Italian Residency and the health care system
Where are you on the path of your dream of living in Italy? Have you got your Italian residency yet?
If you read my first post about getting the certificate of residency, you know that you have to wait 45 days after presenting yourself at the Vital Statistics Office, (Ufficio Anagrafe) and the residency certificate may or may not come in the mail. In my case it did not. Therefore, after 45 days had passed, I showed up at the Anagrafe, and went to the office (without an appointment) of the woman I seen for my fist visit.
I told her it was now over 45 days and I’d not received anything by mail. She quickly went to a filing cabinet and shuffled around and then proclaimed, “It’s here!” and she gave me the official residency certificate. It is in fact not a “certificate” but a letter. Be sure to keep it with all your other precious paper work.
I knew the next step was to get myself hooked into the public health care system. The guy at INAC had actually been unable to tell me where to start this procedure, so I asked this woman if she might know.
“Go to the Campo di Marte Hospital and there you will have to the find the right office to make your request.” She said.
Good, I now had somewhere to start. Arriving at the hospital, I entered through a gate, into a large complex with lots of different buildings. Having no idea which way to turn, I doubled back and asked the guy who manned the booth at the gate.
Once in the correct building I found an info place and asked and the woman said, “you have to make an appointment for that, and the office is now closed. You’ll have to call them tomorrow.” And she gave me the number.
All this time I was feeling glad that I could explain myself in Italian!
The next day I called and got myself an appointment for a few weeks out.
When I went to the appointment the helpful young woman told me that I had to pay yearly to be in the public health system, and that the years are counted from January 1st. She advised me that I might want to wait until January to pay.
I agreed with her and she then gave me helpful information so that I’ll be ready for the January appointment. I realized that even if I had wanted to pay and sign up right then, that I wouldn’t be able to because the payment must happen at the post office and one must jump through mathematical hoops to figure out what one’s specific payment is.
She gave me a sheet called “Iscrizioni Facoltative” which explains that on top of a base payment of Euro 387.34, (this per year by the way, not per month) I must calculate 7.5% of my income if my yearly income is less than Euro 20,658.28. If my income is more than that, I need to calculate 4% of the surplus.
Note that this extra cost is only for those on an ER visa. If you are on a student visa, you pay only Euro 149,77. Also note that these costs are for the region of Tuscany. Each region has their own prices.
For the ER visa, you must fill out a declaration of income and bring it to the post office, so that the post office will know how much to charge you. Then bring the receipt of payment from the post to your appointment.
Take Aways:
Note that you must go to the Ufficio Anagrafe after every time you renew your permesso (within 6 months) to re-register yourself, otherwise they will start a cancellation process.
For getting into the health care system, plan to make two appointments at the hospital: First, to collect the declaration of income paper work, in order to be properly prepared for your main appointment. Or try asking at the INAC office if they have that paperwork.
To get the best use of your money, get yourself into the health care system at the beginning of the year.
To learn about earlier steps in the process go here
To learn about the Integration Agreement go here
AL AMIN says
I applied for the renewal of my permesso which had 4 months validity.. Now I have an expired permesso and postal receipt of the new application. Can I apply for residenza certificate with this postal receipt?
Thanks in advance
Chandi Wyant says
If you are at a point of renewing your permesso, then let me ask you, during the year that you had the permesso, did you not follow the steps of getting your residency certificate? What you need to do, is get the permesso (not just the receipt) and then go to the Ufficio Anagrafe to request the residency certificate. See this post here for more info: http://paradiseofexiles.com/italian-citizenship/
AlAmin says
Thanx for the prompt reply. I came to Italy with a 4 months visa. My research fellowship was also 4 months duration. So they gave me residence permit for 4 months that I received just 1 month before expiry. Then I received PHD enrollment from the university which is 3 years. So I applied for the renewal with this enrollment paper and received another postal receipt. As my appointment in questura is scheduled In November and I assume I will get my new permesso di soggiorno in December. Do I have to wait till then?
Chandi Wyant says
Oh I see, hummm a four-month visa… what is your citizenship? I blog about my process as an American who doesn’t have Italian relatives and doesn’t have EU citizenship, and that’s what I am familiar with and can comment on. I recommend you go to the Ufficio Anagrafe and ask. Do you speak Italian and if not do you have a friend who can go with you? What city are you in? In smaller towns the Ufficio Anagrafe is relatively easy to deal with.
AlAmin says
Hi ..I am from Bangladesh. I speak a little Italian. I am living in Padova. Anyway thanks for the reply and your blog is really helpful. I go to know a lot from all the posts 🙂
Grazie mille
Chandi Wyant says
Oh, Padova is beautiful! I visited it for the first time a few months ago. You can see my post about it here: http://paradiseofexiles.com/padova-surprising-beauty/
I hope you are having a good time living there!
Beatrice Bradarovic says
Many thanks for this information – much appreciated! Please know that your blog is very informative, straight forward and easy to comprehend but above all invaluable for folks like myself. Best wishes , Beatrice from Toronto, Ontario, Canada.
Chandi Wyant says
You are so welcome! Thanks for the compliments. I hope your plans for Italy are going well!
liz says
Today I filed my PdS RENEWAL at the Poste. I was given a date for the Questura in November. Can anyone tell me if this is still part 1 or a 2 step Q process? The initial PdS application, at my first appt they did photos and finger prints. Then, it seemed they texted me a date some weeks later to pick up the actual card. Does the same apply on renewals? Will they again take fingerprints or is the next appointment to actually pick up my new renewed card? Lastly, after the late Nov appt I am heading to the states for Xmas. I am worried the actual card itself may not be ready before I leave. If so am I going to run into problems when I return to EU in January? Thanks in advance! Liz
Chandi Wyant says
Hi Liz,
The renewal is the same process. Get the kit from the post office and collect all the same documents. I recommend going to an INAC office (also called Patronato) for any questions or assistance. See more about that here: http://paradiseofexiles.com/permit-to-stay/
Yes, you may run into problems without the actual card. The process should be started 60 days before the expiry date, and maybe sooner if you intend to travel. As of 2009, Italian law states that if your permesso isn’t ready, you can only exit and re-enter through the Italian border and that you cannot transit through other Schengen countries without the actual card.
Lorna says
Ciao! I got my PDS last week and it has 5 yrs validity only same date with my visa expiration. Is it really required to study their language and if so what school i can enroll. Thanks
Chandi Wyant says
Hi Lorna,
You need to prove a certain level of Italian in order to renew your PDS/residency. For enrolling in a school, find a CTP: “Permanent Territorial Centre” where courses are free of charge.
I believe if you have residency that enrollment in the course is free, and at the end of the course you can get the needed certificate.
Are you saying that the expiry date of you permesso is in 5 years? What kind of visa are you on? Most have to be renewed yearly or every two years.
Anonymous says
Thank you for your reply. No. It has only 5 months validity which will be expire on april 14, 2018. I hope i could find CTP near my place here in Brescia. Your post really helps a lot of people like me. Tommorow is my civic life class☺
Alexandra says
I am surprised at the cost. With the formula you mention, if you earn $20,600/year, the health insurance payment is about $160/month. Does that cover drugs, co-pays? I thought it would be cheaper. If they do not have the service you need at the local facility, does it cover sending you to a big city for it?
Chandi Wyant says
Hi, yes, that is about what it would be per month. And it covers you wherever you are in Italy. I am disappointed too by the cost. I had imagined it would be less but that is for the lucky foreigners who are able to get request citizenship in Italy because of having Italian ancestry. The payment for those of us who have the elective residency visa have to fork over the funds or we can choose not to join the public system and just pay out of pocket as medical things come up, and hope for the best.
Mark HInshaw says
Chandi,
I just came across your excellent site. Its very informative and you have a great deal of patience and humor, which is very much appreciated. Sorry for such a delayed comment, as the dates above end over a year ago.
A couple of comments re the carta d’identita:
You said you received a letter. Ours are small, folded paper booklets with thin plastic overs that we carry in our wallets. (We have been told by the anagrafa that these will be replaced by plastic cards “soon.”) What we didn’t expect was how many times we would be asked for this (vs hardly ever for the pds cards). In fact, we were shocked when, after returning from a tip outside the EU, the customs agent at Ciampino merely glanced at our c d i’s (rather than ask for passports) and waived us through. Seems to have magical powers.
But, more important, several times you have made mention of annual renewals. Our cards were issued with ten year life spans, clearly printed with the renewal year of 2028. Now, I know that things can vary widely in different places, but that seems a wide difference. Perhaps we just got lucky?
Italy can find whole new ways to introduction confusion and chaos into your life.
But its all so worth it, right?
Mark
Chandi Wyant says
Ciao Mark,
I am glad you found it informative. The letter is something that you then change out for the plastic cards. I guess your anagrafe is still doing the old school kind!
It is not that you have to “renew” the carta d’identita, but you must go back to the Ufficio Anagrafe after every time you renew your permesso, to “re-register” your residency. I have been told by those who work at the anagrafe in Lucca, that they will start a cancellation process if you don’t do this.
Lauretta says
Hi Chandi, call me late to the party too, since I am just now able to apply for the health card. I just received my first Residency Certificate and my first Carta d’identita. My Permesso is valid. Now, it seems, I can apply for the health card.
I’m wondering if you have been actively maintaining a health card and, if so, do you feel the value is worthwhile? I was a little bit stunned by the cost of the health card and am wondering if I should get it. I have active health care in the US and am thinking that if I ever get really sick, I’d just go back to the states.
Just wondering how you approach the whole question.
Your posts are really helpful. Thanks!
Chandi Wyant says
Hi,
I found the cost too high for the visa I was on and I chose to just pay out of pocket for any medical visits. And of course I have the international medical insurance that is necessary to have in order to get the visa and continue to renew the permesso.
Arora says
Hi Chandi,
Thanks for very useful article. May I know if I can recieve carta di identita while my permesso is expired?
I am a non EU citizen and came here last year april on a 1 year lavoro autonomo visa and my permesso is expired now in the month of july.
My permesso renewal is in november, I am trying to obtain tessera sanitaria for it. AND carta identita before that.
Please let me know if/ what can be done. I’ll be so thankful to you for the help.
Chandi Wyant says
Hi,
I doubt that it will work to apply for it with an expired permesso. To apply for it you need to bring with you:
Passport
Permesso
Residency
Codice Fiscale
One photo with a white background
I would imagine when they made that list, they were talking about a current permesso.
See my post about it here:
http://paradiseofexiles.com/post-5-getting-the-carta-didentita/