# New dual citizen would like to get a health insurance card



## John and Cecil

Hi, I am a new dual citizen and I just recently arrived in Italy. I was born a USA citizen but I received my Italian citizenship through blood right last summer. I do not plan on establishing residency in Italy though and I would prefer to move to another EU country, possibly Portugal, at least until I can collect social security and possibly qualify for Italy's pensioner income tax break. 

I believe as an Italian citizen I qualify for national health care in Italy and possibly in other EU countries as well. Is it possible for someone in my position to get a health care card in Italy to bring with me to Portugal when I travel/move there in a couple of months? If so how would I go about obtaining my health care card? 

Thanks!


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## Italia-Mx

You must have residency in Italy to get a health care card. If you move to another EU country, you can get on the health plan in that country once you establish residency.


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## John and Cecil

Italia-Mx said:


> You must have residency in Italy to get a health care card. If you move to another EU country, you can get on the health plan in that country once you establish residency.


Thank you. That makes it much easier


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## NickZ

The S1 health card I think only applies to EU pensions. I'm not sure you'd get one with social security. You can obviously get an Italian health card but the S1 you should check the requirements. If you can't get one you'd need to ask how to gain access in Portugal.


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## John and Cecil

NickZ said:


> The S1 health card I think only applies to EU pensions. I'm not sure you'd get one with social security. You can obviously get an Italian health card but the S1 you should check the requirements. If you can't get one you'd need to ask how to gain access in Portugal.


Yes no EU pension and no social security either. I cannot collect social security for another 10 years. I guess I should ask this question in the Portugal expat forum. Thank you.


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## John and Cecil

I have been looking for information online and what I found so far seems to imply that I have to go to the local ASL office here in Italy and apply for an EHIC health card here, and then that card can be used when I travel to other EU countries. Then after I apply for residency in another country I assume I would then try to apply for health insurance in the new country of residence. I think I need to get the health card first though since I believe the residency application in Portugal requires proof of insurance.


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## NickZ

EHIC is mostly intended for tourists. So a week here. A month there. Okay you're fine for emergency care.

It's not intended for moving. That's usually covered by the S1 which I don't think you qualify for.


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## John and Cecil

It would be several to many months. I may not even be able to get to the area where I want to live until July at the earliest, so we may be spending up to 90 days at a time in Spain, France, Portugal, etc until applying for a residency permit. Perhaps I would have to purchase insurance to apply for residency though, but that does not seem right as I though EU rules allowed health ins transfer for Italian citizens with present health care coverage. 

I only need health insurance for emergencies anyway, I despise big pharma and I would rather die than use their chemicals. I won't even take aspirin or pain relievers, I prefer holistic/natural medicine. In the USA over 20% of the population is on antidepressants and all the municipal water supplies are now tainted with pharmaceuticals. I used to work at an engineering firm that sometimes went into their production plants and you should see the chemical byproducts that they dump into the environment, it is horrible.


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## Italia-Mx

You won't be able to get any service from an ASL in Italy if you do not have legal residence in the commune. In fact, it's the commune that gives you permission to go to ASL once you have obtained residence. If you want proof of insurance to use to obtain health care benefits in another EU country, you will have to LIVE legally in Italy first. If not you will have to use proof of insurance from the USA or a private plan that you pay for out of pocket.


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## Italia-Mx

Italian citizens who do not live legally in Italy cannot use the ASL. They CAN use emergency facilities just like any other tourist but that also means that if you need an ambulance, for example, you will have to pay for the ambulance and any other emergency service out of pocket. It will not matter that you have an Italian passport if you are not legally resident. At this point, for your needs, your Italian passport is giving you the right to live in any EU country and that's it.


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## Bevdeforges

You normally can't get an EHIC card unless you are already registered with the national health service - and for that you normally need to prove residence in the country.

But check what the requirements are for health cover in Portugal. Several EU countries have rules where you only need to be able to show 3 to 6 months of residence to qualify for the local health service. (Though it's not free - you normally have to be working or filing taxes in the country.) Until that point, you will probably need to have private insurance cover roughly equivalent to the national cover. It may depend on what you're doing in the country what rules apply.


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## John and Cecil

Thank you everyone, I appreciate all your help! I am curious about your definition of legally in Italy. I am living in Italy, I am here right now renting an apt. My landlord has reported my presence to the authorities for me as I rent month to month. I am not here illegally. I am just not remaining in Italy, I will only be residing here for a few months and then leaving. I would have leases as proof, but I am not working here or paying tax here nor will I be establishing a tax residency here. I am retired, I am buying a small farm in the future and I am going to be self sustaining. I will not be able to collect US social security for another 10 years.

I am not yet registered with the NHS. My citizenship was only recognized about a year ago. From what I read registration in Italy occurs at birth or something, but I missed that by a long shot. I would have thought registration into the NHS is permitted after citizenship approval (for new birth right citizens)if it is indeed granted to all Italians at birth.

It would be nice to know if I must be a "tax resident" or "primary resident" or perhaps just that I must stay here in Italy for a certain amount of time to qualify for insurance. Perhaps there is a website out there that has the requirements listed. I am an Italian citizen with a passport and my citizenship was recognized about a year ago.

I am more concerned about the residency requirement when moving than for what they will pay for. I do not really plan on using it unless an emergency, so I would really only need coverage for emergency surgery, etc.


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## NickZ

Remember the health service these days is regionally run. That means to register you need to be resident in one of the regions. Residence for a citizen is fairly simple. Show up at your local office with your rental contract. ID. And that's about that. You'll then need to get the form to take to the ASL office. There you'll need to pick a doctor. 

https://www.comune.roma.it/resources/cms/documents/cae347415ebb244c525f690dd8ed5779.pdf

That's the form from Rome but it's standard. Smaller towns might fill it out for you larger ones you need to show up with the form filled out. If you don't have a car or drivers license you've got less than twenty lines to fill out.


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## Italia-Mx

If you are in Italy for more than three months you must register your presence with the commune. At that point, you will be given permission to obtain a health card. Everyone in Italy has to be accounted for after 90 days in the country. If not, after 90 days you must leave. It doesn't matter that you have an Italian passport.


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## GeordieBorn

I think you will find your view of EU health cover is likely out of date by around 4 years. The EU did have better health cover for its EU citizens, but they changed everything in or around 2016 because there were too many “health tourists”. It sounds like from what you have said that Portugal is the same as Italy whereby they will want private cover for those not working, but still under retirement age. I’m sure being an Italian citizen now will be of help in Italy in many ways, but it will likely also have its negative side! It will not help you in Portugal apart from being an EU citizen and having the right to stay as such. A bit like me as an EU member (for now) coming from the UK, I can go to Italy, but should apply for residency there if staying more than 3 month. So you need to look at the EU rules for Portugal as to what they require.


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## John and Cecil

Thanks, I will see what I have to do when I have been here for 3 months. I probably won't be staying too much longer than that though. The landlord informed me that he registered me with the commune though and that I did not need to do anything else, he seemed to know what he was doing and he is fluent in Italian and English. I will try bringing my rental agreement and passport to the local asl office and see what they say (if I can understand them as my Italian is beginner at best). I am a little better with my "Silent Bob" gesturing than with Italian.  If I have a problem then I will go to the commune and see what I need from them. I do not have a drivers license here but I have one from back in the US, but I am waiting until I become a resident of Portugal to transfer it or get a new license. For now I am riding a bicycle 

What a headache though. First my banks in the USA want to drop me because I am overseas, the post office in the US has no idea how to forward mail to a mailbox and keep forgetting to put the actual mailbox number on the forwarding label. My dog's microchip has an issue and he had to get a new one and a new toxic rabies shot 2 years too early so he could get a passport. I cannot fly with him and carrying a bike, a suitcase, and a dog on multiple trains/ferries to get around is crazy difficult and complex. Yikes!


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## John and Cecil

GeordieBorn said:


> I think you will find your view of EU health cover is likely out of date by around 4 years. The EU did have better health cover for its EU citizens, but they changed everything in or around 2016 because there were too many “health tourists”. It sounds like from what you have said that Portugal is the same as Italy whereby they will want private cover for those not working, but still under retirement age. I’m sure being an Italian citizen now will be of help in Italy in many ways, but it will likely also have its negative side! It will not help you in Portugal apart from being an EU citizen and having the right to stay as such. A bit like me as an EU member (for now) coming from the UK, I can go to Italy, but should apply for residency there if staying more than 3 month. So you need to look at the EU rules for Portugal as to what they require.


You are so right. I did all of my research about 4 years ago. It took me that long to get all my ancestors documents, then wait for a consulate appointment, then wait for my citizenship approval, then sell my house and liquidate/donate all of my possessions, and then finally to arrive in Europe. 

Hopefully I can find inexpensive insurance that satisfies Portugal but only covers me for large emergency events. I do not care about doctor visits, medications, ambulances, etc. I really only care about major surgery.


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## LoreVila

John and Cecil said:


> Thanks, I will see what I have to do when I have been here for 3 months. I probably won't be staying too much longer than that though. The landlord informed me that he registered me with the commune though and that I did not need to do anything else, he seemed to know what he was doing and he is fluent in Italian and English. I will try bringing my rental agreement and passport to the local asl office and see what they say (if I can understand them as my Italian is beginner at best). I am a little better with my "Silent Bob" gesturing than with Italian.  If I have a problem then I will go to the commune and see what I need from them. I do not have a drivers license here but I have one from back in the US, but I am waiting until I become a resident of Portugal to transfer it or get a new license. For now I am riding a bicycle
> 
> What a headache though. First my banks in the USA want to drop me because I am overseas, the post office in the US has no idea how to forward mail to a mailbox and keep forgetting to put the actual mailbox number on the forwarding label. My dog's microchip has an issue and he had to get a new one and a new toxic rabies shot 2 years too early so he could get a passport. I cannot fly with him and carrying a bike, a suitcase, and a dog on multiple trains/ferries to get around is crazy difficult and complex. Yikes!


Hello John. I just finished reading all of your posts. I see that you seemingly got established in Portugal. I hope everything is going well for you there. I have a question for you, as I find myself in exactly the same situation as an American newly recognized as an Italian citizen, and wanting to reside in Portugal, at least for the time being. Were you able to solve the health insurance requirement in Portugal based on your Italian citizenship?


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