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Publication: 29 July 2021 Latest update: 15 May 2023
What is it?
The benefit provides a financial contribution towards the refund of health-related expenses incurred:
- by the person registered under the system;
- or by the person registered, upon claim, to the Teachers and School Managers Assistance Scheme and/or by his/her family members.
The following expenses are eligible for refund:
- health services of various types, with the exclusion of those for medical-legal activities and for treatments and interventions for aesthetic purposes;
- hydrotherapy treatment sessions;
- assisted fertilisation treatment and care.
Who is it aimed at?
The contribution is reserved for those registered under the system or upon claim to the Teachers and School Managers Assistance Scheme.
In addition to the person registered, the following family members can also be assisted:
- the spouse/civil union partner cohabiting and dependent;
- widowers at the expense of the beneficiary at the time of death who did not contract a new marriage;
- dependent children up to the age of 26, whether married or unmarried;
- fully dependent children and who are permanently incapable of work;
- dependent parents;
- sisters and older brothers, cohabiting and dependent, totally and permanently incapable of work;
- orphans who are holders of a share of the survivor's pension.
The requisites must be met on the date of health expenditure for which refund is claimed.
How does it work?
WHAT AM I ENTITLED TO?
The percentage of contribution to the expenditure varies in relation to the ISEE bracket of the family unit to which the contribution beneficiary belongs to, without prejudice to the minimum thresholds for accessing the contribution, as stated in the following table:
| ISEE of the family unit to which the contribution beneficiary belongs to | Percentage of contribution to health expenses | Minimum threshold for health expenditure for accessing the contribution |
|---|---|---|
| ISEE - up to €8,000 | 35% | €750 |
| ISEE from 8,000.01 to €24,000 | 25% | €1,100 |
| ISEE from 24,000.01 to €32,000 | 20% | €1,500 |
| ISEE beyond €32,000 | 15% | €1,850 |
In addition, maximum refund limits are identified for individual types of health expenditure.
- the amount of the contribution cannot exceed a total of Euro 10,000.00;
- healthcare expenses related to a family member who can be assisted can be refunded within the limits of the percentage of the claimant's dependent family members.
Claim
REQUIREMENTS
The set requirement is the enrolment in the Teachers and School Managers Assistance Scheme.
WHEN CAN I CLAIM?
Expenses for which refund is claimed must have been incurred within the 12 months prior to the date on which the healthcare claim was made.
It is necessary that at least 12 months have elapsed since the forwarding of the previous claim for health care.
HOW CAN I CLAIM?
The claim to INPS must only be submitted online using the dedicated service.
The claim can be sent:
- by the person registered with the Teachers and School Managers Assistance Scheme;
- by the spouse/civil union partner;
- by widowers;
- by their adult children;
- by the guardian or other parent of the beneficiary's child if this has
forfeited parental responsibility.
The accompanying documentation must be delivered or sent by registered letter with acknowledgement of receipt, under penalty of not being admitted, to the relevant INPS office within 30 days from the submission of the claim.
Processing times
The deadline to define the decision was set at 30 days by the Regulation for the definition of the terms to conclude the administrative proceedings adopted by INPS pursuant to Article 2 of Law no. 241/1990.