Haris Ashley
Italy has a well-established public welfare system with a particular emphasis on healthcare. The Italian healthcare system is managed at a regional level by authorities called Azienda Sanitaria Locale (ASL). The National Health Service (SSN) provides Italian citizens with access to free or very cheap basic medical services, including hospitalization and treatment, visits to family doctors and specialists, discounted medication, laboratory services, and ambulance services. Foreigners living in Italy or planning to move there will need to obtain health insurance before arriving in the country. This can be done either through private insurance or public health insurance.
| Characteristics | Values |
|---|---|
| Public health insurance system | Servicio Sanitario Nazionale or "SSN" |
| Spending on healthcare | Over 9% of GDP |
| World Health Organization ranking | Second best healthcare system overall |
| Life expectancy | 11th highest |
| Infant mortality | Very low |
| Requirement for foreigners | Must have health insurance before arrival |
| Stay duration requirement | Must obtain a permit to stay for more than 90 days |
| Private health insurance requirement | Must be valid for the expected time of stay |
| Public health insurance fee | Approximately 145 euros |
| Public health insurance coverage | Full coverage, not limited to emergencies |
| Private insurance advantage | Access to top-class services everywhere without waiting lines |
| General practitioner requirement | Yes, you must register with a general practitioner or "medici di base" |
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What You'll Learn
Italy's public health insurance system
The Italian healthcare system is managed at a regional level by authorities called Azienda Sanitaria Locale (ASL) and operates on a mixed public-private model. While public healthcare in Italy is free for both expat residents and Italians, many Italians and most foreigners opt for private healthcare, which can be very expensive. Private insurance is not a requisite for foreigners, but those who choose to continue with their private health insurance in Italy may wish to invest in INA-Assitalia Insurance, which covers urgent medical assistance in any hospital emergency room.
To access Italy's public health insurance, foreign citizens must register with a general practitioner or 'medici di base' via their local ASL, and apply for an Italian health insurance card. This requires various documents, including a residence permit, tax number, official identification, and proof of employment. Expats requiring chronic or specialist treatment may prefer to opt for private health insurance, as waiting times for ambulances can be longer in rural areas, and emergency services may struggle to provide English-language support.
Italy spends over 9% of its GDP on healthcare, which is above average compared to other developed countries. This spending has resulted in one of the highest standards of healthcare in the world, with Italians ranking 11th for highest life expectancy and very low levels of infant mortality.
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Private health insurance
Italy has a well-established public welfare system that places a strong emphasis on healthcare. The Italian healthcare system is managed at a regional level by authorities called Azienda Sanitaria Locale (ASL). The national health service in Italy, Servizio Sanitario Nazionale (SSN), provides residents with free or low-cost healthcare that includes access to general practitioners (GPs), treatment at public hospitals, subsidised medicines, lab services, ambulance services and certain specialist care.
However, private health insurance is also an option in Italy. While it is considered a luxury, it grants access to top-class services everywhere, without waiting lines. Private healthcare allows expats to avoid the queues and complications of the public system, and enables provisions for more comforts and personal choice when it comes to doctors and facilities. For these reasons, although public healthcare in Italy is free for both expat residents and Italians, most foreigners and many Italians still opt for private healthcare if they can afford it.
Private procedures vary in cost, although the Ministry of Health sets a minimum charge for all operations in this sector, which means it can get very expensive and health insurance is a must. In many cases, employers are obligated to finance health insurance for their employees, but if not, expats should organise it themselves. Non-EU expats must present proof of insurance when applying for their "permesso di soggiorno", or permission to stay. For non-EU expats, the process is more complicated than it is for EU residents.
If you choose private medical insurance, you will have access to a number of benefits. These include admission to more facilities (as well as cover for overnight stays in hospitals), reduced waiting times, and faster access to expert medical support and surgeries. No matter where you are in Italy, all plans include emergency transport, evacuation and repatriation. With some plans, you even have the option to cover outpatient treatments that are not normally covered by Italy’s national health service.
If you have private coverage at home, as a non-EU citizen, the requirements are different. In order for your private health insurance in Italy to be valid and to obtain a permit to stay, some requirements include legitimacy in the Schengen area, exact coverage period and expenses, and a ceiling of 30,000 euros. If you choose to continue with private health insurance in Italy, it is recommended that you invest in the INA-Assitalia Insurance, which accounts for urgent medical assistance in the Emergency Room of any hospital. This costs around 49 euros for six months and 98 euros for one year.
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European Health Insurance Card (EHIC)
The European Health Insurance Card (EHIC) is provided free of charge to all legal residents of participating countries. As of 2021, 31 countries in Europe participate in the scheme: the 27 member states of the European Union (EU), and 4 member states of the European Free Trade Association (EFTA). The card is applicable in all French overseas departments (Martinique, Guadeloupe, Réunion, and French Guiana) as they are part of the EEA, but not in non-EEA dependent territories like Aruba or French Polynesia. However, the EHIC can be used in the Faroe Islands and Greenland, despite them not being in the EEA.
The EHIC makes it easier for people from the EU's 27 member states, as well as from Iceland, Liechtenstein, Norway, Switzerland, and the UK, to access healthcare services during temporary visits abroad. The card is only valid for healthcare that is normally covered by a statutory healthcare system in the visited country. Additional costs can be covered by taking out travel insurance.
The UK was a participant in the scheme as an EU member, but this changed after its withdrawal from the union. However, EU citizens can continue to use their EHIC within the UK, while the UK has replaced the EHIC with a UK Global Health Insurance Card (GHIC). Some UK citizens and permanent residents are eligible for a new UK-issued EHIC, valid for visits to EU countries, Switzerland, Norway, Iceland, and Liechtenstein.
Italy has a well-established public welfare system with a big emphasis on healthcare. The National Health Service (SSN) provides all Italian citizens with access to free or very cheap basic medical services, including hospitalization and treatment, visits to family doctors and specialists, discounted medication, laboratory services, and ambulance services. The Italian healthcare system is managed at a regional level by authorities called Azienda sanitaria locale (ASL).
Foreigners living in Italy or visiting Italy for longer than 90 days will need to obtain private health insurance or register with the SSN. The SSN is funded through a combination of income tax and government funding, with employees contributing about 10% of their income for their first €20,600 of annual income, and 4.6% of income for earnings over this amount.
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Registration process for foreign citizens
Italy has a well-established public welfare system with a big emphasis on healthcare. The National Health Service (SSN - Servizio Sanitario Nazionale) provides universal coverage, including the full funding of public doctors and prescription drugs. The SSN provides free or very cheap basic medical services to all Italian citizens.
Foreign citizens looking to register for health insurance in Italy should follow the below steps:
- Identify your local health authority/provider, the ASL (Azienda Sanitaria Locale). This is determined by your place of residence.
- Register with a general practitioner or 'medici di base'. Your local ASL will have a list of 'medici di base' who are taking on patients. Note that most doctors limit their number of patients and some will have a waiting list.
- If you are an international student, health insurance in Italy is required before you arrive. Visit your healthcare provider at home and obtain the necessary documents to demonstrate proof of coverage.
- If you are an EU citizen, you can use your TEAM (Tessera Europea Assistenza Medica), a Health Care European Card, which is issued by the relevant authority in your respective country.
- If you are staying in Italy for over 3 months, you must obtain a permit to stay. Without proof of coverage from your home provider, this is impossible to do.
- If you have private coverage at home, as a non-EU citizen, the requirements are different. For your private health insurance in Italy to be valid, you must meet certain requirements, including legitimacy in the Schengen area, the exact coverage period and expenses, and a ceiling of €30,000.
- If you are staying in Italy for less than 3 months, you have the right to access free health services.
- If you are an EU citizen and do not fall under the mandatory registration criteria, you can register voluntarily by paying an annual fee. The minimum fee is €400 per year.
- If you are a student, you must pay a fixed fee of €149.77. Paying the fee grants you the right to use the available services free of charge until the end of the calendar year. You can pay this fee at any post office by filling in the F24 form (Modello F24).
- Bring the proof of payment, your passport, and your residency permit to any ASL location to complete your registration.
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Italian health insurance card
Italy has a well-established public welfare system that prioritises healthcare. The country's public health insurance system is the Servizio Sanitario Nazionale or "SSN", which provides free or very low-cost healthcare to all Italian citizens and non-citizens with residency status. The SSN is managed at a regional level by authorities called Azienda sanitaria locale (ASL).
The Italian Health Insurance Card, or Tessera sanitaria in Italian, is a personal card for all citizens entitled to benefits from the Italian National Health Service. The card is made of plastic and is the same size as a typical ATM card. It contains the following information:
- Tax code
- Expiration date
- Biographical data
- Coat of arms of the Italian region of residence
- Braille characters for the blind
- Integrated circuit
- Barcodes
- Magnetic strip
The card is valid for six years from the date of issue and is sent by ordinary mail to the cardholder's address of residence. The rear side of the card acts as a European Health Insurance Card. It is necessary to supply the health insurance card or Italian fiscal code card when purchasing medicine.
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Frequently asked questions
Italy's public health insurance system is the Servicio Sanitario Nazionale or "SSN". The SSN provides universal coverage, including the full funding of public doctors and prescription drugs.
The SSN covers hospitalization and treatment, visits to family doctors and specialists, discounted medication, laboratory services, and ambulance services.
The SSN is funded through a combination of income tax and government funding. Employees contribute about 10% of their income for the first €20,600 of their annual income. Earnings over €20,600 are set at 4.6% of income.
To register for the SSN, you must visit your nearest local health authority (Azienda Sanità Locale) and apply for the card. This usually requires documents such as your residence permit, tax number, official identification, and proof of employment.
Some alternatives to the SSN include private health insurance or, for EU citizens, the European Health Insurance Card (EHIC).
