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HEALTH

Who would be affected by Italy’s plan to charge €2,000 a year for healthcare?

Italy's government has said it wants to charge a €2,000 annual fee for some foreign nationals to register with the Italian national health service - but it's not yet entirely clear who this would apply to.

Who would be affected by Italy's plan to charge €2,000 a year for healthcare?
(Photo by Alberto PIZZOLI / AFP)

We now know that the plan to introduce a €2,000-euro charge for healthcare mentioned in a budget statement by Italy’s economy and finance ministry on Monday will not in fact apply to all non-EU nationals, as it appeared to state.

According to a clarification from the health ministry on Tuesday, the charge will only apply to non-EU nationals who already have to pay an annual fee to use the public health service (servizio sanitario nazionale, or SSN).

The rule contained in the 2024 budget draft is “limited to updating the stipulated lump-sum contribution,” the health ministry said, suggesting that the new charge would replace existing annual registration fees, rather than being an additional fee.

So it doesn’t appear to be a blanket charge applied to all non-EU nationals as many initially feared – and it doesn’t look like this will apply to people who are currently exempt from paying annual registration fees for Italy’s health service (those who are entitled to free healthcare under ‘mandatory’ registration, or iscrizione obbligatoria.)

But for many others, it seems that – if this proposal becomes law – they could face higher charges.

READ ALSO: What we know about Italy’s plan to charge non-EU residents €2,000 for healthcare

Many of Italy’s international residents are required to pay an annual fee (the “lump-sum contribution” the health ministry referred to) if they choose to register with the SSN under what’s called ‘voluntary’ registration, or iscrizione volontaria.

(You can read more about the two different types of registration in a separate article here.)

Under the government’s proposal, it seems people in the ‘voluntary’ registration category are the ones who could face a steep increase in fees from next year.

The SSN registration fee starts at €387.34 and goes up to a maximum of €2,788.86, based on your income and other factors. The average payment is around €1,200, meaning that for the majority of people a €2,000 fee would be a sharp increase.

Still others say they’re unclear as to whether or not the charges would apply in their circumstances.

With very little information about the plans announced so far, a lot of questions remain about exactly who the charge would apply to.

Many of The Local’s readers have expressed concern and frustration about the lack of detail given so far, with some saying that, as they did not factor a €2,000 healthcare charge per family member into their budget when they moved to Italy, they would struggle to afford this extra cost.

Based on the information available so far, the main – and perhaps only – factor determining whether or not someone will face the €2,000 charge so far appears to be whether or not they are signed up to the SSN via voluntary or mandatory registration.

Announcements so far have not dealt with the issue of whether British nationals who were resident in Italy before the end of December 2020, and who are therefore covered by the post-Brexit Withdrawal Agreement (WA) would be treated like EU or non-EU nationals in the application of this rule.

The WA provides that British nationals who were legally registered as resident in Italy before the Brexit date should be treated the same as EU citizens in Italy.

There has also been widespread confusion among Italy’s international residents about what it means to pay a registration fee for the SSN.

This fee is charged annually upon registration with and subsequent renewal of registration with your local health authority, which entitles you, among other things, to register with a medico di base (family doctor, or general practitioner).

It’s important to note that this fee is not the same thing as the INPS (health, social security and pension) payments due if you’re obliged to pay your own contributions in Italy, such as in the case of those who are self-employed under a partita IVA.

In this case, you would be entitled to ‘mandatory’ registration with the SSN, with no fee – but as INPS contributions in this case are charged at around 23-26 percent of your income, the total of these payments usually comes to much more than 2,000 euros a year.

Anyone who is signed up to the ‘voluntary’ system can effectively opt out of the public system and choose to pay for private healthcare instead. However, whether or not this would prove better value than a 2,000-euro fee will depend on the type of healthcare coverage you need.

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For members

TOURISM

Flights, hotels, beaches: How the cost of travel to Italy is rising this summer

Inflation may now be falling but the price of a summer holiday in Italy has risen again - by up to 20 percent compared to last year.

Flights, hotels, beaches: How the cost of travel to Italy is rising this summer

Italian consumer rights groups said last year that the summer of 2023 would be remembered as “the most expensive ever” for travel. But 2024 has already smashed that record, according to the latest price surveys.

The rising cost of air fares, ferry tickets, hotels, restaurants and beach clubs add up to mean a holiday in Italy will be 15-20 percent more expensive this summer compared to last year, according to a survey conducted by the Assoutenti consumer research centre in June.

While price rises in recent years have been attributed to Covid and rising inflation, which is no longer thought to be a factor, this year Assoutenti said high demand was pushing up prices amid the post-pandemic tourism boom.

Prices in Italy were “out of control as a consequence of the resumption of tourism, after the stop imposed by Covid, and the record number of foreign visitors recorded in the last year,” the survey’s authors wrote, calling on the government to take measures to contain price increases.

READ ALSO: ltaly set for summer tourism boom as bookings increase again

They warned that more Italian families were likely to “give up the summer holidays this year, not being able to face an expense that increases from year to year,” and that those who do travel may book shorter trips to keep costs down.

Some 6.5 million Italians say they won’t be going on holiday this summer at all, with half citing economic difficulties, according to a separate survey commissioned by price comparison website Facile.it.

Meanwhile, there had been a nine percent increase this year in applications for personal loans for travel purposes, the survey found.

Flight prices

One of the biggest factors was the cost of air fares, as both domestic and international flights to and from Italy were found to be more expensive again this year.

While the cost of flights between European countries had fallen slightly following inflation-driven price hikes in 2023, Italy was bucking the trend.

Italy’s flight costs had risen instead, according to recent analysis in Italian newspaper Corriere della Sera, with the average price of a summer flight between Italy and the rest of Europe up by seven percent and domestic flights by 21 percent.

READ ALSO: Why are flight prices higher in Italy than the rest of Europe this summer?

Industry sources suggest the price increase is again down to unprecedented demand, while consumer groups say the main culprit is a lack of competition on the Italian market.

Transport costs

There were price hikes too for those using other modes of transport, with the rising cost of fuel and motorway tolls in Italy named as another contributing factor in the Assoutenti survey.

Ferry tickets were also more expensive, it found, with the average increase this August at +6.3 percent compared to 2023.

Hotels and B&Bs

For a family of four, the Assoutenti survey found the most expensive place to stay in Italy this summer was Porto Cervo, Sardinia, where the average price of a week’s three-star accommodation in August came to 3,500 euros.

The cheapest options were found to be Bibione, outside Venice (872 euros) and Rapallo in Liguria (909).

READ ALSO: Tourist tax: How much is it increasing in Italy’s cities this year?

The cost of accommodation at coastal destinations had risen by 23 percent on average overall, a separate survey by consumer group Altroconsumo found.

Hotels in cities were found to be a less expensive option, with most Italian families heading for the beach or mountains to escape the heat.

Restaurants

Adding to the overall cost, prices also continued to rise this year at restaurants in holiday resorts and at beach clubs: Assoutenti recorded an average increase for the catering sector of +3.5 percent on 2023.

Beaches

Renting sunbeds and umbrellas at Italy’s beach clubs is seen as a necessity by many Italian families – and often by international visitors too, given the lack of free options in many areas.

This too was becoming more expensive in 2024, with the average daily rate for a slot at one of Italy’s private beach clubs up by more than five percent on last year. Prices had also risen by as much as 11 percent between 2022 and 2023.

Beachgoers can now expect to pay around €30-35 for two sun loungers and a beach umbrella for the day on average, though prices can rise as high as €90 in Salento and €120 in parts of Sardinia.

Both private and free-access beaches in Italy also increasingly require advance booking due to higher demand.

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