Healthcare after Brexit: What do Brits living in Italy need to do?

After the British government this week urged UK nationals resident in Italy to "check their access" to healthcare, we look at what that actually means.

Healthcare after Brexit: What do Brits living in Italy need to do?
Photo: Depositphotos

On Monday morning, the British embassy in Rome released an announcement that caused further anxiety among the many British citizens living in Italy who are already uncertain about how or even whether their healthcare costs will be covered after a no-deal Brexit

READ ALSO: New campaign urges Brits in Italy to get ready for Brexit

The “Get ready for Brexit” campaign press release and official posters stated that: “As you will be aware the UK is leaving the European Union (EU) on 31 October, whatever the circumstances” before going on to instruct all British citizens resident in Italy to take the following four “priority actions” before the end of the month:

1. Register for residency with the local anagrafe before the 31 October

2. Check your access to healthcare

3. Check your passport is valid for travel

4. Exchange your UK driving licence for an Italian one

While this information isn't new – British citizens living in Italy have long been advised to take these measures as a precaution – the vague point about healthcare caused some concern.

What exactly does “check your access” mean?

“Does anyone know what we should check exactly?” one commenter asked on Facebook on Tuesday after reading the notice. “Does this mean we're losing our right to healthcare?”

The UK government's website provides more information, although it isn't particularly reassuring.

“If there’s no deal, your access to healthcare may change,” the website states. “You must confirm your residency status and decide how you will ensure access to healthcare.”

So what's going to happen if there's no deal?

The website goes on to explain that legal residents in Italy who pay into the public healthcare system “will be covered” in the event of no deal – if an expected agreement is formalised with Italy.

“The Italian no-deal legislation also includes a commitment to continue social security coordination and access to healthcare until 31 December 2020. This includes S1 holders and students.”

Photo: Shutterstock

READ ALSO: What would no-deal Brexit mean for Brits in Italy? Here's what we know so far

“If there’s no deal, and you are a legal resident in Italy on or before 31 October and you pay into the public health care system, through employment or voluntary contributions, you will be covered by Italian no-deal legislation which ensures continued access to healthcare,” it states.

However, this “still requires a formal agreement between the UK and Italian governments.”

The UK government writes that guidance will be updated “when more information becomes available.”

For now, it says, “you should consider registering with the public healthcare system or obtaining private health insurance.”

The short answer, then, is still that no one really knows.

Do we need private health insurance?

According to campaigners, British nationals resident in Italy don't “need go to the expense of private health insurance at this stage.”

After speaking to the British Embassy on September 26th, campaigners from British in Italy wrote in a Facebook post that: “you, as UKinItaly, ie: a UK national resident in Italy, do not need to take any specific steps to safeguard your healthcare at this stage (other than to register as resident and with the ASL if you have not already done so.”


Find The Local's full Brexit coverage HERE

What if I'm a retired UK national living in Italy?

Retired British citizens living in Italy reacted angrily to news last month that they will face losing access to healthcare six months after the date of Brexit.

Britain's health secretary Matt Hancock announced in September that health costs for UK pensioners living in the EU and those with disabilities would be covered for six months if Britain leaves the bloc on October 31st without a deal – which is six months less than the government originally promised in March.

This would affect some 180,000 UK citizens living in the EU who currently have healthcare paid for by the UK under the European S1 scheme.

Tourists who begin their trips to the EU before Brexit and students who began their courses before October would have their health costs covered in the event of a no-deal Brexit, the government said.



Member comments

  1. Here in Umbria EU citizens cannot make a paid for voluntary registration, cannot register without an S1 or cannot register without private health insurance which is unavailable for those with pre existing conditions or employment in Italy. How the hell are we supposed to sort out our healthcare when we fail to meet the criteria. Other regions allow voluntary registration for EU citizens, but not ASL Umbria.

    It’s not just about healthcare though, which is bad enough, it’s about the post brexit carte de sojourno which we will have to apply for. Healthcover is essential for 3rd country nationals applying for CdS. We worry we may be denied conversion of the attestatione di residenzia to CdS and find ourselves losing our rights to residency in our adopted home.

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For members


How to apply for an Italian elective residency visa from the UK

If you're a non-EU UK resident or a British citizen who wants to move to Italy post-Brexit, the elective residency visa is one of the options available to you. Here's how to apply from the UK.

How to apply for an Italian elective residency visa from the UK

Since Brexit was finalised at the start of 2021, British nationals who want to relocate to Italy have been in the same boat as all other extra-EU citizens, requiring a visa to make the move.

For those who receive a passive income and don’t need to work, the elective residency/residence visa (ERV) is a popular choice – though the application process can be confusing.

EXPLAINED: How to apply for an elective residency visa to move to Italy

A recent survey conducted by the Local on the experiences of British citizens moving to Italy post-Brexit found that a number of respondents – mostly retirees – had applied or attempted to apply for this visa.

However many described the process as being far more onerous, complex and stressful than they had anticipated.

One couple who were on their second attempt strongly advised retaining a lawyer, as they found that the information provided by the Italian authorities was not clear or detailed enough to allow for a successful application.

READ ALSO: ‘Seek legal advice’: Your advice on applying for Italian visas post-Brexit

The Local spoke to three experts about how to maximise your chances of success when applying for the ERV.

Most of the advice given was relevant to anyone intending to apply for the ERV, but some related specifically to the experience of people applying from the UK; we’ve compiled that information here.

Because where you’re applying from – rather than your nationality – is the main thing that matters for this application process, this guidance applies equally to non-British citizens who are legally resident in the UK.

Here’s what you need to know if you’re applying for the ERV as a British resident.

Going through an agency

If you want to apply for an ERV from the UK, you’ll likely need to go through VFS Global, an outsourcing agency that handles visa applications for the UK’s Italian consulates.

This is different to how the application process works for people in countries like the US, Canada, or Australia, who usually need to apply directly to the Italian consulate closest to where they are legally resident.

Most UK applicants, by contrast, deal exclusively with VFS Global, whose representatives conduct the appointment, review the documentation and deliver the application to the consulate on their behalf.

Some of the Local’s readers have said they felt penalised by the requirement to go through a third party middleman, as it blocks them from having direct contact with anyone with at the consulate.

But Nick Metta from Studio Legale Metta says going through an agency can actually provide an advantage, as their representatives tend to be well-versed in all the ERV requirements. “Basically they can do a pre-check, and usually that will avoid you the denial letter,” he says.

Agencies can assist you in making sure all your paperwork is in order.

Agencies can assist you in making sure all your paperwork is in order. Photo: Andreas Solaro/AFP

In the absence of an agency, he says, the consular staff member tasked with conducting ERV meetings is often “a front office handler who in most cases is not very well-versed in Italian regulations or requirements,” – some of whom have provided his clients with incorrect information in the past.

Elze Obrikyte from Giambrone & Partners, who regularly assists UK clients with ERV applications, says that the involvement of an agency also means UK applicants have more flexibility about where – and therefore when – they can book an appointment.

For example, while US applicants have to wait for a slot at their nearest consulate to open up, someone in London has the option to book an appointment at VFS’s application centre in, e.g., Edinburgh, potentially fast-tracking the process for those who are keen to get started.

READ ALSO: EU Blue Card: Who can get one in Italy and how do you apply?

What’s required

VFS Global’s checklist says applicants for the ERV in the UK should have:

    • A completed application form, which can be obtained from your consulate.
    • Two recent passport photos.
    • A passport that is valid until at least 90 days after the requested ERV would expire, plus two copies of the front page and of all Schengen visas issued in the past three years.
    • For non-British citizens, a UK residence permit.
    • A cover letter explaining why you intend to move to Italy.
    • Detailed documentation showing “substantial and stable private income”, including official letters from the banks or financial institutions listed (this must be passive income, as ERV recipients are not allowed to work once they arrive in Italy). 
    • Your last two years of income tax returns.
    • A registered ownership deed or rental lease agreement for property in Italy.
    • A reservation for a one-way ticket to Italy.
    • A marriage certificate for those applying as a married couple, and/or a birth certificate showing both parents’ names for dependent minors.

Applying for an ERV to move from the UK to Italy requires a substantial amount of paperwork.

Applying for an ERV to move from the UK to Italy requires a substantial amount of paperwork. Photo: Filippo Monteforte/AFP

Advice for UK applicants

Giuditta Petreni, who assists clients with ERV applications at Mazzeschi Legal Counsels, says she believes the ERV process has been getting tougher for UK-based applicants in recent years.

Obrikyte says she thinks consulates have become more strict in general over the past decade, but has observed that British applicants tend to struggle more with the application process than their North American counterparts.

“I see that most of them tend to be not well prepared for this type of application, while American and Canadian citizens, they’ve been living in this situation for years, so they prepare better,” she says.

READ ALSO: From visas to language: What Americans can expect when retiring in Italy

British applicants, by contrast, “tend to submit the application without actually putting a lot of effort in and then they are surprised when the application is rejected.”

Obrikyte says one key area where applicants often fall down is the cover letter explaining why they want to move to Italy.

In her experience, ‘pre-rejections’ – provisional refusals that give applicants the opportunity to fix an unsatisfactory aspect of their application before the final decision is made – are often issued on the basis of this letter alone.

She says that when asked to write a motivation letter, her clients will often write about loving the food or the weather. “This is not enough,” says Obrikyte.

READ ALSO: Visas and residency permits: How to move to Italy (and stay here)

“You must really convince them that, for example, you have purchased a property, you have already been spending a lot of time in Italy, and you are integrated in that neighbourhood.”

“Italian language is not a requirement for this visa, but of course if you mention that you are studying Italian or you know Italian, which helps you to integrate better, this is also an advantage for your application.”