Healthcare Information Booklet

British Embassy Rome Via XX Settembre 80/A 00187 Rome, Italy

Tel +39 06 4220 0001

gov.uk/livinginitaly

Consult our guide for UK Nationals living in or moving to Italy, which will continuously be updated www.gov.uk/livinginitaly Healthcare Information Booklet You know you can sign up for alerts on our Healthcare in Italy page Healthcare Information for UK nationals living in Italy https://www.gov.uk/guidance/healthcare-in-italy

Visit www.gov.uk/livinginitaly

Healthcare Booklet.indd 1 18/12/20 10:55 HEALTHCARE IN ITALY HOW TO REGISTER A GUIDE FOR UK NATIONALS

EVIDENCE OF HEALTHCARE COVER IS A REQUIREMENT FOR Register at your local health centre (Azienda Sanitaria Locale-ASL) REGISTERING YOUR RESIDENCY IN ITALY. by providing: • your residency document or the receipt1 for your residency ap- In order to register with the Italian national health system ‘Sistema plication Sanitario Nazionale or SSN’ for access to state-funded healthcare • passport you need to meet certain requirements. • tax code (Codice Fiscale- apply for one at your local Tax Office Agenzia delle Entrate) • evidence of your dependants (if you’re registering your family members who are economically dependant on you- a carico in Italian). For example, a translated marriage certificate if registering your spouse or your child’s birth certificate if registering a child. If you register your spouse or your children are over 21 years of age, you might also need to provide evidence that they are economically dependent on you (a carico in Italian). Some offices might accept self-declarations. Other family members may also qualify as your dependants - check with your ASL for more information. • evidence of your entitlement to healthcare which will determine under which health scheme you can register, if any. Most common cases will follow.

1. Some health centres only accept residency documents. In case your residency application receipt is accepted, you might be given temporary cover, which will be extended after presentation of your final residency document. Ask your ASL for more information.

Find out more at gov.uk/livinginitaly Find out more at gov.uk/livinginitaly

Healthcare Booklet.indd 2 18/12/20 10:55 lived and worked in Italy for a year or more, you can continue to WORKER access healthcare for as long as you remain unemployed, by renewing your registration for healthcare every year. This also applies if you register for a professional training course while you are If you are employed: unemployed. Check your entitlement with your local ASL. • work contract and/or last payslip and/or declaration from your employer. You might be asked to provide evidence that the UK does not cover your healthcare. If you are self-employed: Call the Overseas Healthcare Service on +441912181999 and • evidence of registration to Chamber of Commerce or another ask for a ‘legislation letter’. This tells your local health authorities professional order and VAT (aperture Partita IVA) or Social that the UK is not competent for you healthcare. Security institute registration (apertura posizione INPS). When you renew your registration after the first year, you will need to provide evidence of having paid Social Security contributions (contributi INPS). PERMANENT RESIDENCY STATUS

If you’re working or self-employed in Italy, you’re entitled to state If you have permanent residency status (evidenced by Attestazione healthcare through your social security contributions, on the same 2 di Soggiorno Permanente issued by your Comune after living legally basis as an Italian citizen. This is called Iscrizione Obbligatoria . You in Italy for 5 years), you are entitled to register for healthcare on a can register your dependants at the same time. You will be entitled to permanent basis i.e. a health card with no expiry date. Depending on register with a GP and to an Italian European Health Insurance Card the region where you live, this might apply only if you have been (TEAM). registered under Iscrizione Obbligatoria for the previous 5 years3. If you become unemployed after you have lived and worked in Italy Ask your ASL for more information. for less than a year, and you register on the unemployment list (liste di collocamento), you and your dependants will continue to have the right to access healthcare for a period of up to 12 months. If you have

2. The list of documents required by your ASL is available at 3. According to information currently available, Tuscany this link: https://www.gazzettaufficiale.it/do/atto/serie_ge- and Veneto regions have implemented this requirement. nerale/caricaPdf?cdimg=13A0091800100010110005&- dgu=2013-02-07&art.dataPubblicazioneGazzet- ta=2013-02-07&art.codiceRedazionale=13A00918&art. num=1&art.tiposerie=SG. Please note that requirements might change according to where you live. Find out more at gov.uk/livinginitaly Find out more at gov.uk/livinginitaly

Healthcare Booklet.indd 3 18/12/20 10:55 8. Citizens’ Rights 9. Citizens’ Rights TEAM stands for Tessera Europea Assicurazione Malattia and is the ment. Italian equivalent of a UK EHIC. A European Health Insurance Card Apply for your S1 form by calling the Overseas Healthcare Team in (EHIC) gives you the right to access state-provided healthcare to the UK: +44 (0)191 218 1999. cover necessary care during a temporary stay in another EU country, Norway, Iceland, Liechtenstein or Switzerland. When you get your S1 form, you must register it with your local You will be entitled to an Italian TEAM if you register for healthcare health office in Italy (ASL). This will mean you and your dependants in Italy under the Iscrizione Obbligatoria scheme. A TEAM is issued will be entitled to state healthcare on the same basis as an Italian automatically to you after registering for healthcare with your local citizen. After you register, you will be entitled to register with a GP health office (ASL) and it’s normally sent to your address. Once re- and you will receive an Italian health card for use in Italy. You will still gistered, your ASL will issue a health card showing your Fiscal Code qualify for a UK EHIC (not for an Italian one), to use when travelling and personal details. The back of your health card will also show the across the EU. You can now apply for a new EHIC that will continue details of your TEAM, if you are eligible to one. to be valid after 1 January 2021. Apply for your new card at nhs.uk/ ehic.

S1 FORM HOLDERS If you are a UK national who is yet to reach state pension age, you will have the right to apply for a UK S1 once you start drawing your • You are entitled to an UK S1 form if you claim an exportable UK UK state pension, provided you can demonstrate you have lived state pension or another qualifying UK benefit, or you are a de- in Italy by the end of the transition period and remain living in that pendant of someone who does. country. At this point you would also be entitled to a UK-issued EHIC valid for travel across the EU. If you are an existing S1 holder, in receipt of a UK State Pension or a qualifying exportable benefit, residing in Italy before 31 December • You can also apply for an S1 if you are a frontier worker. 2020, your healthcare arrangements will not change and the UK will continue to fund your healthcare for as long as you are residing in A Frontier worker is someone resident in the EU and working in the Italy and remain covered under the terms of the Withdrawal Agree- UK, returning to the EU at least weekly. If you are a Frontier Worker before 31 December 2020 your rights to

Find out more at gov.uk/livinginitaly Find out more at gov.uk/livinginitaly

Healthcare Booklet.indd 4 18/12/20 10:55 10. Citizens’ Rights 11. Citizens’ Rights access healthcare through your UK S1 will be protected for as long as you continue to be a frontier worker in Italy. You will still qualify for VOLUNTARY REGISTRATION a UK EHIC. You can now apply for a new EHIC that will continue to be valid after 1 January 2021. Apply for your new card at nhs.uk/ehic. Evidence of voluntary contribution payment.

• If you are a posted worker You may be able to register with the SSN with the Iscrizione V olontaria by paying an annual fee, if you don’t qualify under other You can also apply for an S1 if you are a Posted Worker. entitlements. This depends on the region of Italy you live in4. A posted worker is someone who is employed in the UK, but tempo- The fee covers one calendar year, from 1 January to 31 December5, rarily sent to another European Economic Area (EEA) country. and each annual payment will also cover family dependants. Your Currently, posted workers use an EHIC or an S1 form (depending on ASL will tell you how much and how to pay, on the basis of previous their circumstances) to access Italian healthcare. year’s income, with a minimum fee of € 387,34 up to € 2.788,86. HMRC has a helpline for National Insurance enquiries from non-UK Show your payment receipt as evidence of healthcare cover when residents. They can answer questions about posted worker status registering your residency6. You can then complete your healthcare and explain which UK issued documents you will need to get heal- registration with your ASL. You will be entitled to register with a GP thcare while posted. and you will receive an Italian health card for use in Italy. You will not be entitled to an Italian EHIC (TEAM). In some regions you can also https://www.gov.uk/government/organisations/hm-revenue-cu- apply for co-payments exemption (esenzioni ticket) if you meet the stoms/contact/national-insurance-enquiries-for-non-uk-residents requirements. Ask your ASL for more information.

UK posted workers in the EU are encouraged to think about their circumstances and consider the steps they need to take to be assured of continuing healthcare coverage. The Government has produced detailed advice for each country. Go to www.gov.uk/uk-nationals-living-eu.

4.According to information currently available, EU nationals in Umbria region are not able to register under the Voluntary scheme. 5.You will be required to pay the same annual fee, even if not registering for a full year e.g. if you register in June or November, you will pay the same amount. Your registration will expire in December of the same year and you will be able to renew it in January of the following year. 6.Payment receipt of voluntary contribution should be sufficient evidence of healthcare cover when registering your residency but this might depend on where you live. Ask your Town Hall for more information. Find out more at gov.uk/livinginitaly Find out more at gov.uk/livinginitaly

Healthcare Booklet.indd 5 18/12/20 10:55 12. Citizens’ Rights 13. Citizens’ Rights As a student you can register with Iscrizione Volontaria by paying an annual fee of € 149.77. RETURNING OR VISITING THE UK

If you are a UK student, habitually resident in the UK, staying in Italy • People currently living in the EU by the end of the Transition for the purposes of studies and starting a course before 31 Decem- Period whose healthcare costs are funded by the UK under the ber 2020, you will be eligible for a new EHIC covering immediate current EU arrangements (eg who hold a valid UK-issued S1 that and necessary healthcare for the duration of your course. Visit NHS. has been registered in the Member State) will be entitled to free uk/EHIC. From 1 January 2021, your student EHIC will only be valid in NHS hospital treatment in England, should they return tempora- Italy. Make sure you also have travel insurance to cover the duration rily to the UK. of your course and for travel outside of Italy. Your UK EHIC is not evidence of healthcare cover when registering your residency in Italy. Different arrangements apply in Scotland, Wales and Northern As an au-pair you can also register by paying a fee of € 219,49. Ireland. For more information, visit the websites for health services These special fees do not cover family members. in each country before travelling: • Wales The application process and requirements may differ in each region. • Scotland Please consult your local regional authority’s website. You can find • Northern Ireland a list of the regional authorities on the websites of the Ministry of Health. • If you live in Italy and you are entitled to an Italian European • Health Insurance Card (TEAM- Tessera Europea Assicurazione If you don’t qualify to register for access to state-funded healthcare, Malattia), you will keep your entitlement to use this for needs when applying for residency you’ll need to have evidence of some • arising treatment when visiting the UK or when travelling across form of private health insurance’ and take out private health insuran- the EU both before and after the transition period. These rights ce. Your policy will need to be valid across Italy for at least one year will apply for as long as you remain resident in Italy. and cover all eventualities for you and your family members. Ask your Comune for more information. • UK nationals living in the EU will be eligible for NHS care without charge if they return to settle in the UK and are ordinarily resident.

Find out more at gov.uk/livinginitaly Find out more at gov.uk/livinginitaly

Healthcare Booklet.indd 6 18/12/20 10:55