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Contribution for health expenses for those enrolled with the Teachers and School Managers Assistance Scheme

Publication: 23/03/2022

The contribution consists of the payment of a financial contribution for the reimbursement of health expenses incurred by the official or on claim to the Teachers and School Managers Assistance Scheme and / or his/her family members.

Expenses incurred for health services of various types are allowed for reimbursement, with the exclusion of those for medical-legal activities and for treatments and interventions for aesthetic purposes. Health care costs included in the reimbursement also include those for spa treatments and for care and assisted reproduction treatments.

The contribution is reserved for beneficiaries registered under the system or upon claim to the Teachers and School Managers Assistance Scheme in addition to the beneficiary, the following family members can also be assisted:

  • the spouse / civil union partner cohabiting and dependent;
  • widowers dependent 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 reimbursement is claimed.

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 beneficiary of the certificate belongs to, without prejudice to the minimum thresholds for accessing the contribution, as stated in the following table:

ISEE
ISEE of the family unit to which the contribution beneficiary belongs toPercentage of contribution to health costsMinimum threshold for health expenditure for accessing the contribution
ISEE - up to €8,000 35% €750
ISEE from 0 to €24,000 25% €1,100
ISEE from 0 to €32,00020% €1,500
ISEE beyond €32,00015% €1,850


In addition, maximum reimbursement limits are identified for individual types of health expenditure.

The amount of the contribution cannot exceed a total of € 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.

Requirements

The requirement for reimbursement of expenses is registration with the Teachers and School Managers Assistance Scheme.

When can I claim?

Expenses for which reimbursement is claimed must have been incurred within the 12 months prior to the date on which the healthcare claim was made. It is also 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 on-line using the dedicated service.

The claim can be forwarded by the beneficiary of the Teachers and School Managers Assistance Scheme, by the spouse / civil union partner, by widowers, by adult children, by the guardian or other parent of the child of the beneficiary in the event the latter has lost guardianship.

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.