SANITARY ASSISTANCE IN ITALY

Sanitary Assistance

When you travel it is necessary to know which precautions to adopt before leaving, how to behave and to whom to address in case of disease or simple malaises.
Every country has precise rules on the distribution formalities of the sanitary assistance to Italian or foreign citizens. It is necessary to inquire yourself in time in order not to get lost in a water glass and to benefit from first need services in case of emergency without any problems.
 

National Health Service

The National Health Service - SSN is the agency appointed by the Ministry of Health with a view to regulating all the activities and guaranteeing medical assistance, health promotion and diseases prevention. The SSN is constituted of agreed public and private structures.
In Italy the Sanitary System is of a state type, organized independently on regional basis (therefore there could be some differences in the level of the service offered in the various regions) and has often specialized hospital structures (dermatology, ophthalmology, and so on).

The E-111 model

The E-111 model (green booklet) is an international document that extends the national sanitary cover to the European countries that have stipulated the agreement allowing those who possess it to use the structures and the services of the Italian National Service at the same conditions of the Italian citizens.
It is important before coming in Italy to get this model at the Sanitary Service offices of the city of origin.

For those who have the E-111 model:
in order to carry out specialistic medical visits or no urgent examinations, the holders of the E-111 must ask for the panel doctor's prescription, a doctor that works for ASL (Local Sanitary Company where is available the list of the doctors operating within the national health service).
After having obtained the request you must go to a hospital that has a specialized unit, reserve the visit or the examination and later on pay an amount (ticket) to the agreed bank.
Some ASL, nursing homes and hospitals put at the customer's disposal intercultural mediators with a view to making easier the communication with doctors and nurses and giving detailed explanations on the SSN operation.

For those who don't have the E-111 model:
For specialistic medical examinations or no urgent examinations, the ones who don't have the E-111 model will be able to address to doctors and private structures paying services or to the public structures that practice the Italian State's rates. In this case the citizen of the European Union will be able to ask to the mutual case of the country of origin the reimbursement for the sanitary expenses faced.

In case, for whichever reason, it has not been possible to use the E 111 model, while back in native country you can ask your Assurance Agency the reimbursement of the sanitary expenses faced. This possibility is valid just presenting the receipts of payment and the sanitary documentation.

Public sanitary assistance

If you have the statement of stay or the residence permit of a period not inferior to one year, you have the same rights of the Italian citizen. The assistance is extended to younger sons registered in the statement of stay or the residence permit.

Foreign people not in possession of the residence permit

A foreign person without residence permit who uses all the sanitary services is not signalled by sanitary operators to the Judiciary police.

The ASL you belong to assigns the foreign person a card called S.T.P (Foreign Person Temporary Present) that he has to show in order to use the sanitary sevices and that must be renewed every six months in the place in which it has been issued the first time.
They are guaranteed free of charge:

  • In the public structures operating within the national health service, urgent or essential surgery and hospital treatments, even if continuative, for disease and accident;
  • The base sanitary assistance;
  • The distribution of some services such as the assistance during pregnancy and for the interruption of pregnancy, the assistance to the minor, the prevention, the diagnosis and the treatment of infectious and spreading diseases;
  • The free essential medicine distribution.

Temporary stay in Italy not for job reasons

It is possible to obtain direct services in public and private structures recognized bythe National Health Service which is constituted of a Local health units and hospitals net (USL) dislocated on all the territory.
For direct services we mean sanitary treatments provided free of charge, except for the payment of a ticket moderateur on the treated person's expenses.
For this aim, the Ministry of the Health has instituted a special carnet that is made out by the USL (that in some regions is called ASL, AUSL, and so on) to all those who present the communitarian certificate (the most frequent is the E 111 form).
On this carnet (called "modular- booklet" and valid on all the Italian territory) are written down the instructions to obtain the sanitary services in the outpatients' departments and the hospitals of the Italian National Health Service managed directly or in the private recognized structures.

It is possible to have further information through the site of the Ministry:
http://www.ministerosalute.it/assistenza/approfondimento/

Sanitary emergency

118
In case of emergency it is possible to call from all the national territory the free telephone number 118. In the cases in which it is not necessary the transport in hospital the service of medical guard (diurnal and nocturnal) is activated, while the service of ambulance or helicopters ambulance (helicopters) is active in the cases in which the transport in hospital is necessary.
The helicopter ambulance service is active just in some regions for very serious car incidents or for incidents in mountain so as to make faster the transport of the wounded people.
The 118 head office is operating 24 hours out of 24 and is in contact with assistance services, the hospitals and the other agencies that take part in emergency case (Civil Protection, Firemen, National Fire Department, and so on).
 

Useful references:

  • Sanitary emergency in Italy: http://www.118italia.net/
    It describes the services of sanitary emergency and operating head officeo f the 118 available in Italy: ambulance, medical urgency car, medical urgency motor-bike, helicopter ambulance, helicopter aid.

Hospital - First Aid
In the main hospitals there is a service of First Aid which is free and guaranteed to every Italian citizen.
Also foreign people belonging to the European Union can use this service free of charge, but only if they have the sanitary card or a medical assurance.
If they do not possess the card TEAM, expenses for the sanitary services must be paid by those who use them, that will ask for reimbursement from the mutual case of the country of origin (using the E126 model).

It is possible to have the addresses of Italian hospitals through the site: http://www.ministerosalute.it/infoSalute/atlanteHome.jsp?menu=atlante

Sanitary emergency on public holidays
During festivity, according to the gravity, can:

  • Contact the domiciliary medical guard, whose telephone number varies from city to city and can be found in the first pages of the telephone directory or dialling the 412 of Telecom (892412 for those who call from a cell phone).
     
  • Go to the First aid of a hospital.
  • In case of emergency call the 118 in order to put yourself in contact with the operating head office that coordinates the sanitary aid from the emergency place to the admission to hospital.

Useful information and web addresses in case of emergency

Ticket and Exemption

The ticket is the rate to pay in order to use a determined sanitary service (specialistic visits, laboratory examinations, drug prescription and first aid services).
The price depends on the type of examination and/or visit and on the type of structure you address to. In some cases it is possible to ask for the ticket exemption in order to avail free of charge of some treatments. The exemption is given on the basis of the age, the registration in the placement lists, the income and the type of disease.
 

Hospitals Treatments
The hospitalizations are ticket free.
However, if you wish a greater comfort, with the payment of a ticket every day, you can obtain a private room.
The admission to public Hospitals (and recognized private ones) can occur, both directly through the "first aid" delivering directly the E111 form, and on the basis of the panel doctor's prescription (using the "Carnet of the health", a bunch of green coloured sheets on which the doctors, the foreign citizen go to, prescribe both specialistic examinations and pharmaceutical products).

Medical guard

The medical Guard is a free domiciliary service supplied by the SSN that guarantees urgent medical examinations in the hours in which the panel doctors and the base paediatrician are not available. The doctor of the medical guard can prescribe medicine but, just those in use for therapies of urgency in the sufficient amount for three days, and moreover he can propose the hospitalization. You can find the telephone numbers in the first pages of telephone directory.
Interventions, in case of nocturnal, festive and prefestive, domiciliary and territorial urgencies, are guaranteed from 14.00 of the pre-festive day to 8.00 of the day after the public holiday and from 20.00 to 8.00 every week days and services are the same as those of the general medicine doctor.
 

Tourist medical guard
The tourist medical Guard is a seasonal service of sanitary assistance, available in venues with consistent tourism, for no resident people, and behaves the same way as the medical guard, guaranteeing on the contrary, the assistance, for the entire day.

Advisory bureaux

In every A.S.L. are available advisory bureaux , that have, by law, to assist free of charge all the pregnant women, even if they do not have the residence permit, let alone their sons until they are out of age. In the advisory bureaux are carried out individual, couple, group activities and are guaranteed, in particular:

  • Health Assistance of the woman in pregnancy.
  • Assistance to the woman who decides to interrupt the pregnancy.
  • Information and orientation on the contraception.
  • Sanitary Assistance to the foreign children not enrolled in the National Health Service.
  • Preservatives free controls.

You can avail of all these services, in a free way and without the family doctor's prescription, going personally to the same advisory bureau in order to fix an appointment or taking the appointment by telephone.

Pharmacies

Before leaving on a trip, it is advisable to buy the medicines you could need and that could be difficult to find.
This above all because in Italy not all the medicines can be bought freely, most of medicines need a doctor's prescription.
Moreover, in case of visits to not urban regions, the pharmacies could not be much widespread.
In turn, both in the cities and among small townscouncils, are guaranteed the service at night and during public holidays: you can find in all the pharmacies the list of the nearest pharmacies on duty, open at night or during public holidays.
In a city centre, it is possible to consult the list of the nocturnal pharmacies in the local pages of the main daily paper.

Useful references:

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