prescription charges

reme5969 Image
09/10/2010 - 08:56

can anybody assist me? we are planning to move to southern Italy in the near future and have a question about prescription charges. At present both my wife and i get free medicaton due to cronic conditions, mine diabetes wife's thyroid, can we still obtain frree medication in Italy as over here?



once you are over here ie. resident you can enroll on the national health system (which for EU nationals is all quite simple) once done your local gp will issue the prescrptions for the drugs you require these chronic conditions are treated the same here as in the UK and for those you won't have to pay.You may well have the pleasant suprise of receiving better ie. new improved drugs that the NHS don't give you due to their budget restrictions.You will probably find that in the better hospitals the treatment is better than in the UK and after spending most of my life here i have no complaints at all.

You will only get free prescriptions if you fit the following criteria:-

  • You are registered with your Local Commune as a Resident with a Doctor.
  •  Over 65 or Employed and paying Italian National Insurance
  • The medication is neccessary due to your condition (Astma, Diabetis, Heart Attack etc)
  • EU citizen

If you don't fit these then you will need to have Priavte Health Insurance that will cover it. Check all the Details on your local Health web site.

Sebastiano is essentially correct. Once you have residency in Italy you are entitled to have full health care and are also eligible for drugs which, once prescibed by a doctor here, you only pay the standard prescription charges for. If you have a chronic illness you can request a special card from your ASL office which will give you the required drugs free of all charges, including prescription charges. You can pay privately for anything if you want to, which for tests and hospital check-ups will vary according to the speed with which you are seen (ie private) and how important the proceedures are - if you want a hair transplant, for example, you will have to pay. If you don't have residenza you are not entitled to anything other than emergency treatment once you are outside of the terms of the European Health Card, which is the scheme that the UK has signed up for. If you are extra communita - ie American, Australian, etc - you only have access to private health care, which can be accessed by insurance or wallet. Simple really.

Melbreak. Easy to see how much better the hospitals here are in my experience. Pneumonia, radiologist said I should go straight into hospital for 1 week .......... 2 weeks later they found after the pneumonia had cleared, that there was a bad heart valve as well. Referred to another cardiac hospital....... 2 days of tests....... weekend home.... Monday in specialist hospital ......... valve replacement on wed ...... home tues after. Some of the drugs were E50 for the time I had to use then, but for the prescription they were free, as were the blood tests for the warfarin levels for 3 months. Would you get that on the NHS?

In reply to by Badger

 My question was, how can you compare the NHS with the Italian health service!! If you make a statement you need to back it up with some constructive comments. It was your comment that you have lived most of your life in Italy, Have you had experience of our NHS!!.

Pay attention. Flip is  correct. Incidentally, I was in A&E  in Brindisi at Easter, very similar to my experience of A&E in Dundee in January. I certainly would not rubbish the NHS. In my experience there are just the same type of chronic smoking related health problems in Italy as one sees in most of the UK and the Italian health service is even more strapped for cash than the UK. Obviously there are variations across the country. However , if you are less than 65 then you realy need Private cover or buy extra NI contributions- if they let you.

Slightly at a tangent, I am given differing advice regarding payment for tests and visits to specialists.And remain confused. What are the guidelines regarding payment?.I will have been resident for 5 yrs after Feb2011, am over 60, and have my Tessera. I was also wondering if charges were income based. Perhaps Sebastiano as a long term resident can give a definative answer.

I recall nearly three years ago asking a similar question. There is indeed an income based factoring, in that (I believe) if you have income (not sure what the definition of the word income is !) of OVER 13,000euros (or thereabouts) you 'pay the ticket' at your age. Over 65 it is all free. Prescription medicines (non chronic illness related), you pay for. Xrays, blood tests, cardiographs, ECGs etc you pay for. (see my other note about Comune interpretations!) Happy to hear alternative views! S    

I'm always amazed at how people that don't live in Italy think they know "the answers" to how things work here. If you actually live here you will need residenza to get a doctor. Once you have a doctor you are in the system, so all of the services are there for you as for any Italian. I've already told you how prescription charges work here, so won't say again - up to you if you want to read it or not. If you don't have residenza here, you are treated as a tourist with health services open to you if your home country has an agreement with Italy - which means that if you are American, you have none apart from basic emergency care as we have available to us in America. To get residenza you must have either a job here (tax payer), a pension or have private health insurance. The 5 year permanent residency has nothing to do with health care - only your residenza entitlements. It's really simple and not hard to comprehend, is it? It really doesn't matter what the British health service is like if you are here, does it? You might not like the Italian health service but, really, what are you doing living here if that is so. Just come here on your holidays and get holiday health insurance, then go back home to your "lovely" NHS hospitals. Job done.

Beeryspice...............I understand and sympathise with your frustrations. There are a LOT of answers already in this Forum (if 'one' could find them), but equally, there will be lots of 'the same' questions cropping up regularly (Cars, Insurance, Healthcare, UK TV, Internet etc etc). I am getting to know 'how it works' here, but there does appear to be at times a different 'interpretation' of rules almost Comune to Comune. I am delighted for people to 'repeat' post here especially if I can offer a view (no matter how good or bad). Your response is very clear and succinct, but there will still be others asking the same question again and again for sure! As we (used to) say in Liverpool..............'calm down, calm down.! Have another spicy beer !  yes ciao ciao.......... S

Obviously if it were simple Beeryspice, I and others would not be asking questions, and this forum would probably not survive, mostly the answers are helpful and polite. Even after 5 years it is still a learning process, perhaps I might some day reach the dizzy heights of "knowing it all" but doubt it. Meanwhile am happy to exchange and share information.

Sorry, but my personal experience has been different from Beeryspice's.   I did not find,  "To get residenza you must have either a job here (tax payer), a pension or have private health insurance." to be the case.  I  guess I am a bit duro di comprendonio.  For me also many times things are not really simple and are hard to comprehend. Valle San Giovanni

I never said anywhere in my comment that I had lived most of my life in Italy, so I do not know where you managed to read that. In fact my time here is about 6 years. Obviously I have had experience of the NHS, long waiting times for tests, consultant visits, mri's etc, plus the A&E departments having to wait for hours to be seen. I have not come across this here......... but perhaps someone else has?  Re prescriptions and healthcare, I am resident, as only 61, but under my wifes E121 as I have been for a number of years, so therefore covered without having private medical insurance or paying for any other cover. Hope this clarifies a few points

You're not totally correct in saying 'To get residenza you must have either a job here (tax payer), a pension or have private health insurance', and that once you have it then you're all covered by the Italian ASL. You only need to provide proof  of Basic Health Care when applying for residence and also your Health Card is the same as any other only your record with your Doctor and how they charge for the medicine varies. You will need to maintain a higher form of Health Insurance that covers for Prescriptions if you wish to have the same as every Italian Citizen (I know because my wife is Italian and she gets the full works including free prescriptions for 'Critical' illnesses). The best advice for anyone is look at the Italian Health web sites where it spells out your entitlements, and if you need to get Insurance check on what you're entiltled to.

You are making the mistake of thinking that health cover here is not tied to your residenza - it is. You may well have an Italian wife, but my claim is based on my being Italian (although brought up in London mostly), with all my family being Italian as well - so let's not play the "I'm more Italian than you" game. Your comune will interpret the private health insurance issue in it's own way when you apply for residenza, which no amount of arguing the point will change, so don't play the beligerant, "I'm European/British" card or you may well come a cropper. When you get your Tessera Sanitaria you can register with a GP of your choice if his "list" is open. This is the open door to the Italian state health card system. If you have no residenza, you have no health cover other than as I said above. Is it really so difficult to understand? It's simple and logical.

Sorry Beeryspice but I am afraid this "The 5 year permanent residency has nothing to do with health care - only your residenza entitlements." is not correct. It is only once you have your "attestazione di soggiorno permanente" after living here for 5 years (not residency for 5 years - subtle difference) that you are entitled to equal treatment as an Italian within the SSN. Until then, there are various different levels of cover depending upon whether you are in receipt of the state pension in the UK or have paid NI contributions in the UK for the 2 years before you moved here. The law changed in 2007 unfortunately. I can point you to lots of documents explaining it all in great detail in the Marche Healthcare group.

It's all getting a bit fraught....  My two penn'orth is as follows, which is largely in line with Beeryspice, but with one important exception..... It has everything to do with residence, but whereas until your permanent residence is established you have to prove every year to the ASL that you have teh right to healthcare - showing income, insurance and/or INPS payments, after the 5 year limit that requirement is dropped and you are treated equally to an italian so dont have to jump through the 'residence' hoops from that point on.  Before the 5 years is up you must show that you have the prerequisites for residency, even though you will already have residency. How each comune, province and region interpret this is of course wildly different. Health care in Italy is not entirely free at the point of delivery.  You will pay for prescriptions, blood tests and scans etc, unless you are exempt - pensioner, registered disabled, or have an income below 7000 euros a year and produce the requisite form.  Emergency care is always free.  To have a doctor and be registered at teh ASL you must have residency.  Whether you get residency with your EHIC card, or private health insurance is again down to whether your comune reads the official circulars from the Ministry.   As to the 'my NHS is better than your NHS' argument - grow up all of you.   There are good hospitals and bad hospitals - the systems are virtually the same, the practise is wildly different.  Being ill and in need of hospital care in a metropolis of 10 million people is completey different from going down the local hospital in a town of 50,000 - whether its better or worse is down to the hospital in question, but lets stop the broad brush approach.. it helps nobody.  

My poor chap, I am not playing any 'game', I am fully covered by the system and know that it is all down to the 'Commune' as to what they deem acceptable, not some 'Barrack Room know it all', wether he/she is Italian or not, doesn't seem to cut any mustard with that fact.  Many people will not know of their rights or entitlement until they get ill and then it can be too late. As I said get the information from the health site and work with that and if you look up previous posts on this subject especially from Penny, then you may be aware of some of the problems people have. So for you to quote the 'I'm  more Italian than you' thing is purely infantile.

In reply to by Flip

What is it about this user who chose the name 'Beeryspice'? Designed to be a troll! Ram (as usual) is giving pretty okay advice, but there are so many places that people are coming from (as in EU, US, resident etc etc), but the prophet Beery has got it all sussed - I think not. Beware false prophets is all I can say.

Sorry reme - your question has engendered a lot of sniping between people who use this site (and who are usually pretty helpful, and the helpful posters do not appreciate input from opinionated idiots) - but actually nobody has answered your questions. If you were to be considered to be entitled to use the Italian health service (by virtue of having lived in Italy for five years, or having taken out a not expensive insurance, or having attained the age of 65), then for sure medicines for chronic conditions are free - as they are for all Italian citizens. Your potential difficulty arises if you find yourself attempting to rely on an EHIC card. Despite what is says on the tin, this is NOT a carte blanche to free health cover (okay, it covers emergencies) and nobody on an emergency basis is going to deny you insulin or whatever, but in order to get yourself onto the 'free medicine' trail you are obliged to enrol yourself with an Itaian medico (after having established residency). Becoming a resident (maybe you do no wish to do this?) involves income assessment plus demonstrating health insurance. Nothing is impossible! Good luck

I have asthma and receive free medicines for that condition in Italy, once signed on with a doctor and with the Tessera Sanitaria. I also received free treatment using my European Health Card from the UK.  However they do not have the exact same medicines here that I was taking in the Uk so I have to adjust the doses slightly. In UK I paid a prescription charge for each medicine - over £35 per month - as I am not receiving my pension yet, so in that respect it is good. When I had an infected insect bite the antibiotics were free but I had to pay for the cream.  Although this is my experience here in Toscana, I think the health rules may differ in other regions. Rosietat