8771 EHIC card: NHS guides to use in Italy

A few misconceptions about the European Health Insurance Card have been posted over the years. Having looked at the links below over the weekend, I thought I'd post them in case anyone might find them useful. Together with additional links within those posted, they provide a fairly comprehensive guide: URL The EHIC: free or reduced cost treatment : Department of Health - Health care[/url] Italy : Department of Health - Health care[/url] The two main misconceptions I was thinking about are 1. 'The EHIC card only covers emergency treatment'. It doesn't, as it also covers chronic and pre-existing conditions unless the main reason for your trip is to get medical treatment (though I wouldn't want to test this out for surgery except in an emergency!) 2. 'The EHIC card covers you if you are moving to Italy to live'. It doesn't, at least not officially (except in a few tightly defined and time-limited circumstances such as while being paid by a UK employer who is making NI contributions for you, or while studying as part of a UK course).

Category
Health & Safety

[quote=bosco;82384]..........'The EHIC card only covers emergency treatment'. It doesn't, as it also covers chronic and pre-existing conditions unless the main reason for your trip is to get medical treatment (though I wouldn't want to test this out for surgery except in an emergency!).......[/quote]

My sister required emergency help last year when she was in Italy & whilst there was never going to be any barrier to treatment, they guys at the local hospital simply swiped her card & bingo, everything was sorted. There were no further questions......It seemed a stunningly simple process.

my tessera sanitaria expired november 07. i cant get it renewed even though i have permanent residency. i live full time in umbria in italy. what are other people in the same situation doing about this?

[quote=villa corgna;83210]my tessera sanitaria expired november 07. i cant get it renewed even though i have permanent residency. i live full time in umbria in italy. what are other people in the same situation doing about this?[/quote]

The new Italian Ministry of Health regulations are posted as PDFs in English and Italian on the British Consulate in Rome website here...
[url=http://www.britishembassy.gov.uk/servlet/Front?pagename=OpenMarket/Xcelerate/ShowPage&c=Page&cid=1152525284045]Italian health system British Embassy, Italy[/url]

Although these regulations are now posted as if they are "Residency requirements" for new applications for residency, they are also being applied retrospectively to some people who already have residency but have been resident for less than five years.

If you comply with the regulations, try showing them to the ASL. If you comply but haven't yet got the evidence. e.g. to show you've been resident five years, are employed or self-employed, or an EC form to show that you or someone in your household is of state retirement age in another EC country, get hold of that evidence.

If you've been resident less than five years and aren't entitled to health cover under these regulations, I suggest you post again starting a new thread called 'Tessera sanitaria - renewal refused'. There may be someone else out there who could help but who wouldn't bother to look at a thread on the EHIC. Otherwise, you'd need comprehensive private medical insurance until you've been resident five years or until you qualify in another way.

France has now officially backed down on applying similar regulations retrospectively to people who already have residence, it is rumoured because of threats of private legal action and because of informal intergovernmental discussions. Maybe someone on this site knows about similar pressures in Italy?

I am not aware of any movement from the Italian government to relax the new residence rules relating to healthcare, but am very tempted, given developments in France and the number of misapplications of the new law in Italy that I have come across (quite a few posted in recent months), to mount some form of challenge.

Villa Corgna: if you have permanent residency you are entitled to state healthcare in Italy. Follow the link provided by Bosco below.

Para B) 4. Permanent residence certificate after at least 5 years residence in Italy. "An EU national who lived on the national territory legally and on an uninterrupted basis, except for short periods in accordance with the relevant legislation, acquires a right of permanent registration with the NHS."

There is some confusion over what evidence should be presented to the Anagrafe to prove 5 years [U]continuous and legal stay[/U]. It is not enough to simply show 5 years continuous registration at the Anagrafe - in this case you may also need to show during the 5 years you were working or self-employed. However, if you have a permesso di soggiorno was granted over 5 years ago and is still valid, this will entitle you immediately to a certificate of permanent residence. If your permesso has expired, you will need to fulfil the new conditions on residence as above. See the most recent circular of Ministero dell'Interno of 18th July 2007, para 10), link here:

[url]http://www.cinformi.it/comunitari/0817_2007_07_18_circolare_Ministro_su_libera_circolazione_cittadini_UE.pdf[/url]

Charlotte

[quote=CMJ Oliver, Solicitor;83260] in this case you may also need to show during the 5 years you were working or self-employed.[/quote]
But what if you have been "early retired" in receipt of a private pension for this time? Would payslips from the Pension Fund suffice. After 5 years my husband will be in receipt of UK State Pension, but I will not.

This is a controversial result of the new residency rules: people who retire early to Italy but below state retirement age in their own country, when applying for residence in Italy, are now required to show they have funds to support themselves and evidence of private health insurance (for at least one year).

There is no automatic right to register with the state health service in any EU member state. You must be working or self-employed or be entitled to one of the E forms..(please see my previous post on this).

The greatest anomaly is for people who have been here for some years, and have previously been registered with the ASL in Italy, who have now lost their right to renew their tessera. This is the situation Bosco to refers in France where the government has now backed down. Isn't it surely time for Italy to follow ...?

Charlotte

[quote=CMJ Oliver, Solicitor;83287]This is a controversial result of the new residency rules: people who retire early to Italy but below state retirement age in their own country, when applying for residence in Italy, are now required to show they have funds to support themselves and evidence of private health insurance (for at least one year).

There is no automatic right to register with the state health service in any EU member state. You must be working or self-employed or be entitled to one of the E forms..(please see my previous post on this).

The greatest anomaly is for people who have been here for some years, and have previously been registered with the ASL in Italy, who have now lost their right to renew their tessera. This is the situation Bosco to refers in France where the government has now backed down. Isn't it surely time for Italy to follow ...?

Charlotte[/quote]

So how did I get a Libretta Sanitario without private health insurance - not that I want to rock the boat?

[quote=MargaretM;83276] After 5 years my husband will be in receipt of UK State Pension, but I will not.[/quote]

Once your husband is in receipt of a UK state pension and therefore qualifies for an E121, you are also qualified for your own separate E121 if you live with him and are dependent upon him (the same applies in reverse if a wife becomes eligible for a UK state pension before her husband). How tightly the notion of dependence is defined I do not know - maybe the very knowledgeable Charlotte Oliver has some knowledge of this?

You presumably gained your Libretto Sanitario because you applied before these new rules were fully implemented last year.

On a more general point, I now note that UK Department of Health website says that the French decision was reversed "Following representations made to the French government" ([url=http://www.dh.gov.uk/en/Healthcare/Healthadvicefortravellers/DH_081416]French government's new decision on access to the French healthcare system for inactive citizens from other EU countries : Department of Health - Health care[/url]). It would be interesting to know by whom these "'representations" were made, and whether any similar representations have been made to the Italian government. And if not, why not!

[quote=bosco;83315]
You presumably gained your Libretto Sanitario because you applied before these new rules were fully implemented last year.[/quote]
Nope, started applying for Residency in July of last year, only gained Libretto Sanitario 3 weeks ago.

I live with my Italian wife, who is resident in Italy, but I am not (yet) resident. She is entitled to treatment on the Italian NHS. Am I also, just by virtue of marriage?

If you're resident you should. If not at worst you should get emergency care etc.

[quote=gradese;83336]I live with my Italian wife, who is resident in Italy, but I am not (yet) resident. She is entitled to treatment on the Italian NHS. Am I also, just by virtue of marriage?[/quote]

You're entitled...

The relevant Italian Ministry of Health Circular states

[I]" An EU national staying in the national territory for a period
exceeding three months shall have to register with the National
Health Service if he/she:-......

3. is a family member of an Italian national;"[/I]

and
[I]
"Family member of an Italian national;

For the definition of family member as per paragraphs 2 and 3,
please refer to Interior Ministry Circular No 19 of 6th April 2007
which provided for the implementation of Directive No 38/2004.
On that basis, family members include:-

1. the spouse;" [/I]

(see the PDF links at [url=http://www.britishembassy.gov.uk/servlet/Front?pagename=OpenMarket/Xcelerate/ShowPage&c=Page&cid=1152525284045]Italian health system British Embassy, Italy[/url])

[quote=bosco;83315]Once your husband is in receipt of a UK state pension and therefore qualifies for an E121, you are also qualified for your own separate E121 if you live with him and are dependent upon him (the same applies in reverse if a wife becomes eligible for a UK state pension before her husband). How tightly the notion of dependence is defined I do not know - maybe the very knowledgeable Charlotte Oliver has some knowledge of this?

You presumably gained your Libretto Sanitario because you applied before these new rules were fully implemented last year.

On a more general point, I now note that UK Department of Health website says that the French decision was reversed "Following representations made to the French government" ([URL="http://www.dh.gov.uk/en/Healthcare/Healthadvicefortravellers/DH_081416"]French government's new decision on access to the French healthcare system for inactive citizens from other EU countries : Department of Health - Health care[/URL]). It would be interesting to know by whom these "'representations" were made, and whether any similar representations have been made to the Italian government. And if not, why not![/quote]

On this very point, supported by my local ASL, I have just written to the Minister of Health in Rome to enquire why it is that (in the 2 years leading up to me gaining permanent residency here - I've only been resident here for 3) he feels able to enjoy some of the benefits of the IRPEF I pay on my private UK ex-work pension, without feeling the need to offer me care should I need it under the national health system.

Should i receive a response i will update the forum.

Chris
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