# Buying into Italian Health Care System?



## byresch

My wife and I are moving to Castel Volturno in February 2018, we already have long term lease on a villa and are going to the consulate in Miami to get our visas. I am 67 and she is 61 will we have any problems buying into the system? We are both US citizens.


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## NickZ

Register for Residence. Then go to the health office and fill out the paperwork. That's about it


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## cruizes

NickZ said:


> Register for Residence. Then go to the health office and fill out the paperwork. That's about it


We are in the same boat. The websites always say you have to have health insurance to get a residency visa but if I went to the office like you mentioned would I still have to buy expensive insurance prior to arriving Italy or could I get state insurance once I arrive?


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## Claudine M.

We had to buy private insurance to register. Once I got my permesso I had to pay the italian health insurance to get onto their national insurance which cost 380 euros. I was 60 years old at that time. I remain surprised as I am sure you will also become surprised at italian immigration and the paper work and waiting involved.


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## Stephanie&Robert

It's also worth bearing in mind that you can get specialist health insurance for residency applications, which is absolutely minimal and costs around 200 euros a year. I wouldn't rely on it for your health needs, but it gets you through the residency process at least. We had to follow this route.


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## cruizes

Did you have to prepaid the private insurance for a set time like 1year before i am being told that you have to have insurance (private) for the duration of the visa (1year). This is where it gets expensive for me because I a 64 soon to be 65


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## PauloPievese

Stephanie&Robert said:


> It's also worth bearing in mind that you can get specialist health insurance for residency applications, which is absolutely minimal and costs around 200 euros a year. I wouldn't rely on it for your health needs, but it gets you through the residency process at least. We had to follow this route.


:target:
Further details on "specialist health insurance" would be *deeply* appreciated.
:target:


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## PauloPievese

:flypig:

PLEASE Stephanie&Robert, with a flying pig on top?

I keep hearing about these things. Another thread said you could buy it at the airport. I diligent search of the Internet and the Airport has yielded nothing.


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## GeordieBorn

RetireInRome, have a look at this LINK which came via this ASL Rome site. I personnaly have no experience of this, but have read a lot about it on this and other forums. From what I understand ASL is funded regionally and some accept voluntary contributions, but other regions don’t. So you would need to check for the ASL in the region of your choice. From all I’ve read there does not always seem to be a lot of difference between the cost of private health cover and the ASL cost. On the other hand I’ve read of people paying x4 or more for private cover. One more minor point for your first payment. Payment is due in January I believe, so if you join and pay in December you still pay for a full year, then pay again in January!


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## NickZ

All the regions should allow you to buy in. The difference is some are allowing people to buy in at below the correct price.

I can't remember off the top of my head what the minimum fee is but I want to say close to €400. It then goes up with income. But some regions are just accepting the minimum.


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## GeordieBorn

Yes, I would not be surprised if what Nick says is true, but "should" and "will" come into play here. On the question of cost, this LINK may (my Italian is not good enough) confirm the position for at least Rome and I would have thought most are the same or similar.


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## NickZ

Ya that seems like the correct amount. The problem is even if they only ask for the minimum today they might send you a bill years later.


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## PauloPievese

NickZ and GeordieBorn, do you have any comment on Stephanie&Robert 's $200 (or was it 200E?) per year insurance? I've got Medicare in the USA and have too many other balls in the air to deal with this if it can be avoided by a derisory, risible, and nugatory payment.

Arrive in Milan next week. 

On a flying pig: :flypig:


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## GeordieBorn

RetireInRome said:


> NickZ and GeordieBorn, do you have any comment on Stephanie&Robert 's $200 (or was it 200E?) per year insurance? I've got Medicare in the USA and have too many other balls in the air to deal with this if it can be avoided by a derisory, risible, and nugatory payment.
> 
> Arrive in Milan next week.
> 
> On a flying pig: :flypig:


They say "around 200 euros a year", but not when or with who. Regardless, until you know where you are going to be, what comune is involved and what they want (if anything) you will not be able to wrap up healthcare. Hopefully S&R will come up with more detail, but I suspect they are talking vol contributions with cost in the link.


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## PauloPievese

GeordieBorn said:


> They say "around 200 euros a year", but not when or with who. Regardless, until you know where you are going to be, what comune is involved and what they want (if anything) you will not be able to wrap up healthcare. Hopefully S&R will come up with more detail, but I suspect they are talking vol contributions with cost in the link.


I think that we may be talking at cross purposes here, perhaps out of my ignorance.

It appears that your advice is about how to get on the national health insurance plan. My understanding is that to get that you have to be a resident (in possession of a Permesso di Soggiorno, PdS). It is also my understanding that to get a PdS you have to have health insurance. So it is this prior-to-national-health-insurance insurance that I'm seeking information about.

Any of the above may or may not be correct said the :flypig:


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## Italia-Mx

I think there is something you are mis-understanding. If having healthcare in the USA was NOT a requirement for you to obtain your Italian Elective Residency Visa, which is what you must have if you're retired and NOT an Italian citizen, then having healthcare is NOT a requirement for you to obtain residency in Italy when you get here. Once you have residency, you can get on the Italian healthcare system -- for a yearly fee -- because you are a foreigner. 200/euros a year sounds in the ballpark but it could fluctuate depending on where you live. US Medicare is not usable in Italy -- ever -- and you might think about dropping it from your social security payment once you're on the Italian system unless you plan to return often to the US.


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## Italia-Mx

Something else. You should not be confused from postings by British expats. British expats are citizens of the European Union. They do not need a Visa to live in Italy but they must prove they have been making healthcare contributions whenever they relocate anywhere in the European Union. However this does not apply to you because you are not an EU citizen and your healthcare contributions that you made to US Medicare cannot be considered as contributions made into the EU. This is why you need a Visa before you come to Italy, which also waives your healthcare contributions. The only problem you may have is that between the time you leave the US and the time you are on the Italian system, you won't be covered by any health insurance. However, if you do have any unforeseen health problems during this time, you can pay out of pocket because Italian healthcare is affordable. This is just a chance you will have to take as I don't know of any other type of healthcare you can buy in Italy. It's either go with the national system when you're eligible after residency or pay out of pocket. That's it.


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## PauloPievese

Italia-Mx said:


> I think there is something you are mis-understanding. If having healthcare in the USA was NOT a requirement for you to obtain your Italian Elective Residency Visa, which is what you must have if you're retired and NOT an Italian citizen, then having healthcare is NOT a requirement for you to obtain residency in Italy when you get here.


Well, if this is true, it certainly IS something I misunderstood. 

As there appear to be some subjunctive aspects to this assertion let me try to restate it:


> If I have U.S. Medicare (which is unusable in Italy) I do not have to have any other healthcare coverage in order to acquire a Permesso di Soggiorno for residence in Italy.


:flypig: Can anyone confirm the truth of my interpretation of Italia-Mx's statement? :flypig:

I'm all packed for my month-long property tour starting a week from today. :bolt:
(I used the "bolt" icon to end the preceding but, given my physique, another "flying pig" might have been in order.)


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## PauloPievese

Article https://www.expatfocus.com/c/aid=4286/articles/italy/an-expat-guide-to-the-permesso-di-soggiorno/ again states that coverage outside the U.S. is required.


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## Italia-Mx

If you are only coming to Italy for a month long property tour, you cannot apply for residence or get a PDS and you cannot get on the health care system. I'm done now with trying to help you.


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## PauloPievese

:flypig:


Italia-Mx said:


> If you are only coming to Italy for a month long property tour, you cannot apply for residence or get a PDS and you cannot get on the health care system. I'm done now with trying to help you.


 :flypig:

Thanks for the help anyway. One month this go-around. Have business to clear up in the USA. Then return. Cheers!


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## GeordieBorn

Well Paul one down and one to go, hopefully S&R will get back to you with details of how to get healthcare for €200. For the short term vist, this back water Brit would suggest if the USA has such things a simple on off travel insurance. The UK does such, with many of them covering people for more than 60 days, so I'm sure the USA will have the same. Whatever "help" you get here I would confirm by looking for the official line:fingerscrossed:


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## Italia-Mx

Good idea.


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## PauloPievese

GeordieBorn said:


> Well Paul one down and one to go, hopefully S&R will get back to you with details of how to get healthcare for €200. For the short term vist, this back water Brit would suggest if the USA has such things a simple on off travel insurance. The UK does such, with many of them covering people for more than 60 days, so I'm sure the USA will have the same. Whatever "help" you get here I would confirm by looking for the official line:fingerscrossed:


:bounce: I don't think that I ever indicated that I needed health insurance for my "short" one month visit. :bounce: 


I'm just a simple confused old man who had been told that in order to get my PdS as a non-EU citizen, or rather the "national visa" preceding the PdS, I will need to have (a) proof health insurance (b) an Italian address, and (c) lots of money. I hope that this upcoming trip addresses (b). (a) is fraught. (c) is problematic. 

:flypig:


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## Italia-Mx

No way. I think you look young and fit in your photo.


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## PauloPievese

Italia-Mx said:


> No way. I think you look young and fit in your photo.


:flypig: On the Internet you can be any age you want to be. :flypig:


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## Donnezmoi

Fantastic help , thanks so much.


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