Non resident home owners

We are UK resident but have owned a house in Lazio for some time, visiting only in the holidays.  We now would like to spend more time there, whilst retaining UK residency. How do those of you in a similar position access health care if there is a problem and do you have to register with the local police every time you arrive/leave?  I know there is a maximum stay of 180 days in any year if we want to keep our UK residency but what if we stay 4 or 5 months? Are there any other requirements we should be aware of - it is such a long time since we first looked into regulations, I'm sure they will have changed! Many thanks.

We are currently in a very similar position to you FBower.  We are UK residents but stay 4-6 months/year in Italy (but always still 183 in the UK).  As UK residents we are covered by our EHIC card but we're also lucky to have travel insurance through our bank credit card (although certain restrictions apply).  Luckily, so far, in some 12 years we've never had to make a medical claim.

As regards informing the local police - we don't, so forget it!

However what will happen after Brexit is a whole new world.

Significant change post Brexit is that when the EHIC card expires, it probably won't be renewable, so insurance will probably be required

Thanks for both your replies - we have the EHIC and travel insurance too anyway.  I remember the days when we had to register at the Questura in Rome and apply for a permission di soggiorno /lavoro. Possibly this will be what we have to do after Brexit:cry:

We are in similar position.  We have received medical treatment in hospital with no problem.  They didn't seem to take any notice of the EHIC card but we weren't charged anything.  However, I wouldn't like to rely on this.

We have travel insurance via Nationwide bank account.  I have extended it to 90 days cover but think next year will increase to 180 days - the quote for that was quite reasonable.  A number of friends in Italy have been having health problems and it has got us thinking about being too ill to travel home by ourselves and needing help which is why I think we will extend it.

One point I would mention is that when we claimed on our travel insurance for something they wanted proof of when we left the UK so if you have limited cover, it would be difficult to say you had only just arrived in Italy!

Flying pigs wrote:One point I would mention is that when we claimed on our travel insurance for something they wanted proof of when we left the UK so if you have limited cover, it would be difficult to say you had only just arrived in Italy!

Good observation Aerial Hogs  

Most travel insurance is for a 30 day trip only.  In the event of a claim they'll not only want proof of when you left the UK but also probably further proof of your booked return journey.

Extending your trip to 60, 90 or 120 days is usually possible but might prove expensive.  In the past, being elderly, I've found that Staysure have been competitive (other companies are also available!) so worth investigating.

My view is that having robust medical insurance abroad is absolutely vital.  Here in the UK we take 'free' medical care for granted.  But you'll be staggered by how much medical care ACTUALLY costs when you're abroad/in Italy.

Another useful observation (I'm a doctor!).  Your EHIC has no 'health exclusions' whereas your travel insurance may very well exclude any pre-existing medical conditions.

Technically, once you stay for more than 90 days in Italy you should register with the comune as a resident. I know a few couples here who go to great lengths to make sure they don't stay more than 90 days together in one trip. They basically come for March to June and September to December. Of course, a lot of people ignore it and stay longer. 

No-one knows what will happen after Brexit but as this is an Italian rule I doubt that it will change. You might need a permesso to stay even 90 days after Brexit but who knows.

The big thing the EHIC doesn't cover (and remember it only covers emergency treatment anyway) is repatriation if you are too poorly to travel. Also remember that treatment in Italy is not free (even to Italians) and neither are prescriptions. Some friends who had an accident and were obliged to stay for ongoing treatment found the consultant visit fees and prescriptions soon added up and the EHIC did not cover these costs as it provides cover on the same basis as a local. Obviously the EHIC covered the emergency treatment for free. I believe this used to be different in the past and you used to be able to claim these costs back from the NHS but no longer.

If I were in your shoes I would take my EHIC and also make sure I had insurance that covered repatriation and the contributory part of the medical fees.

Plus, I would not stay more than 90 days. Once you are resident at the comune then Italy considers that an indication of tax residency and you probably don't want to go there even if you could argue otherwise. I've yet to see anyone win their argument with the Agenzia delle Entrate!

Here is some information on the issue of registering your stay in English.

Thanks Admin, but couldn't see a link.

We were registered as residents as we were in Italy for more than 90 days and thought we had to.  However, we were fiscally resident in the UK and registered in the UK for medical purposes, spending more than six months in the UK.  Then we found some people were being pursued for Italian tax because they were residents despite believing they were fiscally resident in the UK.  Decided it wasn't worth risking, couldn't face the trauma of arguing our case.  No-one seems to really understand what the rules are.  Most of the people we know have ended up leaving Italy because of this.  We rescinded the residency and now have to pay a lot in local taxes, but worth it to us for peace of mind.  We earn no money in Italy and only bring money into the country.  Have always kept proof of when we are in/out of Italy, but this is difficult when you drive, all we have proof of is when we crossed the channel.  Perhaps we will have to do as kidnappers do and take a photo at a landmark with a dated newspaper!

I am hoping that one benefit of Brexit may be that we get some defined rules that everyone plays by - but is that asking too much!  Here in Puglia residency seems to mean something different to each Commune so you never know where you stand!

If you click on the word Here in my post it will take you to the website explaining it all in English. There is also a link to a form you can present to the carabinieri when you arrive/leave to prove you stayed less than 90 days. It's optional but if you don't complete it, they apparently assume you are staying longer unless you can prove otherwise.

Thanks.

Don't think they would have a clue about it here.  When you register with the Anagrafe the only option is for residency and you get an ID card but you have to jump through the hoops of having health insurance, police inspection of the house, etc.  Don't think our police could cope if everyone appeared with a form every time they came in and out of Italy.

Well, in Italy you're either resident (over 90 days) or a tourist (under 90 days) 

technically you can have elective residency, but unless you are nonEU its virtually impossible.   So, once Brexit is done, you can get your PdS on an elective residency. 

People who go back to Britain because they had to pay the IMU they should have been paying?  Good riddance.

I came to Italy on an elective residency PdS many many years ago. I still have it in my filing. Then they changed the rules and we didn't need a PdS if we were part of the EU. I didn't need healthcover at the time but I did have to demonstrate enough income.
Even if it's elective residency the AdE takes it as an indicator of tax residency and will expect you to file a return on your worldwide income. I know quite a few people who got caught out on this one.

I don't know of anyone who is avoiding IMU.  We rescinded residency as we did not want to be considered tax resident and we did not want the hassle of proving how long we spent in Italy.  As soon as you get investigated it seems impossible to sort it out - that is why people I know have left - fine after fine, year after year, despite commercialista saying it is all settled each year.  It is not local taxes that are the problem - they are totally justified, although have increased a lot.

apologies for misreading your post!

From our recent experience with my husband suffering a severe stroke while holidaying in Bagni di Luca. Our aspanish EHIC covered EVERYTHING, including ambulances, all medicines, hospital stays in two major hospitals for a total of over 45 days, all tests, even a bag full of medication to take to Spain to be used while Spanish doctors did the transition process. We did not have to pay a cent. Our car insurance with Direct Line which included Travel Assistance covered repatriation from the Italian Hospital in a private air ambulance accompanied by a doctor and a nurse and sending back our car to Spain. Again... not a cent to pay.

That's good to know Gala.  At times like that you don't want to have to worry about funding.  Even if you have the money sorting it all out can be a nightmare.

When my husband was in hospital over here (Puglia, two separate stays) we also didn't have to pay for anything apart from medication on discharge for which we had a prescription.  However, I am not convinced that they took any notice of the EHIC card as we don't remember showing it on the second occasion.  It may be that they are like the UK and don't get around to billing the other EU country.  We certainly didn't have to sign anything to confirm he had had treatment. 

Excellent care over here.

Hope your husband is still progressing Gala.  All the best to you both.

Thank you FP. He is slowly improving and I only have praise for the level of care received in Italy.

One of the issues which came to mind was what does one do if one doesn't need hospital care - just a the equivalent of a GP? Soon to have baby grand-daughter to visit and don't really want to run to pronto soccorso for every worry?

Gala  my thoughts have been with you ever since the post about your husband - your were the fount of all knowledge for us when we first bought our house. Many thanks

You can go to the Guardia Medica or pay a GP privately. It cost about €40 the last time I knew someone who did that.

Thank you for your kind words, FB, happy to have been of any help.
The advice given by Admin is totally correct. Also, if you have the Red Cross nearby, they usually have a doctor on duty for emergencies who could help. A private GP, particularly taking into account the moderate fees, may also be the solution. Talk to your own GP.