Health care in Italy

How the national health service is organised

The Servizio sanitario nazionale (SSN) is funded from general taxation and run by the Regions through local health authorities, whose names change from region to region (ASL, ATS, AUSL, ASP, ASUR). Registration takes place at the health authority of the Comune where you live (art. 34, para. 7, TUI) and entitles you to choose a general practitioner (medico di base) and, for children, a paediatrician, who prescribe medicines, specialist visits and tests and refer you to hospitals. The document proving registration is the health card (tessera sanitaria), which also carries the tax code; for people registered with the SSN it also serves as the European Health Insurance Card in other EU states. Service levels, waiting times and organisation vary markedly between Regions.

Who is entitled to care

EU, EEA and Swiss citizens. For temporary stays, your own country's European Health Insurance Card (EHIC) entitles you to treatment that cannot wait until you return, under the same conditions as people insured in Italy; it does not cover private care, repatriation or planned treatment. Anyone who moves to and works in Italy is insured in Italy and registers with the SSN; pensioners and other non-active people insured in their home country ask their institution for the S1 form and register it with the health authority where they live.

Non-EU citizens. Registration with the SSN is compulsory, with equal treatment, for anyone working as an employee or self-employed or registered as unemployed, and for anyone holding or having applied for a permit for work, family reasons, asylum and protection, pending adoption, fostering or acquisition of citizenship (art. 34 TUI); it also covers legally resident dependent family members. Anyone outside these categories (for example elective residence) must hold insurance valid in Italy against illness, accident and maternity, or register with the SSN with an annual contribution whose minimum is set by law at 2,000 euro. Students and au pairs may register voluntarily with a flat-rate contribution, whose minimums (700 euro for students, 1,200 for au pairs) are in the same article; actual amounts are set by the Regions.

Tourists and unregistered people. They pay for services at regional tariffs (art. 35, para. 1, TUI). Urgent or in any case essential care, protection of pregnancy and maternity, children's health, vaccinations and prevention of infectious diseases are guaranteed even to those without a residence permit, and seeking care does not lead to reports to the authorities, except where reporting is mandatory (art. 35, paras. 3 and 5, TUI).

How care works in practice

The family doctor prescribes medicines and services with an electronic prescription (ricetta dematerializzata): the patient receives a paper reminder or the electronic prescription number to show at the pharmacy or when booking. For many services and some medicines a co-payment (ticket) is due; exemptions for income, age, chronic illness or disability are defined by the State and the Regions and must be activated at the health authority. Visits and tests are booked through the health authority's central booking centre (CUP), at the counter, by phone, online or in pharmacies; waiting times vary greatly by service and area. Alternatively you can choose the intramoenia private practice, paid, with the same hospital staff and shorter waits.

Pharmacies dispense prescription and over-the-counter medicines, offer booking and measurement services and keep night and holiday rotas. For emergencies the single European number 112 is free and works throughout the Union from fixed and mobile phones, alongside national numbers. Outside the family doctor's hours, for non-urgent cases, the out-of-hours service (continuità assistenziale, guardia medica) organised by the health authority responds. In the emergency room access is ordered by severity (colour-coded triage) and nobody is refused; for the least urgent cases the Regions may charge a ticket.

Private insurance, pregnancy, vaccinations, mental health, dentistry

Private insurance is required when the law does not provide for compulsory SSN registration: for the elective residence visa and permit, for digital nomads and remote workers (the decree of 29 February 2024 requires cover for medical treatment and hospital stays valid throughout Italy for the whole stay) and for students who do not register voluntarily with the SSN. Policies normally cover urgent care and hospital stays; conditions and limits should be compared with what the consulate requires for the visa.

Pregnancy and childbirth are followed by the SSN through family counselling centres (consultori) and hospitals, and maternity protection is guaranteed even to those not registered. For children the national vaccination schedule is defined by the national vaccine prevention plan and published by the Istituto Superiore di Sanità; some vaccinations are compulsory for school enrolment (decree-law 73/2017) and checks are the responsibility of health authorities and schools. Public mental health services are run by the health authorities' mental health centres (CSM), with direct access or through the family doctor. Dentistry is covered by the SSN only in limited cases (minors, vulnerable conditions, emergencies): in practice it is mostly private and paid for.

Registering with the national health service

1. Check your entitlement

   EU citizens: registration as workers, with the S1 form or, for non-active people, with their own health cover. Non-EU citizens: compulsory registration with a permit (or application receipt) for work, family, asylum and similar cases (art. 34 TUI); voluntary with a contribution for students and au pairs; for other permits, insurance or registration with an annual contribution.

2. Go to the health authority of the Comune where you live

   At the doctor-choice counter (or online, where the Region allows it) present an identity document, tax code, residence permit or application receipt, self-declaration of residence or abode and, for workers, the contract or unemployment registration; for voluntary registration, the receipt for payment of the contribution.

3. Choose your doctor

   On registration you choose a family doctor (and a paediatrician for children) among those with places available in your area; the choice can be changed later.

4. Receive the health card

   The health authority issues a provisional certificate; the health card arrives by post. Registration lasts as long as the residence permit and is renewed with it; while renewal is pending, the receipt is valid.