Healthcare Assistance for Italian Workers Abroad

Public Employees and Private Sector Workers

It is important to note that, pursuant to Article 15 of Presidential Decree No. 618 of 31 July 1980 and subsequent amendments, the right to indirect healthcare assistance in non-EU countries is confirmed by a certificate issued to the worker by their local Health Authority (ASL) of residence or, in the case of workers domiciled in a different location, the ASL of the place of assistance. For citizens residing abroad, this certificate may also be issued by the competent Italian diplomatic or consular representation.

The certificate referred to in Article 15 (Annex 1) may be issued by the relevant ASL (either the ASL of residence or the ASL of assistance) or by the diplomatic or consular representation, either in person or via certified email (PEC), following a specific request accompanied by the following documents:

• A notice of transfer abroad;
• A photocopy of the ASL registration booklet or a substitute declaration (Article 46 of Presidential Decree No. 445 of 28/12/2000);
• Tax code or substitute declaration (Article 46 of Presidential Decree No. 445 of 28/12/2000);
• A copy of the identity document.

For all categories of workers (public and private employees), the claim for reimbursement of healthcare expenses incurred must be submitted exclusively by the entitled person to the diplomatic representation, no later than three months from the date the expense was incurred, or the claim will lapse.

For the purpose of calculating the three-month deadline, the period is measured from the date the reimbursement request is submitted, and the date the healthcare expense was incurred or the last expense in relation to a cycle of treatment linked to a single health issue. The three-month deadline can be extended if the applicant proves that they were unable to meet the deadline due to force majeure, with appropriate documentation and justification.

For long-term or chronic conditions, as well as for healthcare services related to pregnancy or paediatric care, a single reimbursement request can be made for expenses incurred within a six-month period or a maximum of one year.

Below is a list of documents that the diplomatic and consular representations must forward for reimbursement claims, under penalty of inadmissibility:

1. Copy of the certificate under Article 15 of Presidential Decree No. 618/80;
2. Reimbursement request from the entitled person, with the date of submission to the representation noted for the purposes of verifying the deadline for reimbursement (Annex 3);
3. A report confirming the appropriateness of the expenses in relation to the local prices, tariffs, and fees, considering the available healthcare services and local practices, in accordance with Article 7 of Presidential Decree No. 618/80, duly signed and dated, according to the attached model (Annex 4);
4. Indication of the place of residence in Italy and the relevant Local Health Authority (ASL) for the entitled person and any accompanying family members;
5. Health-related documentation regarding the services received abroad;
6. Original invoices and/or receipts for healthcare expenses, along with proof of payment;
7. Indication of the preferred method for reimbursement: home address or Italian bank account, including relevant ABI/CAB codes and IBAN;
8. In the case of hospitalisation, a declaration from the healthcare facility specifying the standard daily hospital charges and the cost of available rooms and associated tariffs;
9. Certified Italian translations of medical and expenditure documents, if these are written in a language other than English or French;
10. Indication of a non-certified email address and/or certified email address (PEC) to which any correspondence should be sent;
11. Consent in accordance with EU Regulation 2016/679 (GDPR) on personal data protection. The consent must refer to both the transmission of the documents listed above and the use of the information by the offices (Annex 5).

Once the Embassy or Consular Office verifies the entitlement to indirect healthcare assistance as indicated in the certificate under Article 15, and confirms that all formal documentation is complete and in order, including the original receipts proving payment for the expenses being claimed, the consular office will affix a visa to all the documentation and proceed with forwarding it based on the entitled person’s place of residence.