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HEALTH

Trouble proving residency rights leaves Brits in Italy paying €2k health charge

Amid a lack of clarity about who has to pay Italy's increased healthcare fees, citizens' rights campaigner Clarissa Killwick says British nationals are wrongly being charged despite having permanent residency rights.

Trouble proving residency rights leaves Brits in Italy paying €2k health charge
The huge increase in Italy's minimum healthcare fee puts British residents' difficulties in proving permanent residency rights into sharp focus. Photo by Martha Dominguez de Gouveia on Unsplash

UK nationals living in Italy are stuck in limbo: being permanent residents but unable to prove it.

A permanent resident has at least five years’ residency, whereas with less than five years you are an ordinary resident.

Why does this matter? Under the Withdrawal Agreement (WA), a permanent resident can be absent from Italy for up to five years in one go whereas for ordinary residents it is generally a maximum of six months per year. Consider someone who needs to return to the UK temporarily to care for elderly or sick family members, for example. 

Secondly – and this clearly would affect more people – there are important implications regarding healthcare. And having continuous healthcare cover in some form is required for maintaining legal residency.

Broadly, under the Withdrawal Agreement, WA beneficiaries must receive equal treatment to EU citizens in their host countries. EU citizens in Italy with an “attestazione soggiorno permanente” qualify for free registration for state healthcare, (as do ordinary residents who are employed/self-employed, amongst others such as S1 holders.)

For those who don’t qualify for free registration, the options are private healthcare insurance or voluntary contributions to the state system. 

From 2024, minimum voluntary contributions have jumped from just under €390 to €2,000 per year per person – an increase of around 500 percent. That’s without going into detail into how students are affected.

READ ALSO: Do Italy’s British residents have to pay the €2,000 healthcare fee?

As yet there are no unequivocal guidelines as to who exactly is in scope of these new rules – just non-EU citizens, or non-EU and EU, therefore WA beneficiaries too?

There could also be a legal argument concerning the principle of proportionality given the size of the increase. 

In the meantime, some UK nationals are already being charged €2,000 by their local health authorities. This is particularly harsh for those who are permanent residents, as they should not be paying at all.

Why can’t they evidence their status? Some town halls are refusing to issue WA beneficiaries the attestazione di soggiorno permanente, the same as they do for EU citizens. This is in spite of an Italian government circular stating it should be provided. (Circolare n. 2/2021 Oggetto: Brexit – Attuazione dell’Accordo sul recesso del Regno Unito e dell’Irlanda del Nord dall’Unione Europea.)

The best evidence of residency status for WA beneficiaries is the WA biometric residency card from provincial immigration offices but a significant number are refusing to issue a permanent card, (carta di soggiorno permanente Articolo 50 TUE), until five-year ordinary residency ones expire. This is in breach of the Withdrawal Agreement under article 18.4.

Even when immigration offices are willing, there can be very long delays. Communications can be difficult or, in the case of the Perugia questura, for example, non-existent.

READ ALSO: What you need to know about Italy’s €2,000 healthcare fee

In another region, one of our members has managed to get the permanent card but her health authority will not accept it for free registration. We have communicated, via the embassy, that the guidelines need to be very explicit about WA beneficiaries so there is no room for doubt or misinterpretation.

There is limited support for British citizens in Italy experiencing problems related to the Withdrawal Agreement as resources have been cut back. Some manage to get help, otherwise the standard advice from Consular Services to those in difficulty is to find a lawyer. 

The particular issue of being unable to prove permanent residency is not new – we’ve been raising it for around two years with the embassy in Rome who, in turn, engage with the Italian government. We also discussed it directly with the European Commission last May. 

But the huge increase in minimum voluntary healthcare contributions puts the seriousness of this failure into sharp focus.

One member and her husband have been paying unnecessarily for some time, at the old rate, and will have to pay the new fee if they don’t get any joy soon. They have been here nearly seven years. All their efforts so far to evidence their permanent residency – including appealing to the embassy for help – have proved fruitless. 

And it is very stressful for those who have not quite reached permanent residency, with no certainty of how they will be able to prove it. 

In one such case, a woman in our group who will struggle to meet the new cost has type 1 diabetes, amongst other health issues, but without insulin quite simply she would die. She says she is stuck because she doesn’t have the money to return to the UK either.

As always, the vulnerable and those on low incomes will suffer the most.

Clarissa Killwick.

Since 2016, Clarissa has been a citizens’ rights campaigner and advocate with the pan-European group, Brexpats – Hear Our Voice. She is co-founder and co-admin of the FB group in Italy, Beyond Brexit – UK citizens in Italy.

Member comments

  1. Hello. Are all PERMANENT non-EU residents (such as Americans) qualified for free healthcare, not just permanent residents from the UK who qualify as WA beneficiaries? Where can I find the information regarding these possible rights?

    Many thanks!

  2. We moved to Italy in 2020 before Brexit and obtained our residency before the
    deadline. We have got our Carta di Soggiorno cards. We have been paying the voluntary health contributions for the past 3 years. We are now being asked to pay the full €2000 each before we could get our Tessera Sanitaria cards.
    Should we be paying the full €2000 or are we entitled to pay the reduced voluntary contributions as per previous years.

    1. Hi Steven,

      I’m sorry to say the full €2,000 is the new minimum fee, and this applies to everyone who has until now been paying the voluntary healthcare contribution at a lower rate. (If you’re in any doubt though about whether you should be paying this, check with your ASL office.)

      Here’s all the info we have so far about how it works: https://www.thelocal.it/20240110/qa-what-you-need-to-know-about-italys-e2000-healthcare-fee

      – Clare

  3. Thanks Clare for clearing this up for me. I am not happy about the situation as being on a small pension, this amount takes up nearly a quarter of our total annual income.

    1. Glad to be able to help Steven and I’m really sorry to hear you’re having to pay it. It is a huge amount of money, and I know quite a few of our readers are in a similar situation after having budgeted for lower fees when planning their move to Italy.
      All best wishes,
      – Clare

  4. We’ve been resident in central Italy for over 5 years and were able to get the appropriate attestation last summer from our village Comune, with no difficulty. We now both have the long-term Tessera Sanitaria.

    Our Comune did ask me to bring all my payment receipts from the last 5 years, to show that we had actually paid into the Italian health service for this period. I’d for some reason kept them (and the expired cards), so was able to provide what was requested.

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EES PASSPORT CHECKS

How will the new app for Europe’s EES border system work?

With Europe set to introduce its new Entry/Exit biometric border system (EES) in the autumn there has been much talk about the importance of a new app designed to help avoid delays. But how will it work and when will it be ready?

How will the new app for Europe's EES border system work?

When it comes into force the EU’s new digital border system known as EES will register the millions of annual entries and exits of non-EU citizens travelling to the EU/Schengen area, which will cover 29 European countries.

Under the EU Entry/Exit System (EES), non-EU residents who do not require a visa will have to register their biometric data in a database that will also capture each time they cross an external Schengen border.

Passports will no longer be manually stamped, but will be scanned. However, biometric data such as fingerprints and facial images will have to be registered in front of a guard when the non-EU traveller first crosses in to the EU/Schengen area.

Naturally there are concerns the extra time needed for this initial registration will cause long queues and tailbacks at the border.

To help alleviate those likely queues and prevent the subsequent frustration felt by travellers the EU is developing a new smartphone app.

READ ALSO: What will the EES passport system mean for foreigners living in Europe?

The importance of having a working app was summed up by Uku Särekanno, Deputy Executive Director of the EU border agency Frontex in a recent interview.

“Initially, the challenge with the EES will come down to the fact that travellers arriving in Europe will have to have their biographic and biometric data registered in the system – border guards will have to register four of their fingerprints and their facial image. This process will take time, and every second really matters at border crossing points – nobody wants to be stuck in a lengthy queue after a long trip.”

But there is confusion around what the app will actually be able to do, if it will help avoid delays and importantly when will it be available?

So here’s what we know so far.

Who is developing the app?

The EU border agency Frontex is currently developing the app. More precisely, Frontex is developing the back-end part of the app, which will be made available to Schengen countries.

“Frontex is currently developing a prototype of an app that will help speed up this process and allow travellers to share some of the information in advance. This is something we are working on to support the member states, although there is no legal requirement for us to do so,” Uku Särekanno said in the interview.

Will the 29 EES countries be forced to use the app?

No, it is understood that Frontex will make the app available on a voluntary basis. Each government will then decide if, when and where to use it, and develop the front-end part based on its own needs.

This point emerged at a meeting of the House of Commons European scrutiny committee, which is carrying out an inquiry on how EES will impact the UK.

What data will be registered via the app?

The Local asked the European Commission about this. A spokesperson however, said the Commission was not “in a position to disclose further information at this stage” but that travellers’ personal data “will be processed in compliance with the high data security and data protection standards set by EU legislation.”

According to the blog by Matthias Monroy, editor of the German civil rights journal Bürgerrechte & Polizei/CILIP the Frontex app will collect passengers’ name, date of birth, passport number, planned destination and length of stay, reason for travelling, the amount of cash they carry, the availability of a credit card and of a travel health insurance. The app could also allow to take facial images. It will then generate a QR code that travellers can present at border control.

This, however, does not change the fact that fingerprints and facial images will have to be registered in front of a guard at the first crossing into the Schengen area.

So given the need to register finger prints and facial images with a border guard, the question is how and if the app will help avoid those border queues?

When is the app going to be available?

The answer to perhaps the most important question is still unclear.

The Commissions spokesperson told The Local that the app “will be made available for Schengen countries as from the Entry/Exit System start of operations.” The planned launch date is currently October 6th, but there have been several delays in the past and may be another one.

The UK parliamentary committee heard that the prototype of the app should have been ready for EU member states in spring. Guy Opperman, Under-Secretary of State at the UK Department for Transport, said the app will not be available for testing until August “at best” and that the app will not be ready in time for October. The committee previously stated that the app might even be delayed until summer 2025.

Frontex’s Särekanno said in his interview: “Our aim is to have it ready by the end of the summer, so it can then be gradually integrated into national systems starting from early autumn”.

READ ALSO: How do the EES passport checks affect the 90-day rule?

Can the system be launched if the app is not ready?

Yes. The European Commission told The Local that “the availability of the mobile application is not a condition for the Entry/Exit System entry into operation or functioning of the system. The app is only a tool for pre-registration of certain types of data and the system can operate without this pre-registration.”

In addition, “the integration of this app at national level is to be decided by each Schengen country on a voluntary basis – as there is no legal obligation to make use of the app.”

And the UK’s transport under secretary Guy Opperman sounded a note of caution saying the app “is not going to be a panacea to fix all problems”.

When the app will be in use, will it be mandatory for travellers?

There is no indication that the app will become mandatory for those non-EU travellers who need to register for EES. But there will probably be advantages in using it, such as getting access to faster lanes.

As a reminder, non-EU citizens who are resident in the EU are excluded from the EES, as are those with dual nationality for a country using EES. Irish nationals are also exempt even though Ireland will not be using EES because it is not in the Schengen area.

Has the app been tested anywhere yet?

Frontex says the prototype of the app will be tested at Stockholm’s Arlanda Airport, in Sweden. Matthias Monroy’s website said it was tested last year at Munich Airport in Germany, as well as in Bulgaria and Gibraltar.

According to the German Federal Police, the blog reports, passengers were satisfied and felt “prepared for border control”.

This article is published in cooperation with Europe Street News.

 
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