9803 Private health insurance (again).

[quote=cathnmike;91635]Sorry about this - I know there have been other threads but they are a year or so old now and I need some up to date information. Of course things may not have changed in those twelve months, but then again this is Italy and things do :eeeek:...

So question number 1 : - do we, or do we not, need private health insurance cover to obtain our Residence? Our solicitor (in Italy) has said we do,so we are taking her at her word. However, to take it out for more than a few months at a time is incredibly expensive (unless someone here knows different) so my next question is :
Number 2 : Is it OK to take out cover for a few months or, say a year, or does it have to be forever?

and finally number 3 : If we do need it, does anyone have any recommendations for us?

Hope this isn't being too repetitive, and thanks for your help.

Cath.[/quote]
Why don't you ask "like the Roman" about the inexpensive health insurance he knows about see: [url]http://www.italymag.co.uk/forums/legal/7196-health-ins-required-residenza.html[/url]

Also here is an interesting article about various methods that Expats are using to get into the French health system [url=http://www.french-property.com/newsletter/2007/12/4/health-cover/]A Strategy for Health Cover in France[/url]
Also some other threads that you should read:

[url]http://www.italymag.co.uk/forums/legal/7310-residency-tale-two-comunes.html[/url]
&
[url]http://www.italymag.co.uk/forums/legal/8024-health-system.html[/url]

I am going to my commune tommorow to enquire about my residency. I will report back as to what happens. This may not be particularly relevant to you as I am self-employed but we will see.

Pip pip

I changed my residency from one comune to another last year and had to go through this whole process again as I had a permesso di soggiorno which now does not exist (sort of!).

I had to either self-certify or prove my income with an accountant's letter if I was working (which I was); the comune polizia visited me and I had to either be contributing to the Italian health system, have private health cover or produce an E106 (which would cover me here for 2 1/2 years). As I left the UK 4 years ago, I had not contributed to NI for the last 3 years in the UK so was not entitled to an E106.

Luckily, because I was working and contributing to everything, I was covered. I mistakenly believed that because I was just transferring my residency that I wouldn't have to go through this rigmarole but I was wrong.

I also have a friend (different comune) who had to go through the same process when their permesso di soggiorno ran out after 5 years of being resident here.

In both cases, the comuni were very insistent and there was no way round it.

Just be warned that it doesn't just affect people taking out their residency for the first time but also those who move house and originally came here on a permesso di soggiorno and also those whose permesso expires and requires renewal! Don't mistakenly think that becuase you have a medical card you are covered. They want proof of your contributions.

Hi there. I have just been through all of this. You have to show that you have health insurance which is valid for one year at least--so it does not necessarily have to be private. They also insist that the policy be in Italian. I ended up taking out private insurance with Generali. it cost 400 euros for one year and the policy was of course already in Italian. (Translation costs for an exisitng policy would have been huge). This option seemed to save the most time and money. If you ask around there are several insurance brokers who design insurance especially for foreigners seeking their residency permit. This was accepted and I am now just awaiting a visit by the vigili. I have attached the latest information as a pdf for you to read. Good luck.

Don't forget you can get at least two and a half years with your E106 this will only leave you with another two and a half to find before you automatically get full status.

It also turns out that there are various species of E106, more later.

I had an interesting chat with my local commune today I will post full details of my experiences when I get a moment.

Those of you who are going to use the E106 should read this about getting maximum time from it.

[url=http://www.completefrance.com/cs/forums/465535/ShowPost.aspx]RE: Advice on Applying for E106 - France Forum[/url]

Pip pip

Thank you to everyone who has taken the time to reply to this. It's all a bit mind-boggling really :veryconfused: and does seem to vary from one Comune to another. We're going to have a look at all the options over the next day or so and we'll keep posting how it's all going.

Thanks again for all the advice.

Okey dokey,

Here goes. I spent about an hour chatting with my friend from the commune office about my application for residency. The reason that we are all getting different stories is that there have been about 8 recent revisions of the rules and some communes are using different versions. The change of governmenrt will bring even more as it has promised to be tougher on E. Europeans. They (the commune workers) are pretty pissed-off themselves about the moving goalposts.

Yes you do need medical insurance or a form from the DWP saying that you are covered.

Yes you do need to have an income of €5000 or more per year. You can self-certify. I just showed them a bank account with €6000 in and they ticked that box.

Yes the Vigilli should come round and check you live where you say you do. I explained that I wasn't always there & my friend said "tell me when you are in and he will come round that day" :winki:

Yes after five years of residency you are fully covered whatever your previous status. If before then you have reached the official retirement age (60 or 65 and rising for UK residents), when you will be able to obtain free State health cover through an E121 form

Health cover: If you are leaving the u.k. permenantly then the E106 (all forms here [url=http://snipurl.com/2kqkk]HM Revenue & Customs: National Insurance Contributions, Retirement Pension Forecasts and advice for those abroad[/url] [www_hmrc_gov_uk] ) will cover you for 2+ years. There is cheap medical insurance available if you want it see this thread [url]http://www.italymag.co.uk/forums/leg...residenza.html[/url]. It doesn't matter how good the policy is it is as it will give you the official tessera sanitaria which will get you treated in the state system.
My friend said that this method should be renewed on a "year by year basis" but you would be able to switch to "asicurazione voluntaria" after you had got your tessera sanitaria issued. I asked if I could go straight for the "asicurazione voluntaria" and they said no because they have not been informed of the latest rates. Also I am a registered farmer (don't ask) so it is different (more complicated) for me.

O.k. with me so far? By now my friend was glazing over so I thought I didn't want to overstay my welcome.

Now what I have discovered from the DWP.

The E106. There are at least two types. The non-workers one & the workers one.

[B]The non-workers one[/B]. This the one that runs out after 2 and a bit years. You get this when you write to the DWP and say you are leaving & don't plan to work anymore. When it runs out you no longer have entitlement to the UK health service either. Yeah right! Have you ever been asked for your N.I. number in hospital? No neither have I :yes:
You get this type of E106 if you have been normally employed and have at least 3 years of class 1 (the usual one) contributions. Explantion here [url=http://snipurl.com/2kqy8]National Insurance contribution types | Business Link[/url] [www_businesslink_gov_uk]

[B]The workers one.[/B] This is for people who plan to live abroad but continue to work in the UK either employed or self employed and pay a class1 or class 2 (self-employed) contribution. This is open ended and issued for 1 to 5 years at a time.

You can also pay voluntary class 3 contributions but these only count towards your State Retirment Pension, so don't bother.

Here is the interesting bit, for me anyway. If you are self employed you pay your contributions by direct debit (or similar). If you apply for a workers E106 (like me) and continue to work in the UK for more than half the year but live in Europe then you will continue to get a workers E106 as long as you pay your contributions (£2.30 p.w. in my case)
This is self declared and there are no checks whether you do work in the UK as long as your contributions are made you will get your E106.
It is very easy to become self employed & start paying class 2 (self-employed) contribution. If you have earnings of less than £4,825 you will be exempt from paying contributions anyway & will probably get them back. I don't know about this as I have never qualiied.

So these appear to be your options.

Get your E106 and then buy some cheap insurance or pay the "asicurazione voluntaria" for the 2-and-a bit years you are left with until you have been resident for 5 years.

Get a workers E106 and pay an NI contribution in the UK.

Get a friend to employ you in Italy for a couple of months then you will be in the system. This should work because the new regulations only apply to those from the EU who remain 'inactive'. Once the cycle of 'inactivity' is broken, and you have undertaken a period of employment, then you are entitled to the same rights as Italian persons, including the right to join the State health insurance system.
[I]You should offer to pay your friends expenses, and invest in a crate of good wine. :laughs:[/I]

Get lucky at your commune!:yes:

That's it. I will let you know how I get on applying for my workers E106 as I go.

Pip pip

[quote=chrisnotton;91722]The change of governmenrt will bring even more as it has promised to be tougher on E. Europeans. [/quote]

The problem is they can't write the rules so they don't hit all EU nationals.

[quote=NickZ;91723]The problem is they can't write the rules so they don't hit all EU nationals.[/quote]

The Security Act currently passing through parliament (Chamber of Deputies) is to deal with [I]illegal[/I] immigrants. That is those people of whatever nationality - [U]including[/U] those from the EU - whose 'paperwork' is either not in order or non existent. If passed (unamended), this law will allow the Italain authorities to return people, who are found without their documentation in order, to thier home country immediately. This could affect anyone... it would/could, for example, affect an American who was here working 'in nero' (no work visa) or a Brit who perhaps did not meet 'residency' requirements despite being a member of the European Union!

Perhaps that's why nearly half the Deputies walked out yesterday, [U]before[/U] the vote, in protest about how this new legislation 'might' be mis-used by certain parties (with a small 'p'....but then again, maybe parties with a big 'P' too!)

I saw the head of the local ASL yesterday - he has had a letter from the ministry saying that assicurazione volontaria for EU residents is NOT possible, as it is designed only for extra communitari. This means that for EU residents to get italian residency, the only way is via a private health insurance policy - though he did add that the EU is aware of the anomaly and are sorting something out... In the meantime as an EU citizen you are entitled to emergency health care, but that of course doesnt help with residency.

Today my wife went to the local Sanitaria office to renew her cover. Despite having renewed to full residency ( after the initial 5 years ) with the original E111 earlier this month, she was told that she now needs the E121 form for health cover. She is of retirement age, but no movement from the official as to what she had to supply.
Called DWP in England and they are sending the form by registered post. Interesting thing is that they said register your husband as a dependant on the E121 and there should be no problems with medical cover.
Worth calling the DWP in England if you have problems getting cover if you are of retirement age.

Just as a test, following on from the previous post. On Monday, wife went to the Sanitaria again......... different receptionist ........ very helpful. Checked her file and said we have the E121 here already, so there is no problem. Previous " jobsworth " could obviously not be bothered to get off her chair to check the details and just made phone calls.
New rules apparently are that you need to renew your certificate every year now for the doctor.

You are right Geotherm, sometimes it is worth going to check twice on what they tell you... If I notice that the receptionist is not cooperative or could not care less I always go back at another time when, hopefully, he/she is not around.... I guess it is human nature, but inefficient people do complicate our daily lives!!!!

Thanks Geotherm but I do believe they make it up as they go along. My husband takes so many pills he rattles and goes to the Doctor every month to renew his presciptions. He has never had to renew anything else, having filled out all the forms about 9 years ago! We are in Umbria where the health service is outstanding.

Have been reading Chrisnotton’s post of 19th June with great interest. I only wish I’d seen it earlier. Having bought an Italian property as Prima Casa I need to hurry up and get my residency before the 18 month period of grace expires & am required to pay back the property tax that was discounted.
I now wonder how Chris has got on and has he gained any further information as I am on the brink of calling the DWP. Fore-warned is fore-armed
I have a few queries and wonder if Chris, or anyone else, is able to answer them.
- My partner & I are both self-employed in the UK, still paying Class 2 NI and deriving income from holiday property rentals. Although this requires us to spend little time in the UK, we both have other strings to our self-employment bows & we can, & do, spend time working in the UK. Have heard/read that for a self-employed persons E106 to be issued there is a requirement that at least 6 months is spent working in the UK. I haven’t a clue if we do or not. Will the DWP ask me to prove it, or just take my word that I do?
- Although my reason for applying for an E106 is just to get residency, which is purely just so I can save myself the difference in property tax between Prima Casa & Secondo Casa, & this needs to be done fairly urgently, I wonder if it would be a good idea if my other half were to make an application at the same time. What are the pro’s & con’s? Of course having access to the state health system here is possibly reason enough itself but the plastic EHICard has served me well so far; 2008 has been an unlucky year for me.
- I have been horrified to hear it said that once the UK has issued you with an E106 you can no longer access NHS treatment. This is exactly what was told by DWP to a young couple we know, although the difference between them & us is that they are not self -employed in the UK and are not paying Class 2 NI contributions. I am hoping that by continuing to pay Class 2, should I desire to re-locate back there, full NHS rights will be mine. Chris says that you never get asked for an NI number by the NHS, but if you were changing GP’s you probably would be.
Pilch

Ciao Pilchard,
I have now received my workers E106. They only issued me with an annually renewable one :no: I am remonstrating withe them about this. It appears that they are reluctant to issue anythin else because of "abuses of the system". I am looking into whether they can be forced to issue me with a longer validity certificate. However I will present this one to the Commune in a couple of weeks.

Concerning proof about working in the U.K. I asked about this and they said that it was not an existing requirement to the issue of the certificate but If the situation were to change then they might request travel records be kept. The 6 months doesn't have to be continious, you can go home at weekends.

I recently changed GP. Nothing was checked. I asked and they said N.I. numbers stay with you for life & are never checked with the DWP. I don't think you will have a problem if your N.I. contributions are kept up as this will automatically keep you "alive" in the system.
My feeling is that as long as your N.I. contributuions roll in then the form will automatically be renewed on request.

Other things:
If one of you is resident in Italy & the other in The UK then the spouse/partner will be covered under the spouse/family rules in the non-resident country. This is what we are doing currently.

You only have to duck & dive for 5 years & then you get full entitlement in Italy anyway.

Will let you know how I get on at the Commune in Sept!

Pip pip

[quote=chrisnotton;91722]

Yeah right! Have you ever been asked for your N.I. number in hospital? No neither have I :yes:

[/quote]

No but you do get asked for your name, address and doctor's details - from these NHS records they will know what your NI & NHS numbers are & hence whether you are covered. SInce 2003 there have been stricter restrictions because of health tourists - treatment is restricted to emergency treatment only or for infectious diseases so if you have an existing condition & come to the Uk to try to get treatment you are likely to be asked to pay upfront.

[url=http://news.bbc.co.uk/1/hi/health/3355751.stm]BBC NEWS | Health | 'Health tourism' rules unveiled[/url]

Chris

chris

interesting ... sort of a related story... earlier this year whilst picking up pellets whilst they were being loaded on our trailer the forklift nudged the door which dropped on my head... i know should have been standing further away or wearing one of those funny helmets... but who does here...

anyway drove home and as i habitually wear a baseball cap it managed to contain the stuff poring out of my head... after a couple of hours when the blood would not stop pouring out... stuck a few rolls of kitchen towel on top...wedged in place with another cap and drove off to Teramo hospital... emergency room people could see it was pretty bloody underneath ht as by now it was leaking out down my face again... so got taken in fairly quickly... doctor took my health card and filled out details and then proceeded to interrogate me suggesting i was from eastern Europe and working here illegally and that it had been a work related accident....hence my delay in rushing straight to hospital...

it took a lot of talking before she would bother telling a nurse to start treating the wound.... obviously hospitals here now have instructions to check accident patients that are non Italian.... saying this... it was luckily for me shift change time... the dragon that seemed to think despite my UK ID that i was Albanian went away and the new doctor that took over was much more rational....
i feel sorry for those that end up in front of the former doctor if they do happen to come from one of the Eastern EU areas...

however i guess the point is that emergencey treatment now and the staff that work there are used to control details and am sure my accident details were most probably passed onto whatever agency controls these things and my status as regards living here was checked... for those that might think i am paranoid regarding this question it is a fact now that estate agents are required to identify clients and hold records of all money transfers so that the agenzia entrata can check these details if they so wish.....

And I noticed this week John that there were many more checks at the regular Fermo clinic I have started to attend, and this was for all patients not just me, it was all done very pleasantly, but my Tessera was taken away and only returned just before I left, this has never happened before in the nearly 3 years we have been here, so it would seem that new instructions have been issued to staff with regard to controls.
Hopefully this may alert people living here who have not yet sorted out their eligibility to Italian NHS care, it does seem new rules are in place.
Hope you are recovered from the head injury.
Angie

[quote=pilchard;95588] I am hoping that by continuing to pay Class 2, should I desire to re-locate back there, full NHS rights will be mine.
Pilch[/quote]

As I understand it, as a UK citizen who has the right to Iive in the UK, you cannot lose your NHS rights permanently - you only lose them for the period in which you are resident in another country.

Whether you continue to pay contributions or not, if you relocate back to the UK you will immediately receive full NHS healthcare rights (though it is possible that checks might be made to ensure that you are undertaking a genuine relocation rather than engaging in health tourism from your former country of residence).

In answer to a private email about my health insurance, which may be useful to other forum members: The insurance policy I took out with Generali is specifically for stranieri in Italy seeking residency. It is for individuals and families. Hope this helps.

[quote=pilchard;95588]I - Although my reason for applying for an E106 is just to get residency, which is purely just so I can save myself the difference in property tax between Prima Casa & Secondo Casa, & this needs to be done fairly urgently, I wonder if it would be a good idea if my other half were to make an application at the same time. What are the pro’s & con’s? Pilch[/quote]

If you bought your house jointly with your partner you both have to have residency to claim the Prima Casa tax rate. If only one of you has residency you will pay Prima casa rate on one half of the purchase price and Seconda casa on the other half. If you pay Prima casa rate on all of it when only one of you has residency you will end up paying the difference and a fine. The powers that be do check up so it is not worth trying to buck the system.

I had occasion to visit the pronto socorso for the first time a couple of months ago. At the time I thought I had broken my wrist. Anyway other than a long wait everything went smoothly. This was a great surprise as I have never registered with a doctor or got my health card. I am resident, and pay my IMPS as a registered farmer. Anyway they "found" me on their computer and the rest was simple.
As it was a accident at work (in the vineyard) I also received a cheque a month or so later for a week of being unable to work! Cheque was small but more than I would have had - had I worked (for myslef) as normal! Now if only I could be sick for enough weeks to get back all those IMPS payments!

Does the policy you took out with this insurer have a name/ref. number? We've been working our commune for over a month trying to figure out the right type of insurance. It seems the law was introduced last year re foreign applicants needing to have health cover but there are no detailed guidelines on exactly what the insurance should cover.

This may be of some use to those seeking clarification: [url]http://ukinitaly.fco.gov.uk/resources/en/pdf/3094091/ministry-health[/url]

[quote=chrisnotton;91722]Okey dokey,

Here goes. I spent about an hour chatting with my friend from the commune office about my application for residency. The reason that we are all getting different stories is that there have been about 8 recent revisions of the rules and some communes are using different versions. The change of governmenrt will bring even more as it has promised to be tougher on E. Europeans. They (the commune workers) are pretty pissed-off themselves about the moving goalposts.

Yes you do need medical insurance or a form from the DWP saying that you are covered.

Yes you do need to have an income of €5000 or more per year. You can self-certify. I just showed them a bank account with €6000 in and they ticked that box.

Yes the Vigilli should come round and check you live where you say you do. I explained that I wasn't always there & my friend said "tell me when you are in and he will come round that day" :winki:

Yes after five years of residency you are fully covered whatever your previous status. If before then you have reached the official retirement age (60 or 65 and rising for UK residents), when you will be able to obtain free State health cover through an E121 form

Health cover: If you are leaving the u.k. permenantly then the E106 (all forms here [url=http://snipurl.com/2kqkk]HM Revenue & Customs: National Insurance Contributions, Retirement Pension Forecasts and advice for those abroad[/url] [www_hmrc_gov_uk] ) will cover you for 2+ years. There is cheap medical insurance available if you want it see this thread [url]http://www.italymag.co.uk/forums/leg...residenza.html[/url]. It doesn't matter how good the policy is it is as it will give you the official tessera sanitaria which will get you treated in the state system.
My friend said that this method should be renewed on a "year by year basis" but you would be able to switch to "asicurazione voluntaria" after you had got your tessera sanitaria issued. I asked if I could go straight for the "asicurazione voluntaria" and they said no because they have not been informed of the latest rates. Also I am a registered farmer (don't ask) so it is different (more complicated) for me.

O.k. with me so far? By now my friend was glazing over so I thought I didn't want to overstay my welcome.

Now what I have discovered from the DWP.

The E106. There are at least two types. The non-workers one & the workers one.

[B]The non-workers one[/B]. This the one that runs out after 2 and a bit years. You get this when you write to the DWP and say you are leaving & don't plan to work anymore. When it runs out you no longer have entitlement to the UK health service either. Yeah right! Have you ever been asked for your N.I. number in hospital? No neither have I :yes:
You get this type of E106 if you have been normally employed and have at least 3 years of class 1 (the usual one) contributions. Explantion here [url=http://snipurl.com/2kqy8]National Insurance contribution types | Business Link[/url] [www_businesslink_gov_uk]

[B]The workers one.[/B] This is for people who plan to live abroad but continue to work in the UK either employed or self employed and pay a class1 or class 2 (self-employed) contribution. This is open ended and issued for 1 to 5 years at a time.

You can also pay voluntary class 3 contributions but these only count towards your State Retirment Pension, so don't bother.

Here is the interesting bit, for me anyway. If you are self employed you pay your contributions by direct debit (or similar). If you apply for a workers E106 (like me) and continue to work in the UK for more than half the year but live in Europe then you will continue to get a workers E106 as long as you pay your contributions (£2.30 p.w. in my case)
This is self declared and there are no checks whether you do work in the UK as long as your contributions are made you will get your E106.
It is very easy to become self employed & start paying class 2 (self-employed) contribution. If you have earnings of less than £4,825 you will be exempt from paying contributions anyway & will probably get them back. I don't know about this as I have never qualiied.

So these appear to be your options.

Get your E106 and then buy some cheap insurance or pay the "asicurazione voluntaria" for the 2-and-a bit years you are left with until you have been resident for 5 years.

Get a workers E106 and pay an NI contribution in the UK.

Get a friend to employ you in Italy for a couple of months then you will be in the system. This should work because the new regulations only apply to those from the EU who remain 'inactive'. Once the cycle of 'inactivity' is broken, and you have undertaken a period of employment, then you are entitled to the same rights as Italian persons, including the right to join the State health insurance system.
[I]You should offer to pay your friends expenses, and invest in a crate of good wine. :laughs:[/I]

Get lucky at your commune!:yes:

That's it. I will let you know how I get on applying for my workers E106 as I go.

Pip pip[/quote]

Just to follow up. I hear that my residentcy is granted & my paperwork is ready to pick up.
Now I just have to get started on my "Carta Identita" & Tessera Sanitaria"

I will let you know how I get on!

Pip pip