Dreaming In Italian

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.

I don’t want to continue to talk about my hip or the pandemic and an American friend had talked about a desire to live in Italy so I want to recount my experiences. As background, if you don’t know already, I had been coming to Italy in the spring and fall every year for 7 years. I finally decided in 2018 that I really would prefer to live here so maybe you can find my experiences useful. If you would like details on any of this leave a comment.

Surely if you are contemplating such a move you know that it will be a huge change in your life and will not be easy. I would assume that you are well along in your learning of Italian. I would advise you to open an Italian bank account on your next trip here. You will of course have expenses and you want to have a stable source of funds in Italy. You can transfer funds from an American account periodically, hopefully when there is a favorable rate of exchange. There are rules for the transfers and the maximum funds in the account during the year. Also you need an American bank that supports expatriates. I opened an account here a year or two before I moved. I used Carisbo (which is now completely Intesa Sanpaolo) and it was relatively easy to do. I don’t know if Intesa Sanpaolo has changed the rules. You will also need to get your Codice Fiscale which is roughly the equivalent of the U.S. social security number. To be safe I went to the office that deals with such things. Actually you may need that before you go to the bank to open your bank account (conta corrente).

Since I was retired and had no intention of working or long term study in Italy the visa that I needed was “Elective Residence”. So you need to find out what are the requirements to get this visa issued to you. I found that the rules varied a bit between consulates. There are 9 in the U.S. plus the embassy in Washington D.C. You must deal with the consulate responsible for your place of residence. I lived in northern California so I had to go through the San Francisco consulate. By the way as a side note, at some point you need to have an appointment with a consular official to present all of the required paperwork for the visa application. There are also kind of satellite consulates (Consolato Onorario). Northern California has 3 and I went to the one in Fresno where I could get an appointment much sooner than the other two. San Francisco was the most difficult. Also I was not able to ever talk with a consular officer in San Francisco other than going there (that too is difficult) but I could exchange emails.

The two most significant hurdles for a visa for me were (1) proof of adequate income without working to live comfortably in Italy and (2) an Italian residence. They never say what is an adequate income so I did a lot of web searching and it seemed like $45 annual income from pensions, rental property and/or other income producing investments was considered a sure bet. I passed that hurdle. The second means that you either have to own a house (typically an apartment) or rent one with a rental contract (lease) that is certified by the city (comune) where the property is. I chose to rent. Obviously you have to do this while in Italy and then have a certified copy in hand when you present your documents to the consular officer. This pretty much means that you’re going to be paying rent on your first apartment in Italy for 2 or 3 months when you will not be able to reside there. I think that I had to pay for 3 months. Just part of the price to realize your dream.

So after you get all of your documents together and present them you have to hold your breath for what seems like forever (I think it was only about a month for me) until you receive an envelop with your passport with the visa fixed inside. Feel free to weep with joy at have successfully overcome the first set of hurdles. For me the next step was my house. I had anticipated that I would in fact receive the visa so I was already working with a realtor to rent my house. I thought it prudent to not burn that bridge immediately by selling it. So I rented it on a 2 year lease. I quickly realized that at least in the US where I lived it is almost impossible to rent a furnished house for 2 years. So I had to sell basically everything that I owned that would not fit into 2 large suitcases, transported 2 or 3 times from California to Italy. Once I had faced that fact I actually found it relatively easy to part with a bunch of stuff that I personally valued. It was something of a freeing experience. By the way it is relatively easy to rent a fully furnished apartment in Italy.

It was the only time in my life that I had bought a one way ticket for an international flight. At check-in they were a bit stunned and demanded to see the visa which was of course in the passport. I don’t really know why they cared.

So now you will have dealt with the Italian bureaucracy in the U.S. which is just warm-up for the serious bureaucracy in your newly adopted home. You will by now know that you have to apply for a Permesso di Soggiorno (Permit to stay) within, I think, 8 or 9 working days of your arrival. An Italian friend had done some research and directed me to an organization which helps immigrants with such matters. At least here in Bologna one is CGIL which is a labor union which has a branch for helping immigrants. You’ll want to make an appointment as soon as you arrive. They are very helpful and fill out all of the paperwork for you. There is no cost but I donated 20 euros – a small price to pay for such a valuable service. You then take this packet of documents in the envelope provided to the post office where they have you pay whatever sum is required (the last renewal was something like 140 euros) and they give you an appointment for the questura (police office) section for immigration where you will get fingerprinted and give them passport sized photographs. Then you will wait again for what seems like eternity to find out when your permesso is available.

There is a lot more to this story so I will do chapter 2 on the next post if there is interest.

Things are going pretty well with the hip so this post will have an update but will not be the central theme. The central theme will all of the bureaucratic stuff that I need to do by the end of the year including the two least favorite things: renewing my permesso di soggiorno (residence permit) and renewing my annual contribution to the SSN (servizio sanitaria nationale – National Health Service). Plus I need to see my dentist for one of the last steps for a dental implant.

A quick update on the hip. I returned to the hospital for a checkup last week. This included an x-ray and examination by an orthopedist. I had been a little worried about the relatively slow recovery but I was reassured that everything was in great shape and he said that from that day on I should only use one crutch. I was incredulous but when I got home I gave it a try and found that I could do it without any real problems. So it was more my mind that was holding me back. So now I’ve made the appointments for the next two weeks for all of the things that I mentioned above. Also I’ve been reassured that after two more months the hip will be totally healed. Of course there is still the other one (the left) but I hope to get that one done maybe in May if I can get it scheduled that soon. It should heal faster than the right one.

The forms for a permesso di soggiorno are long and complicated (and only in Italian bureaucratize) and I have gone 3 times to an organization that helps foreigners to navigate the process. The first for the initial document and twice to renew it. They are very helpful and are used to having people that speak imperfect Italian and have a lot of patience with us. So I’ve gathered the necessary documents: my passport, the existing permesso that expires at the end of the year, a copy of the apartment lease, a statement of pension income (social security 1099 for 2020) and I always have my carte d’identita (ID card) and tessera sanitaria (medical card) with me when I go out. After I have the forms then I need to buy a tax stamp (marca da bolla) for 16 euros and then go to the post office to send the document package to the wherever it goes (immigration department – I think it goes to Rome) and receive a date and time to go to the local immigration office to finish the process (fingerprints), etc. But before I go to the local immigration office I need to go the bureaucratic office of the SSN and pay for the next year – usually about 1600 euros. Considering that that’s about $180 a month it’s a real bargain. The folks at that department are not very friendly so it’s always a pain in the ass. Next year I can apply for citizenship after 9th of October because at that point Laura and I will have been married for two years. I’ll also apply for a permesso di soggiorno because I’ve read that the citizenship application can take a LONG time. Considering the the permesso di soggiorno usually takes 3 or 4 months that’s really saying something. There’s a reason that Italy if notorious for it’s bureaucracy. When I do get citizenship then that eliminates the two most annoying contacts with the bureaucracy, the permesso and the SSN renewal. I’ll feel a little guilty about having free health service since I’ve not paid into the system (like social security in the U.S.) during my working life. I plan to give a similar amount to some health related charity here to bureaucracy assuage my guilt.

I have now been home for a week and a half. I left out one interesting detail of the trip from my hospital room to my bedroom here. As in the U.S. I was given a wheelchair to go from the room to the exit from the hospital. Unlike the U.S. there was no nurse or orderly to push the wheelchair. Staffing is light so Laura had to push the wheelchair and since there was no staff person she had to also return it before she could get the documents to leave the hospital and bring the little suitcase with my stuff while I sat in an uncomfortable chair near the exit. We took a taxi to the house which was not very expensive and I had to cross the street, go up 5 stairs, cross the sidewalk, up 3 more stairs and finally be inside and take the elevator. The longest trek that I had made to that point.

Returning to the positive side, the physical therapy continues at our apartment every two or three days as well as a nurse comes twice a week to change the dressing and this week will take out the stitches. I will also have someone come to draw blood for blood tests at least twice. The removal of stitches and the drawing of blood are not automatic like the visits by the nurse and physical therapist. I had to get a “prescription” for those things and that has it’s own complications. First my primary care physician has to write them and then Laura needs to take them to where appointments are made, usually at a pharmacy but for the blood tests she had to go to a particular center for making appointments. If the doctor doesn’t mark the prescription as being required in a brief time the appointment can be a month of more away – part of the downside to the SSN (national health system). It’s really a pain in the ass and Laura of course had to do all of the footwork as well as talk to the doctor who speaks no English and is very impatient with my Italian. It has been a challenge but we both have learned a lot and the next time it should go more smoothly.

I get better every day but still am reluctant to go out of the house but perhaps after another week or 10 days I’ll be walking well enough with the crutches to venture out for a coffee at a bar nearby with friends once or twice a week. Inside the house I’m pretty active to improve my walking ability. We have a mezzanine below the main floor so I also have a stairway for practice and exercise. I’m also helping out in the kitchen which is something that I enjoy and makes me feel useful during this period.

I’m expecting that in 6 to 8 weeks I can resume reasonably normal outings and have full recovery after 3 months.

Oh, by the way, I don’t know if I mentioned that the other hip needs to be replaced. I’m hoping to have that one done in the spring giving me 3 months of relatively normal life before reliving this experience.

And so far the the price has been zero although I think that I’m going to have to pay something like 14 euros (about $16) for the blood tests.