The restricted household pays
A beneficiary with low income living with adult children who work and have substantial incomes.
CAF services · ISEE
Health and social care ISEE (ISEE socio-sanitario)
You need it for home care, day centres and fees for residential care homes. It has a rule that the ordinary ISEE (the Italian household means-test indicator) does not have, and it almost always works in your favour: the option of counting a smaller household.
01 · The benefits
Which benefits use the health and social care ISEE
It applies to means-tested health and social care benefits, meaning those for people with disabilities or who are not self-sufficient, provided at home, in day settings or in residential facilities.
- Integrated home care and personal support services.
- Day centres and semi-residential facilities.
- Residential facilities: RSA, RAF, supported housing (residential care homes and units), with a contribution to the fees.
- Support for living at home and independent living projects.
- Board and lodging in facilities for older people and people who are not self-sufficient.
It is a separate certificate from the ordinary ISEE: when you file the Dichiarazione Sostitutiva Unica (DSU, the self-declaration the ISEE is based on) you state this purpose and get the corresponding certificate.
02 · The favourable rule
The option of a restricted household
This is the feature that sets this ISEE apart. An adult beneficiary can choose to count a restricted household, made up of themselves, any spouse and any children under 18, leaving out the other members of the registered household.
The reasoning is simple: when a person who is not self-sufficient lives with adult children who work, the ordinary ISEE would end up counting income that is not meant for their support.
Who can choose it
The adult beneficiary of the health and social care benefits. Different rules apply to minors.
Who stays in the household
The beneficiary, their spouse and their children under 18. Adult children living with them and other members are left out.
The additional component
Adult children who do not live with the beneficiary and are not dependants do not disappear: they count through an additional component calculated on criteria of its own.
The choice
It has to be assessed with the figures: the restricted household does not always give a lower ISEE.
The additional component for children is the most delicate technical point: it is calculated for each child separately, with its own thresholds and allowances, and the total can come out more or less favourable than the full household. The comparison has to be made before choosing.
03 · The care home case
Residential care benefits
For a place in a residential facility, the health and social care ISEE follows further rules, because the contribution to the fees is one of the largest expenses a family can face.
- The beneficiary's income and assets are counted, with the restricted household if chosen.
- The additional component for each child not included in the household counts.
- Gifts made in earlier periods are taken into account, under the rules provided, to prevent assets being moved for the purpose.
- The beneficiary's home is treated under the rules for property assets.
- The provider may ask for its own additional documents, besides the certificate.
What to prepare for a care home application
These are the items that cause the longest delays if they are missing.
- Certificate of non-self-sufficiency or of disability
- Records of financial accounts, including average balances
- Land registry extracts for properties owned, including partial shares
- Personal and income details of all the children, including those not living with the beneficiary
04 · The case of minors
When the beneficiary is a minor
For beneficiaries under 18, the option to restrict the household does not apply. Instead, the rules of the ISEE for benefits for minors apply, including the one on the parent living elsewhere.
- The household is the child's ordinary one, according to the registry rules.
- The parent living elsewhere counts unless a documented ground for exclusion applies.
- Household members with a disability affect the equivalence scale and bring increases.
- Disability allowances reduce the income counted, by more as the severity increases.
05 · What to bring
The extra documents
On top of the ordinary checklist, you need the documents on the disability and on the children outside the household.
- Civil disability report or handicap certificate, stating the degree.
- Children's personal details, including those not living with the beneficiary: codice fiscale (Italian tax code), residence, family situation.
- Children's income and asset details relevant to the additional component.
- Records of gifts made in the relevant periods.
- Guardianship orders or appointment of a support administrator, if any.
Where there is an amministratore di sostegno (a court-appointed support administrator), the Dichiarazione Sostitutiva Unica is made by them, attaching the appointment order. It is a document worth bringing only once: it stays on file.
06 · The assessment
Restricted household or ordinary household?
The choice is not obvious and has to be made with the figures in front of you. These are the profiles that come up again and again.
The restricted household pays
A beneficiary whose children have dependent children of their own: the allowances in the additional component reduce the impact.
It may not pay
A beneficiary with significant assets of their own and children with modest incomes: the full household dilutes the indicator.
It needs calculating
Several children in very different situations: the sum of the additional components can outweigh the effect of the full household.
Frequently asked
The questions that keep coming up
My father lives with me. Can I be left out of the household?
Yes: if he is the adult beneficiary of the health and social care benefit, he can opt for the restricted household, which includes himself, any spouse and any children under 18.
You will still be part of the calculation through the additional component for children, with its own criteria and allowances. You do not disappear, but you count in a different way.
Do gifts made years ago count?
For residential care, the rules require gifts made in the stated periods to be taken into account, so that assets are not moved in view of the application.
The rules are specific and must be checked against the actual case: they affect the calculation, but not always to the extent people expect.
Do I also need the ordinary ISEE?
It depends on what you need to apply for. The same Dichiarazione Sostitutiva Unica can generate several certificates: ordinary, health and social care, for minors.
If you also need it for utility bonuses or other benefits, all the purposes are stated at once and you avoid coming back.
How long does it take to get it?
A few working days pass between filing the DSU and the issue of the certificate. The long part is gathering the details of the children, which often takes several steps.
If the application for a place in a facility has already started, begin with the ISEE straight away and do not wait for the provider to ask for it.
Let's talk
With applications for a care home, time is almost always short
If you are starting an application for a place, begin with the ISEE: it is the document needed first and the one that takes most gathering.