What happens to your health cover after 5 years of residency and your permesso expires

Penny
06/10/2009 - 10:41

I wasn't sure whether to post this under Marche or here so here goes. I thought I would tell you my experience of trying to renew my "libretto sanitario" as it and my permesso have expired after 5 years. I am having trouble getting the "attestazione di soggiorno permanente per i cittadini dell'unione europea" from our anagrafe office here in Amandola. The reasons are partly because they are busy with the elections and partly because he has never had to do one before (hard to believe!) and wants to look the law up as it changed in 2007 so I have to wait another 30 days after already waiting 30 days. Today I went to the doctors who said I need to renew my "libretto sanitario" (not the plastic "tessera sanitaria" but the white slip of paper that covers you for SSN health care here) as I only have 30 days after expiry to do so, so off I went to the office at the hospital in Amandola to renew it. They insisted that I prove I am paying tax (which luckily I could do) and would only give me one for one year. The person I spoke to said even if I had the document stating I have permanent residency, she could only give me a Libretto sanitario for one year as all stranieri can only have one for a year and showed me a regulation from the Marche health authority. My understanding was that after 5 years I am entitled to a libretto for an indeterminate period. She said "no". Then I asked who I should contact if I return with the EU law stating my entitlement, after 5 years, to the indefinite health cover (just like s have). Then she pulled out another document, this time from the Marche region) stating that EU citizens with permanent residency (after 5 years of ordinary residency) are entitled to SSN cover for an indeterminate period. I pointed out to her that it clearly stated what I was saying was the law and she kind of shrugged and said she must use the rules from the health authority. She did kindly copy the page of the document from the region and give me the name of someone from the health authority to contact. I am going to write to the health authority quoting this document from the rgion and see what happens. Basically the health authority is breaking EU law. The guidance she showed me from the health authority did not specifically mention EU citizens with permanent residency so I suspect it is an oversight. Watch this space. I'll let you know what happens but if anyone knows the exact law to quote in my letter I'd be grateful.

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Penny,I have to say there are times when I wonder why I am here.................Personally I have worked for 40+ years in the UK and paid taxes, NI and all the rest, I come here thinking that well we are in the EU so we'll be sorted....................then you have all this ridiculous bureaucracy, and I feel I am here HELPING the eceonomy ofItaly through buying property, using local builders, shops, paying insurances (car in particular outrageous 1,100 for 3rd party only!!!).If my language skills were able enough I would come with you to protest.....................I try my best to 'do the right thing' but there are times that I despair! I will also go through what you are going through in a few years time, hopefully my language skills will have improved enough by then!  Good luck, please keep us posted !

Hi PennyThis is the link for the "UK in Italy" website (British Embassy website in Rome) where you will find the Ministry of Health Circular (English Version) dated 3rd August 2007 available for downloading."A permanent residence certificate after at least 5 years' residence in Italy""An EU national who lived on the national territory legally and on an uninterrupted basis, except for short periods in accordance with relevant legislation, acquires a right of permanent residence which entails a permanent registration with the NHS.To be registered, the individual should produce the residence certificate issued by the relevant Local Authority and stating that he/she is entitled to permanent residence."The bold letters are in the circular.  The paragragh goes on to discuss periods of absences etc.The UK in Italy website contains invaluable information for UK citizens visiting, working or living in Italy.  It has always been my first port of call when researching information

Penny, there has been a change in the laws as from 2007; however, this should affect new applicants only. I remembered reading something about it a couple of years ago and I found this thread in the old forum with interesting information:I hope that it will help you. Please let us know how you go.

Hi Gala,I was interested to see the link you posted in reply to Penny however it is taking me to the old site and I cannot open it.  Is there another way to get the information please?with thanksMontana 

Dear PennyIn a nutshell, you need the attestation to be provided by the Comune to certify that you are entitled to permanent residence. If your permesso has expired you need to show that you have been here legally (and are still). So proof that you are now working should satisfy them.You then take the attestation to the ASL for your permanent tessera sanitaria.You should check  law no. 30/2007 and the subsequent Ministerial Circulars which help to interpret this law. Let us know how you get on. Charlotte

Thanks Serge for the link. I have downloaded the documnt in and will take it back to the woman at the ASL office as it comes from the Health Ministry she might just accept it. Sprostoni - I agree. It is so wearing sonmetimes and you just know that if you don't get the paperwork right, it will come back to bite you here. We pay a fortune in INPS (despite earning very little) and who knows how many thousands we paid over the years in the UK (having been an employer and and employee, it was a lot!) and this is the result. Still, I am keeping positive and assuming it is an oversight. Charlotte, thanks too for the law number. I have one slight concern. When I moved house in 2007, the new law had just come in. The Amandola comune insisted on regsitering me as if I had just arrived from the UK despite my protestations and those of my italian accountant (and general Mr Fixit) - they would do it that way or not at all. Luckily I kept a copy of my permesso! The problem is now, that in the Amandola comune, I look like I have only been in Italy 2 years and not 5. The new chap there (the old stroppy one has retired finally) says not to worry and sheepishly admits it was a mistake to register me that way. He, however keeps trying to tell me that because the "attestazione di iscrizione anagrafica di citadino dell'unione europa" says it is for an indeterminate time period, that is sufficient. I just keep insisting I must have an "attestazione di soggiorno permanente per i cittadini dell'unione europea". I have a sneeking suspiscion he is fobbing me off because he can't now square the paperwork/computersystem. I am assuming I am within my rights to insist on this and the latter is actually the document I need? Thanks to you all. I will let you know how I get on. A big dose of patience is required!

 Hi Montana,The way I do it is to go to:Then I look for "Search" at the top and I enter the key words for what I am looking for. In this case, it would be "health card". I have the advantage of remembering some of those old threads which interested me and this makes it easier, but you should get a few to have a look through. You have a choice between threads and individual posts. It is easier to go through threads first.Happy hunting!

My comune just asked me to go in and see them last week because my 5 years on my PdS was up. I had to take two Marche da Bollo of €14.62 and they are now preparing my Certificate of Permanent Residence. As the clerk said "Once you've got that, it's the last time we'll have to bother you!"Permanent residence gives me exactly the same rights as an Citizen now, and having deposited my E121  five years ago my Libretto (Carta) Sanitario is permanent too. That may be because I'm a pensioner, but the E106 covers working age people and their families so together with the Certificate of Permanent Residency you should be OK.

But E106 is only available to people that are still employed by a UK employer or still paying into the NHS (working in Italy on temporary secondment, for example),  or whose NI payments are up to date and are using the E106 for only 2.5 years cover in Italy without working, no?  

That's correct Bill. Congrats Carole!! That it exactly how it is supposed to work for me too (and I'm not retired). Just that no-one in this town seems to believe me.I'll give the guy at the anagrafe office a week and try again.

I have a friend in the same position as me and she informs me that apparently, the guy in the Anagrafe office has been doing his homework (finally!) and now agrees that the "attestazione di soggiorno permanente per i cittadini dell'unione europea" does exist and we do require it. Hooray!!! But..........I can only have it 5 years from the date of my residency application to the comune and not just because the permesso has expired. I think the sentiment of the law is that it should happen when the permesso expires but the letter of the law does talk about residency. Of course it used to take approximately 3 months for the permesso to come through making it impossible to apply for residency at the same time as the permesso. So as my friend put so succinctly "he is right for the wrong reasons". My 5 years of residency is up in September and as I work here have got health cover for the next 12 months, it won't cause me a problem if I have to wait until September. I can imagine it might cause other people a problem though. I just know I won't be able to persuade him to issue it any earlier - Relevant quote from the law: "Il cittadino dell'Unione che ha soggiornato legalmente ed in via continuativa  per  cinque anni nel territorio nazionale ha diritto al soggiorno  permanente  non subordinato alle condizioni previste dagli articoli 7, 11, 12 e 13."  

In reply to by Penny

Deary deary me!...........Excellent progress but still not a perfetto result eh ?...............well done for your getting throughit, you're obviously made of strong stuff!! By the way, I was going to click a 'grazie' box ut have yet to find one in this new wordl !! S

Thanks Sprostoni! The good new is that I have in my hand the "attestazione di soggiorno permanente". Finally!! I'm off to the ASUR office in Ascoli on Thursday morning with my friend who is in the same situation. Fingers crossed.

Well, the women behind the desk in Ascoli referred us to the direttore. We went and saw her and she said they have a "deroga" here in Marche to say that they need to count how many european citizens are resident in the Ascoli Piceno health authority - hence us having to renew our libretto every year. She explained this as an extra requirement, over and above the legal requirements. We got partial success as she agreed that my friend, who is neither retired nor working, is entitled to health cover but again only for 12 months. I explained to the direttore that we have no objection to going to the ASUR office every year and saying "we're still here" but under no circumstances should we be required to produce proof of income and other docs every year as this is clearly against the law, which says we are entitled to a permanent registration. (Always better to compromise in my opinion). She said she would review both the law and their deroga and internal regulations and call me. In summary - not a "No" I suppose but not entirely satisfactory.