# self-employment + healthcare in Italy



## jojoboulette

My husband and I are considering relocating to Italy, probably Rome area. We run a business here in the US that is easily transferred anywhere as everything is done online.

My husband is French, I'm American. I will soon have my EU passport, so fortunately, immigration papers and healthcare should not be too difficult.

Our bigger questions right now concern the business. I think we would leave it legally in the US and keep most of our existing US clients. We would pick up any EU clients we could, but I know things are tough all over Europe right now, so we'd rely primarily on our US clients, at least to start, and most likely long-term. Doesn't matter to them where we are, fortunately, as long as we can continue to provide our services which we would be able to do.

Our questions are:
- tax laws: where to find reliable information on the tax laws regarding this situation? I am sure there are experts in BOTH US and Italian tax laws out there; just not sure where to find them.
- input from people who've done this: anyone out there done something similar? If so, how did it/has it gone for you?

I am also wondering about healthcare:
- since we'd have EU papers, I'm assuming we'd have easier access to Italian healthcare - is this correct?
- how do you find a good doctor in Italy?
- do you need additional coverage if you're in the EU system, or is the basic coverage enough?

Thanks for your input, much appreciated!


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## Bevdeforges

OK, I'm no expert on Italian law, but you may be operating under a couple of false assumptions here.

Having an EU passport is no sure entrance into the Italian health care system. Normally, you need to have a document from your home country showing that you have been covered by that health care system for a period of time (i.e. have been making contributions toward the social insurances). Since you've been operating in the US, you don't have that.

You may want to have your husband check this site ameli.fr - La carte européenne d’Assurance Maladie which is the French information on getting the new European Health Insurance Card - basically what you need to get into the Italian system before you start making whatever contributions there are for the Italian system.

As far as your business is concerned, if you're resident in Italy, you're probably going to have to set up at least an Italian branch of your business to properly handle taxes and social insurances on the Italian side of things. 

There is no EU health care system. It's a matter of reciprocity between the various national systems, so your first step is getting enrolled in the Italian health care system. (Unless your husband can somehow qualify for one of those EHIC things based on prior working experience in France. It's certainly worth an inquiry.)
Cheers,
Bev


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## jojoboulette

*maybe, maybenot*

My husband worked in France for 10 years before moving here. So he did pay into that system. He's been here with me for about 8 years now, so there was a period of time in which he did not contribute. 

Thanks for the link, I'll check it out.


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## NickZ

If you're currently outside of the EU it's unlikely you could get an EHIC from France.

OTOH you can get into the Italian system. You'll just have to pay the fee. I don't remember the rate but it's supposed to be a percentage of worldwide income.

On the tax issue you would be best served by looking for an international tax lawyer. They aren't cheap but the average cowboy will just waste time. Remember if you're American you need to file and pay US taxes no matter resident. If you're Italian tax resident [which you might not be] then you need to pay Italian taxes. Your business if incorporated is considered a human being and has it's own residence. Then you have the various tax treaties. While it's not overly complicated setting things up right the first time is important to avoid long hassles.

When you register with the Italian health care system you'll be offered a list of local doctors. You pick one to be your primary care doctor. Unless you have a reason to like one of them most just pick the nearest.


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