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Doctors on demand: why digital healthcare is great news for expats

When you live abroad, one of the biggest challenges is working out the local healthcare system. You may be unsure how to arrange to see a doctor – or short of time to squeeze in an appointment once you’ve found out.

Doctors on demand: why digital healthcare is great news for expats
Photo: Getty Images

Even once you’re face-to-face with a doctor, you may still be worried about a potential language barrier or your lack of local knowledge. It’s hardly what you want when making a medical appointment becomes one more source of stress.

Now, however, digitalisation is rapidly changing healthcare – and offering international residents the chance to speak to a doctor without leaving home. In partnership with AXA – Global Healthcare, The Local looks into this and some of the other ways in which digitalisation is reshaping healthcare. 

Five levels of cover to suit your needs – find out about AXA – Global Healthcare

How digital tech promotes healthcare at home

Many of us have already embraced technology when it comes to looking after our health and fitness. Wearable devices that track your steps, heart rate or sleep are no longer an oddity – you may check one before going to bed or as soon as you wake up.

The number of health apps you can choose to put on your smartphone is mind-boggling – at least 318,000 as of 2019. The rise of digital consultations with doctors and other health professionals is the latest example of technology bringing healthcare into the home.

According to a report by Deloitte, most healthcare will be delivered to patients at home or through “virtual, outpatient, and other settings” in 20 years from now.

It suggests this will come as healthcare focuses increasingly on helping individuals to stay healthy through tips on wellness and preventing illness. The long-term hope is that technological innovation will help make healthcare more efficient for everyone – patients, doctors, nurses and taxpayers.

Just what the virtual doctor ordered … 

In the digital era, life seems busier than ever for many of us. Luckily, a growing number of digital solutions also enable us to take care of crucial things remotely – and nothing is more crucial than healthcare.

It’s not surprising that people are attracted to the idea of on-demand access to highly qualified doctors – all without having to travel to a clinic or health centre and sit in a waiting room. 

Add in the option of speaking to a doctor in English (or perhaps even another preferred language) and availability around-the-clock, and it’s easy to see why apps and services offering doctor’s appointments are growing fast.

Speak to a doctor in a language of your choice 24/7 with the Virtual Doctor service from AXA 

You can get a diagnosis for you or your family member, advice on the next steps or even have a referral to a specialist arranged.

Photo: Getty Images

The global market for online doctor consultations is worth $3.9 billion in 2020 – but will quadruple to $16 billion in just six years, according to Global Market Estimates. 

These services include the Virtual Doctor service from AXA, which saw up to a 264 percent rise in registrations in a recent eight-month period*.

The app offers access to internationally qualified doctors over the phone 24/7 or via video consultation (between 8am and midnight UK time) for all individual and SME customers.

As well as offering diagnosis and referrals, doctors on the Virtual Doctor service can also provide e-prescriptions in many locations, when medically necessary and where regulations allow.

Moving faster into the future

While coronavirus has played a part in driving demand for online appointments this year, it’s clear that the change has longer term implications. The challenges of the pandemic may simply move us even faster towards more digital consultations in a way that was destined to happen before long anyway.

Digital technology is also changing medical treatment in a variety of other ways that could have significant benefits for patients. For instance, big data has the potential to alert health professionals to potential medication errors through software that can analyse a patient’s history. Another possible usage is in predicting hospital admission rates to help managers anticipate their required staffing levels.

What about virtual reality (VR)? This technology is already offering much more than just a video gamer’s idea of paradise. In healthcare, VR is already being used in innovative approaches to treating everything from pain to post-traumatic stress disorder.

* According to Advance Medial, the virtual doctor service provider, based on registrations from AXA – Global Healthcare members, with policies administered by AXA Global Healthcare (UK) Ltd between Dec 2019 and July 2020. 

Moving abroad or looking to boost your local healthcare coverage? Find out more about AXA – Global Healthcare’s international health insurance options

This article was produced by The Local Creative Studio and presented by AXA.

AXA Global Healthcare (EU) Limited. Registered in Ireland number 630468. Registered Office: Wolfe Tone House, Wolfe Tone Street, Dublin 1. AXA Global Healthcare (EU) Limited is regulated by the Central Bank of Ireland.

AXA Global Healthcare (UK) Limited. Registered in England (No. 03039521). Registered Office: 20 Gracechurch Street, London, EC3V 0BG, United Kingdom. AXA Global Healthcare (UK) Limited is authorised and regulated in the UK by the Financial Conduct Authority.

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HEALTHCARE

Who can register for national healthcare in Italy?

Who is entitled to free registration with Italy's national service health service, and what are the options for people who aren't? Here's a guide to the basics.

Who can register for national healthcare in Italy?
Registering for public healthcare in Italy will allow you to get medication at a subsidised rate. Photo: Andreas Solaro/AFP

The Italian National Health Service (SSN – Servizio Sanitario Nazionale) is open to anyone living in Italy, and registering with it guarantees foreign residents all the same care available to Italian nationals at the same cost.

But that process is more straightforward – and cheaper – for some than for others.

Here’s what you need to know about registering with Italy’s public healthcare system.

Who can register for free?

Certain people are entitled to iscrizione obbligatoria, ‘mandatory registration’ or ‘registration by right’, in the national health service.

That means you can register with the SSN for free.

Iscrizione obbligatoria applies to the following categories:

  • Immediate family members of an Italian citizen living in Italy
  • People with a valid work contract from an employer in Italy
  • Self-employed people with a partita IVA (VAT number)
  • People who previously worked in Italy but are currently unemployed and registered on the unemployment lists (liste di collocamento)
  • People who have a residence permit expressly for the purpose of applying for citizenship, fostering or adopting children, or because they are pregnant or have given birth in the past six months
  • Asylum seekers, refugees and others under international protection

People in these categories are also allowed to register their spouse, children or other dependents under the same conditions, with the exception of elderly parents.

READ ALSO: Tessera sanitaria: How do you apply for or renew your Italian health card?


Photo: Filippo Monteforte/AFP

Who else can register?

If you don’t fall into any of these categories, you can also opt in to the Italian health service (iscrizione volontaria or ‘voluntary registration’).

It involves paying an annual registration fee in order to access public healthcare.

Once registered, you’ll pay the exact same for the care you receive as people who enrolled for free.

ITALIAN BUREAUCRACY EXPLAINED: 

Voluntary registration is open to anyone legally resident in Italy who doesn’t qualify for free registration, notably non-working elective residents, students, diplomats, volunteers, people aged 65 or over who have moved Italy to be with their children, or anyone else who doesn’t pay social security contributions.

The only condition is that you must be staying in Italy for more than three months – unless you are a student or an au pair, in which case you are still allowed to register for healthcare during a short stay at a reduced fee.

You can also extend voluntary registration to your dependent family members.

How much does it cost?

The fee for voluntary registration is calculated by your local health authority (ASL – Azienda Sanitaria Locale) according to your means. It therefore varies depending on where you live in Italy and your financial circumstances.

The minimum annual fee is €387.34, rising to a maximum of €2,788.86. One fee also covers any dependents you’re registering at the same time.

Students and au pairs can benefit from fixed fees of around €150 and €220 respectively, though this will not allow you to register any dependents (you can do so by opting to pay the full fee instead).

NB: the fee is fixed for the calendar year, so you’ll pay the same amount whether you register in January or November. If it’s late in the year, it might work out better value to wait and if necessary use private healthcare for a month or two before registering.

How do you register?

You register directly with your nearest ASL. Find a list here

You will need:

  • Your passport
  • Your certificate of residence (for EU citizens and Brits) or permesso di soggiorno (for non-EU citizens), or an official receipt to show you have applied for it
  • Your codice fiscale, or tax code
  • For iscrizione obbligatoria: a work contract, payslip, declaration from an employer, VAT registration, UK S1 form, or any other document that shows your entitlement to free registration.
  • For iscrizione volontaria: evidence of your previous year’s income, such as a tax return.
  • If registering dependents: birth or marriage certificates that document your relationship, as well as evidence of family members’ income.
  • If registering as a student or au pair: proof of enrolment in a study programme or a contract with a family.

Ask your ASL exactly which documents you require for your particular circumstances.

If you’re registering voluntarily, you’ll also need to have your ASL calculate your annual fee, which you have to go to the nearest Post Office to pay by postal order (bollettino postale). You’ll then return to the ASL office to show receipt of payment and complete your registration.

Either way, be prepared for multiple consultations – in person – before the process is complete.

And since registration is annual, you can expect to repeat it all over again the following year.

READ ALSO: How do you renew your Italian health card?

The following video explains the process for British nationals and may be applicable to others too:

What are you entitled to once you register?

The benefits of registering are that you’ll be able to access the Italian public healthcare system for free or at a subsidised rate.

Once registered, you’ll receive a tessera sanitaria or health card that shows you’re entitled to public healthcare. You can also register with a GP (medico di base) and register your children with a paediatrician, whom you can consult without charge.

Other forms of care may require you to pay part of the cost (a co-pay known in Italian as the ticket), but the amount will be subsidised by the national health service.

READ ALSO: 

Registering can also help you secure residency in Italy: proving you have healthcare is a condition of being granted a residency permit, in many cases, so if you’ve registered with the SSN (or can at least show you’re in the process of doing so), that will meet the requirement.

However, since residency is a condition of registering it can be a Catch-22 situation. You may be able to persuade officials to accept provisional documents, but there are no guarantees.

You might find it more expedient to take out private health insurance in the short term to allow you to secure the residency permit you need to register with the SSN; or if you prefer, you can opt to skip the public health system altogether and pay for private care throughout your time in Italy.

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