A Slice of Life in Italy

Everyone complains about Italian bureaucracy.  Here’s a perfect example.

Margaret here:

Mike submitted paperwork to the Questura in October 2024 to renew his Permesso di Soggiorno (PDS) that would expire March 2025.  As the spouse of an Italian citizen, we believed that he could get it renewed for five years, instead of just one year, as were his previous PDSs two.  But the officer told us “We only do two years now. Come back in a month and you can pick up your card.”  Well, okay….

We returned in a month, and we were brushed off.  “Come back in two months.”

We returned again in March 2025 and got his card only to find out that it would expire in October 2026.  So, apparently it is only issued from the date that the PDS was requested, not issued.  Lesson learned from this was to not be pro-active, but put the paperwork in motion in October 2026 and just carry the paper receipt that shows that it is in process.

Then, Mike’s health card, the Tessera Sanitaria, was set to expire in February 2025.  So prior to it expiring, we went to the ASL office in Citta’ Sant’Angelo to try to renew it.  For some reason, the clerk would only renew it through April 14, 2025.  She said we needed to get approval from the stranieri office in Pescara, at the hospital.  They are only open from 11:00 a.m. to 1:00 p.m., so we rushed to Pescara (about 30 minutes, allowing for time to find a parking spot).  Here, after much back and forth, we were told that they would not accept Mike’s 2024 Italian tax return.  We needed to go to a CAF, or patronata office, to get what they called a “red document” in order to authorize issuance of a Tessera Sanitaria card. 

We had been to a patronage office in Montesilvano before, and they had been very helpful.  So we decided to go see them again.  Their office didn’t open until 3:00 p.m.  We were hungry.  Most places of business and many restaurants don’t open for lunch.  We drove around looking for a place to get something to eat, with no luck.  Now, after living in Italy for three years, we finally broke down and went to McDonald’s.  It actually wasn’t too bad – McD with an Italian twist. 

The staff at the patronage office were very nice.  They were somewhat confused when we told them we needed a “red document.”  Apparently that document had been discontinued in February.  So, they told us to ask our commercialista (accountant) for our 2025 Italian tax return or a statement to give to the folks at the Pescara office.

When we got home, Mike immediately shot off an email to our accountant.  It was several days before we got a reply.

The commercialista said that she doesn’t even get the software for 2025 tax returns until May, and that they should accept our 2024 tax return.  She offered to call them for us. Mike printed off her message, and we took off for Pescara.  After driving around the block five or six times, we found a good parking space, arriving at the office four minutes before opening hour.  There were already four people waiting.

Again, we were asked for the red document.  Mike handed them the printed message from our commercialista.  They scratched their heads.  They asked to see his Italian 2024 tax return again. 

Finally, one clerk wrote on a yellow sticky note (truly) the office’s approval to renew his Tessera card until April 2026.  He stamped it with two different stamps, and then the doctor initialed it.

We immediately drove to the ASL office in Citta’ Sant’Angelo (30 minutes).  Here, the nice lady had Mike fill out a request form and she went ahead and issued his new card, good through April 2026.  Then we start all over again…

Mike here:

Our 2025 Permesseo process involved 4 trips to the Pescara Questura, carrying a 3-ring binder of documentation so that when, not if but when, they attempted to shoo us away by saying something was missing we could then pull out a copy of that “missing” information. We kept going back to check because we knew not to put any credence in their promise to SMS us when the Permesseo was ready. The day we picked up Mike’s permesseo, we stood for 2 hours in the rain to get the card. For us it was a series of annoying steps but since Margaret is now an Italian citizen, Mike was protected as a spouse and, of course, we were diligent in our paperwork. The gatekeeper to this process was a true circus ringmaster. He organized the press of people, listened to their complaints and firmly pushed back when people got anxious. We had gone through a less organized process in prior years at the Lanciano Questura and we much preferred this version.

The health card process, Tessera Sanitaria, was more of a scramble as the people at the offices we went to were uncertain as to what they were allowed to do and kept referring us back to the office we had just come from. The joys of being a foreigner in Italy. Mike did one visit without Margaret but her status as a citizen, even just standing there, got a different response from the clerks. We took stock of our situation and realized that we were not making progress. Getting our outside experts involved was something we should have done sooner. At least this time we did not have to bring our lawyer to force the clerks to follow the legal process.

The reason Mike’s Italian tax return was important to this process is that foreign residents who do not pay taxes are required to pay at least 2,000 euros a year for a health card.  Margaret’s Italian father used to say: “It’s a privilege to pay taxes.” We are happy to pay our taxes and enjoy our Italian lifestyle.