Senior citizens’ cards: confusion over how to use the 300 euros, but in the meantime the Department of Health remains on the sidelines

Among the measures set out in the 2027 budget, the one that has probably attracted the most attention is the €300 ‘voucher’ for the elderly. There are two distinct approaches to analysing this legislative measure: one political and the other concerning legislative technique. As regards the former, reactions and comments have obviously varied widely depending on one’s perspective. Everyone is entitled to their own legitimate view on the matter; what is more interesting, however, is an examination of Article 53 of the draft bill in terms of its technical and legal content.

The Prime Minister herself has stated that the allocation of 1.7 billion is in addition to the 2.4 billion increase in the Health Fund, demonstrating the significant financial investment in healthcare. However, what is being discussed is by no means a healthcare measure, and its placement within the draft bill alone is sufficient proof of this. In fact, Article 53 is not included in Title V, entitled ‘Measures relating to healthcare’, but rather in the preceding Title III, which covers a wide range of measures relating to employment, social security and social welfare. Furthermore, as further proof, the Ministry of Health will not be involved in drafting the implementing decree. The entire administration of the Card is entrusted to the INPS, which, as is well known, does not deal with healthcare. The measure applies only to 2027, another rather unequivocal indication of the true nature of Article 53.

As regards the beneficiaries – who, according to the Technical Report, number almost 5.5 million – two cumulative requirements are set out: having reached the age of 75 by 31 December 2026 and receiving a pension of any kind not exceeding, for the year 2025, €28,000 (almost four times the amount of the social allowance). As for the first requirement, there is nothing to be said; it is an objective and indisputable criterion. The second, however, conceals an obvious and serious flaw in its design, as it refers solely to pension income and ignores other important components of the individual’s financial situation; above all, it fails to take household income into account. Consequently, the €300 could be claimed by a widow on a minimum pension who owns dozens of properties, as well as by the retired wife of a person with an income of €100,000.

But it is the finalisation of the amount that is shrouded in the greatest uncertainty. Given that, in the comments, the ‘card’ has been referred to variously as a ‘voucher’ or ‘coupon’, it should be noted that the media and specialist websites have gone to great lengths to try to decipher the dry legislative provision, which merely states that the card will be used ‘for the purchase of goods and services relating to healthcare, as defined by the decree referred to…’. As for the specific nature of these goods and services, commentators have almost unanimously made a general reference to services not covered – or not reimbursed – by the National Health Service; or, to go into more detail, medicines, specialist consultations and certain dental treatments.

The crux of the matter, according to some rumours, would appear to be the fact that these services fall outside the scope of the LEA – that is, the Essential Levels of Care guaranteed by the National Health Service. And the reference to ‘dentures’ is, in this sense, a prime example. These doubts will be dispelled by the interministerial decree, which is expected by next January and is tasked with setting out in concrete terms ‘the conditions for the accreditation of commercial premises, healthcare facilities and professional healthcare services’. The guidance provided by the law for ‘commercial establishments’ suggests pharmacies, parapharmacies, supermarkets and shops selling healthcare products. Meanwhile, ‘healthcare facilities’ will likely be private ones, whether accredited or operating purely on a private basis.