Italian residency part 2

After 4 months of silence on my blog, I’m back with another bit of information about Italian residency. On the last post I ended with the first request for a Permesso di Soggiorno – a very important document which you will need to renew for 5 years after which you can obtain a Permesso that doesn’t expire. This is like a Green Card in the U.S. After 5 years you will be considered a permanent resident and can avoid one of the most distasteful bureaucratic interaction here in the “Bell Paese” – beautiful country. When requesting the permesso they will note that you have no documented health insurance in Italy (unless you have paid for an insanely expensive policy). At least in my case private health insurance for a 72 year old man would either be totally unavailable or thousands of dollar a month. However I found that you can join the national health service; the SSN – Servizio Sanitario Nazionale. The voluntary enrollment (iscrizione volontario) is on a strictly a calendar year basis. That is it begins on January 1 and ends on December 31. So if you enroll in September, as I did the first year, you pay for a year even though there is actually insurance coverage for 4 months – September through December. In subsequent years you can enroll in December for the following year. So every year I do exactly that an receive my health insurance care (tessera sanitaria) in the mail usually after 6 or 8 weeks although there is a temporary paper document that shows that you are insured. To enroll you must have made an application for your permesso and use the document that you receive to show that you are a resident. As soon as you receive the document showing that you have enrolled in the SSN you need to send a photocopy of the SSN inscription to the questura because you must have health insurance to receive a permesso di soggiorno. Have I confused you enough yet. It’s kind of one of those “Catch 22” things. If you don’t know the significance of “Catch 22” you can look it up here.

To get the insurance you need to pay based upon your prior years income. I use my Social Security document that shows how much I received the prior year. That seems always to work. I pay about $1800 dollars a year for the insurance which in comparison to the costs for insurance in the U.S. is quite a bargain. To join the national health system you go to the Ausl nearby (Azienda Unità Sanitaria Locale) quite a mouthful. It is basically the office that deals more with the business side of the health care system. While there they will assign you to a primary care physician ( medico di base) near where you live. You can change doctors if you find the one initially assigned is not to your liking just as you could in the U.S. although it’s unfortunately more complicated. You can find all of the primary care physicians at website but you really cannot filter the results for the neighborhood that you live in and even more importantly for those that have openings for new patients. The medical system as I’ve probably said before is good in some important respects – universal coverage and reasonable costs. The negatives that I have found are (1) changing primary care doctor as I just described and (2) you pretty much always have to wait if it’s not a medical emergency.

I have been considering applying for Italian citizenship which I can do two years after a marriage to an Italian if we both live in Italy. I’ll do a blog post on that the next time if anyone expresses interest. Leave a comment and let me know if that interests you or if you’d like to know anything else about living in Italy.

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