Procedures for Health Care for Mariners
To access the health care and services offered by SASN clinics by eligible beneficiaries, as indicated in Article 2 of Presidential Decree No. 620 of July 31, 1980, prior registration is required. Interested parties must submit a specific application for registration with the Ministry of Health’s assistance to the SASN territorially competent, to be submitted directly or through the belonging shipowner company.
For any doubts about the service delivery methods, it is recommended to refer to the SASN Offices and Clinics. Regarding procedures for accessing indirect assistance and the related reimbursement system, please contact the General Directorate of Prevention, Office X.
In Italy, mariners residing or temporarily located in areas where a clinic is directly managed by the Ministry of Health or where a trusted physician of the Ministry operates must necessarily seek medical services at the clinic or with the trusted physician. General medical care is provided both on an outpatient and home visit basis, depending on the patient’s physical condition.
Specialist care is provided in locations where SASN clinics are located, at the same SASN clinic, upon the prescription of the SASN clinic’s general practitioner or a trusted home-based physician of the Ministry of Health.
In areas without SASN clinics, services are provided upon the prescription of the trusted physician, at the facilities and clinics of the Local Health Authorities (ASL) or those affiliated with them.
If a mariner resides or is temporarily located in an area without SASN clinics or a trusted physician affiliated with the Ministry of Health, they must contact the competent ASL, presenting the health assistance card obtained upon registration from the relevant SASN Office. In this case, the procedures for obtaining health services and their limitations are the same as those for the general population of Italian residents, including the payment of any applicable co-payments.
During navigation for mariners and aviation personnel, medical care must be provided by the onboard medical services.
In Italian territorial waters, it is possible that the patient, if transportable, may be assisted by an SASN clinic or a trusted physician, or, in the absence of these, by the competent ASL, or if non-transportable, by a Ministry-affiliated trusted physician who visits the patient on board.
In foreign territorial waters or foreign airports, when onboard medical services cannot provide effective assistance, the patient is assisted by a trusted physician affiliated with the Ministry of Health, or in the absence of one, by the nearest healthcare facility or a private practicing physician. In this case, the costs for health care (which is indirect in this scenario) are advanced by the ship’s command or the shipowner and subsequently reimbursed by the relevant SASN Office, within the limits provided for indirect assistance.
Abroad, a distinction must be made between the care provided in European Union (EU) countries and other countries.
In EU countries, eligible mariners can receive assistance in the host country by presenting the European Community model E 111, which is issued in advance by the relevant SASN Office and is valid for six/twelve months. However, in ports or airports where the Ministry of Health has its trusted physician, the mariner must contact them.
In other countries, healthcare services are directly provided by trusted physicians or facilities affiliated with the Ministry of Health. In the absence of a trusted physician or in cases of specific documented needs where it is not possible to locate the physician, the beneficiary can turn to local public or private healthcare facilities. The costs of these services are advanced by the shipping companies and reimbursed by the Ministry of Health upon request, accompanied by the original expenditure certification.