (b) hire a lawyer to "fight the anagrafe". To answer your question, no I'm not actively seeking citizenship, and my wife's request rests on a gray-area legal point which must be heard in court, so there is no using that information in the current, time-limited situation. Even though I've come from US, I'm using my British passport and identifying as a Brit, so to speak, only to ease the residency process; specifically, I don't need a visa as an EU National, and neither does she as the spouse of an EU Nat'l. (At least not until Brexit actually happens.) This is why I'm focused on finding a recommended Italian health insurance company...if possible.


In my time of Italy I find that hiring a lawyer is not really required, the threat that you will tends to be enough to get people off their behinds and make the calls they need to to get the correct info...


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## Troz (Jan 29, 2018)

Friends of ours in Italy are in a similar situation to you: he is British (albeit resident in Australia not UK) and she is Australian. So he couldn't produce the EU form, and had to take out medical insurance before he could apply for residency. However, he has never renewed it and has never been asked to show any evidence of it when getting medical treatment!

She, on the other hand, as an Australian spouse of an EU citizen with residency, could get a permesso di soggiorno on that basis, and what is more could get a health card from the regional government on the basis of an intergovernmental agreement on health care between Australia and Italy. Once your wife gets citizenship she will be OK anyway.

It's all a bit baroque but there always seems to be a way through if approached with the right attitude, ie it's their country and they don't owe you anything, so be humble, and if an official tells you something is impossible, then ask what they would suggest you do. It's amazing how many times that works.


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## spepper222 (Apr 18, 2019)

Thanks! Appreciate hearing that.


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