Dreaming In Italian

My path to Italian residence

Monday, December 6th, 2021

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.

Hip update and bureaucracy rant

Tuesday, November 16th, 2021

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.

New Adventure with the Italian health care system – Part 3

Monday, October 25th, 2021

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.

New Adventure with the Italian health care system – Part 2

Monday, October 18th, 2021

The Italian national health care system (SSN) works pretty well in many ways but like any such system it has it’s flaws. I of course couldn’t help but comparing it with the system in the US. On the positive side, everyone is covered and there are few and low priced co-pays. None for your primary care physician and low ones for specialist visits. In my case since I’m over 70 I have rarely had any co-pay. In general the medical costs are much lower in Italy than the US. The prescriptions are either very inexpensive or free – imagine that. On the other side of that coin the non prescription drugs (ibruprofen, aspirin) cost much more. The pharmacies need to make money somehow. The medical care is probably about equal to that in the U.S. Some doctors are better than others and a couple times I changed the primary care physician or specialist. In general I would say that the system is less responsive since it has less money and the patient has more responsibility for his/her medical care. Add to this some quirks of Italian bureaucracy and it can lead to frustration. For instance they requested a bunch of documents that I had to obtain from the health care system itself and from my primary care physician plus prior test results, ecc. prior to check-in at the hospital. Having duly gathered everything I was never asked for several of them during the check-in process.

I was notified of the date to arrive at the hospital for the hip surgery on 5 October in a fasting state at 7:00 AM. Fasting would indicate that the plan was for surgery that day. So being punctual I arrived at that hour and went to a waiting room where there were probably 6 or 7 other people waiting by a few minutes after 7. I waited for over an hour before being called. So why can’t they space out the arrival times? The interview for all of the information during check-in was rather brusque. I had asked via email for a list of personal things that I should bring with me to the hospital that was never answered. So I brought a bunch of stuff including the few prescription medications that I take regularly. It made sense. Maybe all hospitals are this way but they would not accept mine since they were not in the bubble packs as they always come from the pharmacies here. This kind of leads into my complaint of the general lack of information during the entire process. So anyway I was in bed in a room by about 9 AM and was told that the surgery was to be sometime in the afternoon. I can’t really fault the hospital that I couldn’t have it that day since there had been some sort of operating room emergency, however it would have been nice to have that information before 5:30 PM. By that time it was pretty obvious that I wouldn’t have it that day.

The room was really pretty nice with two beds spaced relatively far apart, a bathroom, individual TVs, etc. One thing different from hospital stays that I’ve had in the U.S. is the almost complete lack of privacy. At least in the U.S. there was always a curtain that could be drawn around the bed but here there was nothing and since after the operation I was pretty much always in bed that meant also that all personal bodily functions were done without privacy other than a sheet over me.

So now getting back to the positive side of the stay. I was in the hospital for a total of 9 day. It would have been 8 if not for the one day delay in the surgery. By American standards I think that pretty long but during this time I had physical therapy twice a day for which I’m really grateful. If I had left after only 2 or 3 days it would have been much more difficult because I would have been weaker, had more pain and little experience with the crutches to walk and go up and down stairs. There was kind of a rotating cast of therapists but they all seemed pretty competent and caring except for the one who thankfully I saw for only one afternoon session. The nurses were generally caring and likeable (again with one exception who I mentally thought of as Nurse Ratched – “One Flew Over the Cuckoo’s Nest” reference).

Finally, I think 2 days before being released from the hospital I was given the date and a suggested time of my release from the hospital. In retrospect I should have asked more questions at that point which I will further explain in the third and final chapter.

One great thing is that Laura came to visit me every day. The visiting hours were from 6 to 7 PM which makes sense because the physical therapy appointments and generally other activities in the hospital shouldn’t be disrupted by visitors and frankly while it was always great to see Laura we generally ran out of things to talk about before the hour was up.

The third chapter will come soon.