Moving to Trieste: public healthcare and international schools

An American or British family moving to Trieste without a job here can join the Italian national health service for at least €2,000 a year and no more than €2,788.87, however high the income. One registration also covers dependent family members. EU citizens who work here, or draw a pension with the right form from home, pay nothing extra.

Schools are simpler than people fear. A child can join an Italian state school at any point of the year, and Trieste has an English-language international school and, at Duino, a United World College.

In short

• Non-EU, not working: private insurance, or voluntary registration with the national health service. The contribution is a share of last year's worldwide income, minimum €2,000 a year.
• Non-EU, working here: registration is compulsory, on the same terms as Italians.
• EU pensioners: the S1 form from the country that pays the pension gives full cover in Italy.
• The European card (EHIC) is for temporary stays, not for living here.
• Schools: foreign children enrol in state schools on the same terms as Italian children, at any time of the year. The International School of Trieste teaches in English from Kinder 2 to Grade 13.

How do I get health cover in Trieste if I'm not from the EU?

It depends on why you are here. Foreign nationals legally staying in Italy for work are registered with the national health service compulsorily, with the same rights and duties as Italian citizens (Legislative Decree 286 of 1998, article 34).

Everyone else with a residence permit, such as a retiree on an elective residence visa, must either take out a health insurance policy valid in Italy or register voluntarily with the national health service. The voluntary registration also covers dependants.

You register with the health authority of the municipality where you live. In Trieste that is ASUGI (Azienda sanitaria universitaria Giuliano Isontina), which runs Cattinara and Maggiore hospitals in the city.

How much does voluntary registration cost?

ASUGI applies two rates to the total income of the previous year, earned in Italy and abroad:

Slice of income	Rate
Up to €20,658.28	7.5%
From €20,658.28 to €51,645.69	4%
Above €51,645.69	nothing more

The contribution can never be lower than €2,000. Students without dependants or other income pay a flat minimum of €700, au pairs €1,200; those two do not cover dependants.

Worked example: a retired American with €80,000 of income last year, and a spouse registered as a dependant. 7.5% of €20,658.28 is €1,549.37; 4% of the next €30,987.41 is €1,239.50. Total: €2,788.87, the most anyone pays, because nothing is charged above €51,645.69. With €30,000 of income the formula gives €1,923.04, so the minimum of €2,000 applies. Our arithmetic on ASUGI's rates.

Three rules that catch people out:

• registration runs for the calendar year, January to December, and cannot be split, even if your permit expires mid-year;
• it starts on the day the office enters it, not the day you pay, and is never retroactive;
• you pay only by F24 form, tax code 8846, region code 07 for Friuli Venezia Giulia.

I'm an EU citizen. Am I covered?

Usually yes, through your own system. If you work in Italy, EU rules make you subject to Italian legislation (Regulation 883 of 2004, article 11). If you draw a pension from another EU country, ask that country for the S1 form: it gives you full healthcare in your country of residence, at the expense of the country that pays the pension.

If you neither work nor draw a pension, Italian law asks you, for a stay over three months, to have health insurance or another title that covers all risks in Italy (Legislative Decree 30 of 2007, article 7). EU citizens can also register voluntarily, and pay. The residence registration itself is explained in becoming resident after buying.

The European Health Insurance Card (EHIC, TEAM in Italian) covers people staying temporarily. It is not a substitute for registration once you live here.

What about children's healthcare?

The children's hospital is the Burlo Garofolo, a research hospital for mothers and children in Trieste since 1856. Children of foreign nationals registered with the national health service get the same treatment as registered children from birth, while their own registration is pending (article 34).

Can my children go to an Italian state school?

Yes. Foreign children present in Italy have the right to education on the same terms as Italians, and are subject to compulsory schooling. They can be enrolled at any point of the school year (Presidential Decree 394 of 1999, article 45).

The school does not simply match your child's age. Its teachers' board chooses the class, taking into account the school system of the country of origin, the child's skills and level, the course followed and any qualification held.

Trieste also has state schools that teach in Slovenian, recognised by the law that protects the Slovenian minority (Law 38 of 2001, article 11).

Which international schools are there?

Here are two, with very different profiles.

	International School of Trieste	UWC Adriatic
Where	Opicina (Trieste)	Duino (Duino Aurisina)
Since	1964	1982
Ages	Kinder 2 to Grade 13	16 to 19, residential
Teaching	in English, except Italian, Latin and world languages	International Baccalaureate Diploma Programme
Diploma	its own, which the school says is legally recognised in Italy	International Baccalaureate
Cost	fees published by year on its website	most students on full scholarships, worth €52,000 for the two years
Admission	direct application	only through a UWC national committee

The International School of Trieste was founded as a non-profit by the International Centre for Theoretical Physics and the Italo-American Association, and has been accredited by the Middle States Association since 1990. UWC Adriatic takes students from over 80 countries, chosen on promise rather than ability to pay; most attend on full scholarships.

What to do now

• Decide which health route applies to you before you apply for the visa: insurance or voluntary registration.
• If you are an EU pensioner, request the S1 form from your pension country before you move.
• Budget the contribution on last year's income: between €2,000 and €2,788.87 a year.
• Ask the school you choose for its enrolment papers early: translated report cards help the teachers' board.
• Look at homes with the school run in mind: Opicina and Duino are not the city centre.

Frequently asked questions

How much does Italian public healthcare cost for a US retiree?

On voluntary registration, 7.5% and then 4% of last year's worldwide income, with a minimum of €2,000 and a maximum of €2,788.87 a year; dependants are covered by the same registration.

Is there an international school in Trieste?

Yes. The International School of Trieste, at Opicina, teaches in English from Kinder 2 to Grade 13; UWC Adriatic, at Duino, offers the International Baccalaureate to residential students aged 16 to 19.

Can I use my EHIC card if I move to Italy?

No. The EHIC is for temporary stays. Once you live here you need registration, an S1 form or private insurance.

Can foreign children start school in Italy mid-year?

Yes. Enrolment can be requested at any point of the school year, and the teachers decide the class.

Where this guide stops

It does not cover visas, private hospital fees, special-needs schooling or university. Rules on the contribution can change each year by ministerial decree. For your registration, the ASUGI district office; for visas, the Italian consulate.

If you own a family home in Trieste, within reach of a good school and a hospital, that is what the families moving here ask about first. Request a confidential valuation: we sell to buyers relocating from abroad, in English and German.

These are the rules, not medical or legal advice. Write to richieste@triestevillas.com or WhatsApp +39 331 8940822.