Two things worth knowing before you read anything else
The indennità di accompagnamento is paid regardless of income. Not reduced by the pension, not means-tested, not affected by whether the family has money. Families who assume they earn too much simply never apply, and that assumption is wrong.
And it is paid whether the person lives at home or in an RSA, with certain adjustments where the stay is publicly funded. It is not an alternative to a care home. It is money that helps pay for one.
What each one is
Invalidità civile is the recognition of a degree of civil disability, expressed as a percentage. It is the gateway: several entitlements, including exemptions and Legge 104 protections, hang off it.
Indennità di accompagnamento is a monthly allowance for a person who cannot walk unaided or who cannot perform the ordinary acts of daily life without continuous assistance. It is granted at 100% recognised disability plus that condition of continuous assistance.
For dementia, the second criterion is usually the one that applies. A person who walks perfectly well but cannot be left alone qualifies on the grounds of continuous assistance, and this is precisely the case that families most often fail to present properly.
The route, step by step
- The certificato medico introduttivo. The family doctor files it electronically with INPS and gives you a receipt with a number. Nothing starts without this number.
- The application to INPS, filed within a limited window after the certificate — normally done through a patronato, which is free, or through a CAF.
- The assessment, before a medical commission. This is the step that generally requires the person to be present, though a home visit can be requested where the person cannot travel, and that request must be made explicitly and supported medically.
- The decision, followed by payment set against the date the application was filed — which is why filing early matters even if the file is imperfect.
Use a patronato
For a family abroad this is the single most useful piece of advice in this article. A patronato is a public-interest assistance office. It files these applications every day, it costs nothing, and it can be given a delega to act.
Trying to run the process yourself from another country, through a portal that assumes SPID and Italian residency, is slow and error-prone. A patronato removes most of that friction for free.
Where applications fail
The medical certificate is generic. A certificate that says the patient has Alzheimer disease says less than one describing what the patient cannot do without help — which is what the commission assesses.
Nobody attends the assessment with the person. A family member who can describe the ordinary day, and the ordinary night, changes the outcome. If you cannot be there, brief whoever will be, in writing.
Everyone waits for the diagnosis to be complete. The application is filed on the current situation, not the final one. It can be revised.
A refusal is treated as final. It is not. There is a defined appeal route with a strict deadline, and refusals overturned on appeal are common, especially where the original file described the good days.
And once it is granted
The allowance is paid monthly and the recognition also opens other doors: exemptions, Legge 104 rights for a relative who works in Italy, and access to certain regional support.
If your parent later moves into a publicly funded RSA place, the position can change and must be reported. Report it — an undeclared change becomes a repayment demand later, and repayment demands arrive at the worst possible time.
*Curalune supports the search and the orientation. Curalune is not a patronato and does not file applications on the family behalf. Decisions rest with INPS and the medical commission.*