Before falling pregnant, I had often heard that having a baby in Italy is free. Since becoming pregnant I have found out that for most people this is not the case. The cost of medical care varies from region to region and I can only speak of my experience being pregnant here in Calabria.
In Italy you can choose to go private or public. Private means you call and book your own appointments with a gynecologist in his/her private clinic. The majority of these doctors work in the public hospitals and have a private practice on the side. You will be looking at paying around 100 euro per visit - and this is without a receipt. If you ask for a receipt then you'll pay more, about 120 euro. Why...well - I'll let you figure that out, don't forget this is Italy we are talking about! You can have visits, and also ultrasounds at these private clinics, but don't be shocked if you get charged as much as 150 euro for an ultrasound. Also, don't be expecting a calm, orderly experience. Yes, it may be more calm then a lot of hospitals but you still have to wait your turn. When I went for a private visit, I was given an appointment at 10:30am. Stupidly thinking it would be like a doctors appointment in Australia, I assumed at about 10:45-11:00 I would be seen. I did not expect to walk into a waiting room full of women who had all been given a 10:30am appointment. It is then first come, first served of the batch of women with the same appointment time.
If you don't go private then the other option is to go public, which means booking your appointments with the public hospital. Here in Calabria gynecologist visits during pregnancy are free at the public hospital for all pregnant women. A lot of people prefer to go private since often you have to wait for an appointment at the public hospitals, and also you may see a different doctor each time. If you go private you can call and mostly make an appointment for the next few days. If you go to a big public hospital (such as Cosenza) then you need to wait about 3-4 weeks for a visit. If you're closest public hospital is smaller and less busy then the wait it much less. Bel fidanzato and went private for our first appointment, were shocked by the price for all 2 minutes of the gynecologists time, and since then have gone public. We have seen the same gynecologist each time and although she may not be the most happy, friendly person, at least she is always the same person, and at least she is free and seems to know what she is talking about.
Having ultrasounds and getting your blood/urine tests are charged depending on your circumstances. If you want to have anything done at a public hospital then you need to go to your general doctor and get them to write you a receipt/ticket. In Italy you register with a doctor, and this also is a free service for all Italians. If you visit another doctor then you pay, but if you see 'your' doctor, it is free. For example, your gynecologist will say you need to get X,Y,Z blood tests, you then visit your doctor who writes these on a ticket, and you then either go to a private clinic and pay, or make an appointment at the public hospital. If you go public, you will need to pay for this ticket. The price of a ticket depends on what you are getting done. If you need to have an operation, anything at all (not just pregnancy things), you must get a ticket and make the necessary payment. This can be anything from 2 euro - 40 euro, and possibly more as I don't pay for a ticket.
Now, why don't I pay for tickets? Well, thankfully here there is help for those on lower incomes. When we moved to Malito, bel fidanzato and I went to the comune to see what assistance there was. A friend had told us that she has this health care card of sorts which also gives you a discount on the electricity bill and medicine. To request this assistance you have to declare your earnings (as an individual/couple/family) for the previous financial year. If you fall below the threshold then you are entitled to this aid. Bel fidanzato and I fall into the bracket of low income. You also have to declare all assets, which unfortunately for us is next to nothing at the moment! I would recommend that those of you living in Italy go and speak to your comune to see if you can get this benefit.
It has been a god send for me since I have so far only paid 105 euro during my pregnancy (100 euro for my first private visit, then 5 euro later for this special sugar drink test to see if I had diabetes.) Since developing diabetes, I've had to have extra ultrasounds to make sure the baby is not growing too big, I also have to visit the diabetes specialist nearly every week, on top of my monthly gynecologist visits, and blood tests. I've recently been put on insulin and have not had to pay as much as one cent for my blood level testing kit, my testing strips, little needle things, and the actual insulin-pen like contraption thing I have. I do pay for my multi vitamins, but then that is to be expected as they are not a necessity, but a choice! In this sense, for me, having a baby in Italy has been money wise, stress free.
Up until my last blood test, I was also able to visit a beautiful private clinic and not pay for tests, but at the end of September there was a change in law here in the region of Calabria that says those of us with this benefit can no longer use private clinics. This is fair enough and not something I can be angry about as I did think it was a little too good to be true that I was able to go to any private blood testing clinic and have my tests done for free. The down side of this is that to book in for blood tests at public hospitals often means a long waiting list. The upside of this downside is that normally when you tell people you are pregnant they give you a little special treatment, and let you bend the rules....most of the time.
Now I've explained private and public costs for appointments, ultrasounds and blood tests, I need to move on to the birth itself. The funny thing that I have found is that the majority of women go private during the pregnancy, but then go public for the birth. This is for a few reasons. As I said above the majority of private gynecologists work in the public hospitals, so will be there to deliver your baby, also the public hospitals are much better equipped to deal with emergencies should they arise. The Cosenza public hospital also has a beautiful maternity ward. The rest of the hospital is as ugly as can be, but as soon as you enter the maternity ward you are put at ease by the pastel colours decorating the place. The corridors, bedrooms, everywhere you look, it painted in pinks, blues, purples, greens and yellows. My friend who has given birth there twice has nothing but positive things to say about the care she received in hospital.
When the baby starts letting you know 'it's time' then you need to go to the emergency ward. If your waters break, or contractions start then you don't book into the hospital. (If you have a C-section, or are going to be induced etc...then you make an appointment but it's still free.) Once you are seen and assessed you'll be sent up to the maternity ward, given a bed in the shared rooms (most of them are 2 or 3 beds) and then discharged after a few days.
So that is my rather confusing description of having a baby in Italy - well, a description of my experience having a baby in Italy! If you have questions I will try and answer them, and I will be posting more on this topic too.
EDIT: You may want to read my comments, as after posting this a fellow blogger has lashed out at me for basically taking advantage of the Italian government, saying that more or less I should not be entitled to this benefit. Perhaps I was not clear with my post, but I would like to say again that healthcare in Italy is more or less free FOR EVERYONE and that people only pay for tickets. In Calabria a gyno visit during pregnancy is always free regardless of your situation.
I would also like to say again that this benefit that I have is for people on a lower income - not just unemployed people, and furthermore I am not unemployed. I work and I pay tax (a lot.) I will apply for this benefit again next year, and I will get it again as my income from 2010 will still be under the threshold. A lot of people have lower incomes in Italy- by saying lower income I don't mean we are poor, starving victims crying out for help. I just mean that the government has at least acknowledged that if you fall below XXX euro per year, then you are able to get a little bit of help with medical care. There is a massive, massive differnece in wages here in Italy, a large division between high and low income earners, and FYI my discount on the electicity bill is a whopping 6 euro if I am lucky - so it's not like I am not paying even for my lap top to work! There are many benefits available in Italy and I do not claim, nor have I ever requested any of them. The differnece between me, and someone without this benefit is that they pay for their ticket and I don't. The operations, the doctor visits, the medical care is always free in Italy, you just pay a minimal amount for a ticket. I hope one day to not have access to this benefit, I hope one day my income is no longer in the lower wage category, I hope to have a finished house which will be a great asset to me...I hope, I hope.