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National Health Services for Expats in Italy

Submitted: April 2014

Italy has a comprehensive national health system, which is the second best in the world according to the WHO 2000 ranking. The right to health is recognised as a fundamental right under Italian law.

Unlike many other countries across continental Europe, Italy’s healthcare system is tax-financed and residence-based. Italy’s shift away from the continental, insurance-based tradition took place in 1978, when the Government undertook structural reforms as a result of the near-bankruptcy of social insurance schemes. As a result, Italy’s healthcare system now strongly looks like the UK’s National Health Service (NHS).

Entitlement to subsidised treatment is available for all residents in Italy, regardless of their nationality. To this effect, new residents must register with their local health office (Azienda Sanitaria Locale – ASL)in order to be issued a health card (Tessera sanitaria). You will need to show up your health card when you go to the doctor. In practice, you should carry your health card with you at all times.


Registration requirements

If you are an EEA citizen, registration is mandatory if you intend to stay for at least three months. If you are a non-EEA citizen, registration is generally mandatory if you have a residence permit.

Registration is not mandatory for students, but it is possible. EEA pensioners should first claim a portable document S1 from the country paying their pensions, failing which private health insurance may be required. The same rule goes for EEA working expats who keep paying social security contributions in their home country under a portable document A1.

Note that you will need to have obtained an Italian tax identification number (Codice fiscale) before registering with your local health office. More information on registration with SSN can be viewed here.


Service provision and health benefits

Healthcare is principally provided through the National Health Service (Servizio Sanitario Nazionale – SSN). Just like the UK’s National Health Service, the Italian SSN pays doctors directly.

Healthcare services may either be free of charge at user-point, or subject to a co-payment mechanism (a “ticket” – typically 25% of the bill). Unless you opt for unsubsidised private sector treatment, the system is typically as follows:

Co-payments may be waived for the elderly, the disabled, as well as low-income individuals.


European Health Insurance Card (EHIC)

If you come from another EEA country or Switzerland, the EHIC normally grants you access to public healthcare on the same conditions as Italian residents while you are temporarily visiting Italy, unless you specifically come to Italy to seek treatment. However, your EHIC may be invalidated by your country of origin if you are no longer residing there.

It is generally advised not to rely solely on your EHIC. European expats should therefore seek health or travel insurance to supplement their EHIC.



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