Health insurance - AMO
Registration of AMO Beneficiaries
To be eligible for Mandatory Health Insurance (AMO), the insured person and eligible family members must be registered with the program.
This process, known as registration, allows the system to identify beneficiaries and create their records. It should be distinguished from the actual entitlement to healthcare benefits, which also depends on the applicable insurance conditions.
1. Who is eligible for registration?
The system covers, in particular:
- salaried workers covered by the Labor Code;
- civil and military service members;
- members of parliament;
- retirees from the relevant pension plans.
Individuals enrolled in the INPS voluntary insurance program may also join the AMO under the specified conditions. Self-employed workers should therefore not be considered automatically covered solely by virtue of their occupation.
INPS, individuals covered by AMO.
2. Which family members are eligible for coverage?
Eligible dependents are family members who receive coverage through the insured person.
| Eligible Individuals | Main Conditions |
|---|---|
| Spouse or spouses | Must be a dependent and not personally eligible for AMO |
| Children under 14 years of age | Must be a dependent |
| Children aged 14 to 21 | Be a dependent and still be in school |
| Children with disabilities | No age limit when the disability prevents the person from engaging in paid work |
| The insured person’s father and mother | Must be dependents and not personally eligible for AMO |
A family relationship alone is not sufficient: eligibility must be proven, and the individuals must be registered.
INPS, beneficiaries of the insured person.
3. How do you apply?
The application for the worker’s registration may be submitted by the employer or the worker themselves, using the designated form, along with proof of identity.
The insured person must also declare their dependents.
Decree No. 09-552/P-RM, Articles 15 and 16.
Before submitting the application, verify that the last names, first names, and dates of birth on the documents match. Keep a copy of the application and proof of submission.
4. What documents must be provided for beneficiaries?
Depending on the situation, the required documents include:
| Person to be declared | Main required documents |
|---|---|
| Spouse | Marriage certificate and birth certificate, or substitute judgment |
| Child | Birth certificate or supplementary court order; certificate of life for children under 14 |
| School-aged child, ages 14 to 21 | School enrollment certificate |
| Child with a disability entitling them to coverage | Medical certificate attesting to the required disability |
| Dependent father or mother | Birth certificate or substitute court order, certificate of life, proof of financial dependence, and proof of ineligibility for AMO |
The documents must reflect each person’s actual circumstances.
Decree No. 09-552/P-RM, Article 17.
5. What should be done when multiple insured individuals can claim the same person as a dependent?
When both parents are insured, they jointly choose which parent the children will be enrolled under.
For a father or mother who may be claimed by several insured children, the child is assigned to the first insured person who registered the child. A transfer is possible when that person no longer qualifies for benefits.
Decree No. 09-552/P-RM, Articles 18 and 19.
Example: If both spouses are personally covered by AMO, they must coordinate their children’s enrollment to avoid duplicate registrations.
6. What is the health insurance card used for?
Registration allows the beneficiary to be enrolled and assigned an identification number. The card is then used to verify the beneficiary’s identity with participating providers.
It must be presented when seeking coverage. In case of doubt, the provider may also request a form of identification.
APPM, registration, and beneficiary cards.
The card is personal. It must not be used by a family member who is not the identified beneficiary.
7. How do you keep your records up to date?
Report any changes regarding the insured person or their dependents: address, employer, or family status. The decree requires that such changes be reported within 30 days, accompanied by the necessary supporting documents.
Decree No. 09-552/P-RM, Article 22.
If the card is lost, request a replacement from the appropriate agency. When the beneficiary loses their eligibility, the card must be returned in accordance with the applicable procedure.
8. Key Points
- The insured person and their dependents must be registered.
- Each family member must meet the eligibility requirements for coverage.
- The required documentation varies depending on the person being enrolled.
- Children must be enrolled when both parents are insured.
- The card is personal, and the file must be kept up to date.
- Enrollment should not be confused with the actual commencement of entitlement to healthcare benefits.