Use of S1 as retiree

If we retire to Italy as UK OAP holders with an S1 - what healthcare rights do we have please?

wood99 wrote:If we retire to Italy as UK OAP holders with an S1 - what healthcare rights do we have please?

Full rights as I understand it, but what that entails here (Italy) I can't say. Others may be able to advise what you pay for and what you don't. Have a look at THIS LINK and this one.. Ignore putting yourself on the radar with your GP regards the advice to tell them if you are going abroad more than 3 months, could be just as much hassle as it's worth. I assume by "OAP holders" you mean State Retirement Pension" ?

Thanks for this.  I am not clear what Italians pay!  It seems that an S1 gives the same cover as an Italian would get but that is what!!!!

wood99 wrote:Thanks for this.  I am not clear what Italians pay!  It seems that an S1 gives the same cover as an Italian would get but that is what!!!!

From what I understand it's very similar to other place such as the UK where you pay for certain things, nothing major, but different e.g. if you need a blood test you may have to pay, but likely it will happen immediately as would the result (well that's what I've read). Dental treatment may be another matter as I understand that can be very expensive here, but private I believe, so likely same as the UK would be if private. Really nothing to worry about regards getting treatment, but having treatment may be another matter, especially if you don't speak Italian. Their are also minor things like a lot of medication may involve sticking a needle in your bum... well so I've heard... If you already have a medical problem, then I think it likely is obviously a little more of a bit of a worry, but I have heard of and indeed know of people who have arranged all sorts of matters with their UK doctors and those here in Italy.

As far as I'm aware you would fall into the lowest category on Health Care payments (as Pensions are included as income) so you would pay a 'Ticket' (about €30-40)for most tests and some appointments for checks in Hospitals , as for medication you would have to pay fro some depending on what it's for , but necessary medication for existing conditions (i.e. Heart medication, diabetic medication) would be free. There is lots of info about on the ASL site but it's in Italian.

Reading Flip's reply leads on to the ASL, of which I don't have a clue. However using that to search came up with lots of information, you may wish to look at these (2 in English and 1 Italian;

http://www.euraxess.it/services/types.php?voce=incoming&pag=health_services


http://www.stranieriinitalia.it/guida_alla_salute_in_otto_lingue-medical_assistance_1796.html

[url=http://www.salute.gov.it/portale/temi/p2_4.jsp?lingua=italiano&tema=Assistenza, ospedale e territorio&area=Assistenza sanitaria]http://www.salute.gov.it/portale/temi/p2_4.jsp?lingua=italiano&tema=Assistenza,%20ospedale%20e%20territorio&area=Assistenza%20sanitaria[/url]




The latter is well out of date as it is talking E121 (old name for the now S1).

Your S1, as a pensioner, means you get the same cover as an Italian and the UK picks up the bill. This is only if you are in receipt of a UK state pension - if you retire early and have a private pension you are not covered.

Italians (and us ex-pats that get 'full' health cover here in Italy on the same basis) have to pay a contribution to every type of appointment and treatment except a GP appointment. There are no NHS (SSN in Italy) dentists so this is private. You are entitled to choose a family doctor (GP).

Here in Liguria we pay €10 for every chit the doctor writes on top of the fee. This may be for a test or for a consultant's appointment. Not all drugs are on the SSN so some you must pay for privately. There is no set prescription charge, you pay for the drugs and can deduct them from your tax return (up to a certain limit).

I will give you an example of a cost - a mammogram just cost me €43. Sometimes it is cheaper just to go private to be honest as tests and the like are very reasonable in Italy.

If you are over Italian retirement age (still 65 for the minute) and your family income is (including pensions) less than €36,151.98 you can have free prescriptions, tests and appointments. The same applies if you are under 65 and have a chronic condition.

The main differences I have found between the UK and Italy in terms of healthcare is that in Italy you keep all your own records (so make sure to get a copy from your UK doctor before you leave) and the fact that the GP almost always refers you to a specialist and does little prescribing him or herself.  The other big difference is that you can pay to see a private consultant (quicker and often not much more expensive) but still have any actual treatment on the SSN which for me is a good system.

Do remember that if you join the Italian SSN and present your S1 form you are no lnger entitled to a GP and medical care in the UK. It is a one or the other choice - you can't have both.

This document is useful. It is more aimed at non-EU citizens but still usefull.

Thanks Admin for the detailed information, just a point on the not being entitled to UK treatment as it might worry some. This NHS LINK gives two options where you will be entitled, one to full treatment as per your UK entitlement and the other if needed whilst in the UK. The first is if you go back to the UK and state you are staying there... The second is for those in receipt of a UK state pension, where if in the UK and treatment can't wait, it will be as if you were UK resident.
One important this I did think of was the very fact the OP did not say they would be resident in Italy, I simply assumed they must intend to?

Sorry - I should have been clearer. If you have joined the Italian SSN then you are entitled to an Italian EHIC card which gives you cover for treatment in the UK when you visit. My point was that you must choose which country you are resident in and choose a health service to belong to. You cannot belong to both the NHS and SSN at the same time.

I'm not sure that link applies in this case Steve as the OP would be resident in an EU/EEA country and that link is for visitors from outside this area. The OP would be covered by their Italian EHIC.

Yes, you are absolutely correct - you must be formally resident in Italy (if you are a pensioner) to join the SSN. You will also need to show the S1 form to get the Italian residency in the first place.

Thank you all so much, that is exactly the information I needed.  I had been told that no cover was provided in Italy by an S1 which is clearly wrong. It sounds much like France where, like the French, one would get around 70% of most things covered and either pay for or have top-up insurance for the remainder. Once a properly accredited resident of course.
We have made no decision yet on where to retire and as our French is not too bad would probably opt for France if anywhere. It is helpful though to get insights into various regimes in case we decide, for instance that we prefer the lifestyle in a particular place.

Admin wrote:Sorry - I should have been clearer. If you have joined the Italian SSN then you are entitled to an Italian EHIC card which gives you cover for treatment in the UK when you visit. My point was that you must choose which country you are resident in and choose a health service to belong to. You cannot belong to both the NHS and SSN at the same time.I'm not sure that link applies in this case Steve as the OP would be resident in an EU/EEA country and that link is for visitors from outside this area. The OP would be covered by their Italian EHIC.Yes, you are absolutely correct - you must be formally resident in Italy (if you are a pensioner) to join the SSN. You will also need to show the S1 form to get the Italian residency in the first place.

No Admin it is me that should be sorry...! You are absolutely right, the link is for non EU states.

However I was sure it did apply, so dug further. I looked at this Guidance LINK , and it would seem indeed from Regulation 23 that anyone (this bit surprised me) that has had 10 years UK continuous residence can get treatment. I've not looked for it, but I'm also sure you would get treatment if you were back in the UK for good. Obviously the easy solution is to take an Italian/French EHIC with you, assuming they will give you one...

Steve you are right, if you are a British Citizen you are entitled to treatment in the UK no matter if you are resident elsewhere.

Flip wrote:Steve you are right, if you are a British Citizen you are entitled to treatment in the UK no matter if you are resident elsewhere.

Mmmm, Flip you might have to define "Britsh Citizen" a bit more, best wait until tomorrow 

British Passport Holder with right to live in UK.

But Flip, only under the EHIC arrangements. You have no right to a GP etc.

Admin, I think Flip was just being Flip... But also "absolutely correct", and amusing, well I see the funny side of it. However I do think these topic are important and best thrashed to death... Until there is a consensus (or not). It's a bit like a wiki edit, except all over the place. Yes it can be boring, but likely not to those looking to find out what an S1 covers these days. I (and I'm sure everyone here) fully appreciate the time and effort you put in to these subjects. Love the over all picture for the things like residency and tax, where they are updated to cover changes, but realise how much time and effort this must take.
Sorry Flip if I misunderstood your post, but it did in any case make me chuckle.

Should have added, I do think reading the guidelines the NHS have (people would be dead if they have to read all those for every case), that the OP at least would be entitled without an EHIC, it in fact states in there (where they have 10 years continuous UK residence) that they don't need one, but if they do have one to still take the details as they could still get the cash back for the UK...

Admitted the subject is a nightmare and open to interpretation, if you are British, back on a visit to the UK,  the EHIC obviously applies, but if you land back there after being resident in another say EU country, you would have to register with a GP practice but that would be a formality no? Would you then have to get a new NI number? What if you're over retirement age? So many variables.

Well one I can answer for definite, your NINO (National Insurance Number) is for life!

stevegwmonkseaton wrote:Well one I can answer for definite, your NINO (National Insurance Number) is for life!

Used to be, you can change it in special circumstances.