06 – Tessera Sanitaria (Medical Insurance)

Getting sick without an insurance is extremely costly. In Italy, the National Health Service has a standard insurance system, the “Assicurazione Volontaria al Servizio Sanitario Nazionale”. An ID card is issued for those insured, called the “Tessera Sanitaria”.

With the Tessera Sanitaria, visits to the medico di famiglia are free. Some medicines are free, while others are obtained from any pharmacy with a huge discount.

• Visits to specialists, laboratory tests and operations could be free or may require some payment but at much lower fees than normal. This insurance covers most illnesses, even preexisting ones, as well as maintenance medicines.
• On the other hand, dental and opthalmological services are not covered; you’ll need an insurance costing some €500 a month for these.)

Without the Tessera Sanitaria (or some other equivalent medical insurance), it will be extremely difficult to accompany you to the doctor, as he or the hospital will be asking for a Tessera Sanitaria or else charge you a huge amount. Even assuming that one is admitted for free through the Emergency Room, popst-hospitalization care and medication will not be free (we had a student who spent only 30 Euros which was optional, to have his medical records mailed to him; but for the following months he needed daily injections and medicines, one of which costs 90 Euros per tablet, taken daily – almost all were free because of the Tessera Sanitaria).

• For those who do not get a Tessera Sanitaria, you need to submit a document for the Collegio Rector to file, formally indicating, in case you need to see the doctor, who should accompany you, and where to get the money for eventual payments running in the thousands of Euros.
• The document should be countersigned for acceptance by the person(s) indicated to accompany you, and who has access to the funds you indicated.
• (This is because in the Dichiara for the Permesso di Soggiorno, the Rector is required to certify that the Collegio will take care of the Priests’ medical needs — which can be carried out only by requiring a Tessera Sanitaria or an alternative insurance from each one.)

Based on their positive experience as to the quality of care, the Rector of another Collegio has recommended the Istituto Dermopatico dell’Immacolata (or IDI). It is run by a religious order, the Congregazione dei Figli dell’Immacolata Concezione and is very close to our Collegio. While the cost of ticket if any (or co-payment, explained below) is the same as in public hospitals, the waiting period could be shorter and services better. Just show them your University ID, and say that you stay at PCF.

STEP 1: FORMS TO PREPARE TO OBTAIN THE TESSERA SANITARIA (whether first time or renewal) – either in pdf or scanned if applying online, or printed if going to the ASL office.

1. Application form which you may print and fill up following this model.
2. Form for Extracomunitari which you may print and fill up following this model. For the doctor, you may select the name from the list provided in www.salutelazio.it; note the name and indicate it in the corresponding step below.
3. Delega form (if delegating) which you may print and fill up following this model. The Administration may delegate the staff for us at the start of the school year (after which each one should file on his own), so please coordinate with your Batch capo for this, who would submit as soon as possible the forms of those interested to the PCF Administration.
4. Bolletino Postale which you may fill up and pay at the Post Office.
   • sul C/C n.: 370007di Euro (amount): as of November 2022, the amounts were: € 149.77 for those with Motivo Studio Permesso di Soggiorno, and € 387.34 for those with Motivo Religioso Permesso di Soggiorno
   • importo in lettere: either “Centoquarantanove Euro e 77 cent.” or “Trecento ottanta sette Euro e 34 cent.”
   • intestato a: AMM. P.T. REGIONE LAZIO
   • causale: ISCRIZIONE AL S.S.N. ANNO 2022 [indicate current year!]
   • eseguito da: [put your name and address]
   • You may also use the online Bolletino Postale and print (alternatively, you may print, cut lengthwise, and fill up a blank Bolletino Postale form). The form might vary a bit, but the information needed is the same, as follows (you may follow this model, though your form might only have two instead of three sections). In this case, you will have to load your Poste Pay (with a fee), then pay the online service (another fee). You might as well just pay at the Post Office to save on fees.
5. Autocertificazione di Residenza, which is a simple letter in plain bond paper you sign, stating that you live in PCF. Sample:
   ========================
   [DATE]
   
   ASL-Roma 1 – Distretto 13
   via Boccea, 271 – 00167 Roma
   
   io, [NAME AND FAMILY NAME], certifico che abito presso il Pontificio Collegio Filippino, a Via Aurelia 490 – 00165 Roma.
   
   Con saluti cordiali,
   [NAME AND FAMILY NAME]
   ========================
   
6. Valid Passport (information page only; and for newcomers, valid visa)
7. Codice Fiscale (if renewing: your old Tessera Sanitaria instead)
8. Permesso di Soggiorno both sides (or for old timers with expired soggiorno, and for newcomers: also the receipts given by Poste Italiane when you applied for the Soggiorno and if you have not yet done the fingerprinting, the Convocazione per la Fotosegnalamento)
9. Certificato di Iscrizione from the University (has to indicate that you are enrolled in current school year, not just continuing from previous school year or pre-enrolled). NOTE: Students with Permesso di Soggiorno Motivo Religioso may try to appeal from the ASL and ask for the Motivo Studio rates. Be sure to attach your most recent Certificato di Iscrizione from the University as well.
10. If renewing: the “LIBRETTO” (some also call this the “cedolino”) given to you the last time you applied; it is the bond paper with missing 1/4 part, with the words on the upper left: “Regione Lazio” and “TESSERA DI ISCRIZIONE AL SERVIZIO SANITARIO REGIONALE”, and on the lower half, “ELENCO STUDI MEDICI”.
11. For choice of Doctor, those who wish may indicate Dr. BALONAN Jerilyn Tan (codice 092739). She is a Filipina, with clinic at nearby Via Baldo degli Ubaldi 22, a 10-minute walk from the Collegio.

STEP 2: PAY THE BOLLETTINO POSTALE. OPTIONS:

1. Online using Poste Pay.
2. In any Tabacchi (€2.00 fee), but only for those renewing.
3. In any Post Office (€1.50 fee), get a number by pressing the button for Servizi Finanziari – Bolletini (usually button letter F), and wait for your turn to be called.

STEP 3A: PROCEDURE IF YOU APPLY ONLINE (PREFERRED)

1. Scan and email the above documents to: sportello.distretto13@aslroma1.it
2. Email subject: richiesta Tessera Sanitaria per [YOUR NAME AND FAMILY NAME]
3. Email body:
   =================
   
   Stimati Ufficiali, vorrei gentilmente richiedere la Tessera Sanitaria. Allego documenti pertinenti.
   
   Medico da Famiglia scelto: [NAME OF DOCTOR YOU CHOSE, WITH THE COD. AND ADDRESS IF YOU HAVE THEM]
   
   [FOR NEWCOMERS ONLY, WHO HAVE NOT YET DONE THE FINGERPRINTING AT THE QUESTURA, PLEASE ADD]
   Non ho ancora nessun vecchio Permesso di Soggoiorno dato che sono arrivato recentemente. Allego invece le ricevute Poste Italiane e la Convocazione per il Fotosegnalamento presso la Questura di Roma.
   
   [FOR NEWCOMERS ONLY, WHO HAVE ALREADY DONE THE FINGERPRINTING AT THE QUESTURA, PLEASE ADD]
   Non ho ancora nessun vecchio Permesso di Soggiorno dato che sono arrivato recentemente. Allego invece le ricevute Poste Italiane presentate dalla Questura di Roma.
   
   Con distinti saluti.
   [YOUR NAME AND FAMILY NAME]
   [YOUR CELFONE NUMBER]
   
   =================
4. Don’t forget to attach the documents!
5. They might send you the libretto by email as soon as the next day, or few days after. Double check your information, and reply to their email if there is some error (name, address, etc.).

STEP 3B: PROCEDURE IF YOU APPLY AT THE ASL OFFICE, OR IF YOU ARE ASKED TO GO THERE

1. Make one photocopy each of all the above documents. If the document has information back to back, for example, the Permesso di Soggiorno, then the photocopy should also be back to back, just like the original – not on separate sheets, and not two sides of the document on the same side of the sheet!
2. Call for an appointment at 06 6835 3271 (unless you received an email or text message giving you an appointment). As of January 2021 they do not accept walk-ins without an appointment.
3. Bring the ORIGINALS AND PHOTOCOPIES to the ASL office indicated (should be at Via Boccea 271 – 00167 Roma 15 minutes away walking).
   • As of February 2020 they are open Mondays to Fridays 10:00-12:00, but just follow the appointment given to you.
   • The old office at Via Valle Aurelia 115a – 00167 Roma no longer receives applications.
   • Alternative offices and telephone numbers to make an appointment are Via Tornabuoni 50 (06 6835 6243) and Boccea 625 (06 6835 4563).
4. Before you leave the counter, make sure you are given:
   • the originals of the documents you showed (Passport, Permesso di Soggiorno, Codice Fiscale, Post Office ricevuta, etc.); depending on the ASL Personnel, they may or may not get the original of your Certificato di Iscrizione from the University;
   • a printout of your Tessera Sanitaria, which is valid for all legal purposes, as the original card of which will reach you by mail after a few days; and
   • a new libretto (described above).

STEP 4: AS SOON AS YOU RECEIVE YOUR TESSERA SANITARIA AND CEDOLINO, EMAIL A SCANNED COPY TO THE RECTOR.

1. Also email a copy of your Tessera Sanitaria and your Cedolino to the doctor, indicating the following details:
   • Cognome:
   • Nome:
   • Data di Nascita:
   • Età:
   • Sessso: maschio
   • Luogo di Nascita:
   • Codice Fiscale:
   • Indirizzo: Via Aurelia 490 – 00165 – Roma
   • Cellulare:
   • Email:
   • Residente del: Pontificio Collegio Filippino
2. For those who choose Dr. Balonan, please send her a scanned copy of this Privacy form (just indicate the date, your family name and name, and sign).
3. The Rector needs to show a copy of your Tessera Sanitaria and latest libretto in case you need to be brought to the hospital. In an emergency, there might be no time for you to find your copy and give it to him. For this reason, he needs to have a copy in his files.
4. Be sure to apply for a Tessera Sanitaria as soon as you arrive in Italy. For newcomers during summer, check if you can already apply for one, otherwise you will need to get a different kind of medical insurance.

SPECIAL NOTES WHEN YOUR PERMESO DI SOGGIORNO EXPIRES WITHIN THE YEAR

1. When your Premesso di Soggiorno expires, the system automatically deactivates your Tessera Sanitaria, without informing you.
2. The day after your Soggiorno expires, look for your latest Tessera Sanitaria application in your email, which was supposed to be last January. Note that the Tessera Sanitaria services are not automatically renewed, so you have to do the steps outlined here even if you already received your new Permesso di Soggiorno recently.
3. Reply to that email, writing the following:
   
   “Stimati Ufficiali,
   allego (A) ricevute poste del rinnovo permesso di soggiorno, (B) convocazione presso l’ispettorato vaticano, (C) la tessera sanitaria, e (D) bolletino pagamento ALS per l’anno corrente — con la richiesta di gentilmente rinnovare la mia tessera sanitaria fino a 31 dicembre.
   
   Medico di Famiglia scelta:
   BALONAN, Jerilyn Tan
   Codice: 092739
   
   Con saluti cordiali.
   [YOUR NAME AND FAMILY NAME]”
   
4. Change the medico di famiglia name and Codice if you have another doctor.
5. Attach in the email the documents indicated: (A) your ricevute poste (for the Soggiorno renewal), (B) the schedule given to you at the Poste for fingerprinting at the Questura, (C) your Tessera Sanitaria, and (D) the Poste bolletino of your payment when you renewed last January. Wait for a day or week for the ASL’s reply.
6. The ASL will reply to your email, with a new Cedolino, still indicating the validity of up to Dec. 31. Email a copy of this Cedolino to your Medico di Famiglia and the PCF Rector.

SPECIAL NOTES FOR THOSE WHO RECEIVE A REPLY FROM THE ASL STATING THAT THEY CANNOT FIND YOUR RESIDENCE ADDRESS:

1. This probably means that when you applied for the Codice Fiscale, the agent there did not enter your PCF address. In the past (or in the present if you are lucky), the agent will just put the PCF address in your Codice Fiscale record, so you will not get such a reply from the ASL.
2. Starting 2019, the agent might tell the student to:
   • first get a Permesso di Soggiorno (to make him legal in Italy)
   • then a Cambio di Residenza to register him in the Anagrafe (Registry Office) of the Comune, which takes around two weeks to process
   • and finally to return to the Agenzia delle Entrate to put the PCF address in his Codice Fiscale database.
3. The Permesso di Soggiorno is required to get a Cambio di Residenza (according to the Cambio di Residenza form).
4. The Cambio di Residenza could be processed in up to two weeks, so be sure to apply for one as soon as you get your Permesso di Soggiorno. Follow this guide for the Cambio di Residenza, where you will also see how to change your Codice Fiscale address, needed to continue your application for the Tessera Sanitaria.
5. Meanwhile, you might as well also apply for a Carta d’Identità, which you may show to government and private offices as your identification document instead of the passport when in Italy (not valid outside Italy).

USING THE TESSERA SANITARIA

1. Regardless of the date you apply (even if, for example, on December 15th), the Tessera Sanitaria fee remains the same, and the expiration will always be on December 31.
2. Note that sometimes the card expiry is up to five or more years from the present. This only means that they do not have to replace the card; but it does not mean that your insurance is still valid. THE VALIDITY OF YOUR INSURANCE IS INDICATED BY THE DATE ON YOUR LATEST LIBRETTO (“OR CEDOLINO”), NOT BY THE DATE ON THE CARD. The card’s later date simply means that when you renew come January, you will not be given a new card, since your old card is still useful (even though your health care insurance benefits ended last December 31).
3. The new libretto will be valid until December 31 of the current year, or until the expiry of your Permesso di Soggiorno, whichever comes first. In the latter case, just email (or return to the ASL office) when you get your new Permesso di Soggiorno, so that they will give you a new libretto valid until December 31. Be sure to attach via email (or bring to the ASL office) your latest libretto, a copy of your Poste receipt to show that you had already paid previously, and a copy of your new Permesso di Soggiorno.)
4. If you need to have a check up, go to the doctor you indicated. For simple complaints, this doctor will give you a prescription. Buy your medicines from any pharmacy, showing your Tessera Sanitaria and the doctor’s prescription, which entitles you to discounted prices.
5. If your sickness requires some examinations (blood test, x-ray, ultrasound, etc.) or operation, your “medico di famiglia” will give you a prescription for the tests, and may refer you to a specialist doctor. He will inform you where you can set the appointment and have the tests done. You will be charged a “ticket”, that is, a co-payment, of around €31 per test or visit to the Doctor. But the amount saved (compared with paying for these procedures without the Tessera Sanitaria) will be much more that the cost of the Tessera Sanitaria itself.
6. If your situation is urgent, you will be scheduled for follow up within a few days. If your situation is not urgent, you might have to wait long for your schedule, as it means that there are others with graver illnesses than yours. In the latter case, you might have to wait weeks or even months. An alternative would be to go to a private clinic (but affiliated or “convenzionata” with the government system) to be checked earlier, at discounted prices.
7. Emergency Room services are completely free in Italy, and do not require the Tessera Sanitaria. But the moment one is transferred to the wards for admission, one will be asked for the Tessera Sanitaria (even if the stay was initiated from the Emergency Room). If you do not have the Tessera Sanitaria, you might be considered a private patient and asked to pay for all the fees, which will run into thousands of Euros after just a few days. The Collegio Filippino will not be responsible for paying the bills.
8. This medical insurance is valid for the whole European Union, so bring your Tessera Sanitaria if you need to go out of Italy. Switzerland is NOT a member of the European Union. Hence it is recommended that you also get an insurance when you book your plane tickets for trips outside the European Union.
9. Check their website for updates. For the current fees, click on their link there, where it says, “contributo forfettario annuale”.

REGARDING PAST ARRANGEMENTS

While in the past it was possible to get the insurance when one was already admitted to the hospital, nowadays the government is getting stricter.

• In fact, if one does not have the insurance yet and gets admitted to the hospital (even if coming from the Emergency Room), he or she might be automatically considered a private patient, and might be asked to pay for all the hospital fees, which will run into thousands of Euros after just a few days.
• For the above reasons, almost all training institutions in first world countries, where medical costs are high, require a health insurance from their students. Similarly, the Collegio Filippino requires that each student procure a health insurance for himself.
• While Bishops and Dioceses commit themselves to shoulder their Priests’ medical needs in Rome, it is the Priest’s ultimate responsibility to ensure that he is properly covered — in the same way that it is his responsibility (not his Bishop’s) to ensure that his board and lodging, tuition, transportation, and other fees are duly paid.

As for the “Indirect Insurance” (which even the Collegio used to facilitate)

• The “indirect insurance” that costs around €100.00 annually covers only admitted patients, that is, hospitalized at least overnight. Out-patient visits to doctors for a check-up, and medicines and laboratory tests prescribed in such cases, are not refunded.
• In this system, one has to first pay for all fees, and will be reimbursed months later, after the insurance agency studies all the pertinent medical files, and ONLY IF they determine that the contract conditions have been met. A visit to the doctor for a simple check-up could cost €100 to €200, blood tests and x-rays €250, ultrasound €400, etc.
• This type of insurance costing €100 does not cover annual check-ups, preexisting illnesses, dental and opthalmological services, and even some diseases considered as part of normal life and ageing, such as certain heart or kidney diseases, diabetes, etc.
• Given the above limitations and inconveniences, and since most medical needs of Collegio Priests are visits to the doctor for check-ups rather than hospitalization, the Collegio Filippino NO LONGER RECOMMENDS OR FACILITATES any “indirect insurance” for the residents.