Healthcare System Italy – Information on the Italian national health service and details on how to register and benefit from the system…
Healthcare System Italy – National health insurance in Italy is managed by the National Health Service (Servizio Sanitario Nazionale – SSN) and funded through direct taxation (IRPEF and IRAP) as well as indirect taxation such as VAT and excise taxes on petrol.
Registration is handled at a local level by the Local Health Authority Service (Azienda Sanitaria Locale, ASL) which issues a social security number and a health card (Tessera Sanitaria). This entitles the holder to low or no-cost treatment. Hospital services are provided free and a 75 percent reduction is given on the cost of outpatient and some dental treatment. The addresses of ASL’s are displayed outside Pharmacies. Some ASL regional offices have their own websites with online services and contact details. Milan has the largest Health Authority: ATS Milano
Note: Regardless of coverage, emergency treatment is available at free or low-cost to anyone in need in Italy.
Information on who is eligible to register with the Italian National Health Service…
EU and non-EU nationals making National Insurance contributions can register with the National Health Service (SSN) and are entitled to the same health care and equal treatment as Italian citizens.
EU citizens staying in Italy for more than three months must register with the SSN if they are:
- An employee or self-employed
- A family member (EU or non-EU) of an employee or self-employed person in Italy. (A family member is a spouse, dependant child under 21-years and dependant parent)
- A family member (EU or non-EU) of an Italian citizen
- Has a permanent residence certificate obtained after at least 5 years’ residence in Italy
- Registered as unemployed, or unemployed and enrolled in a vocational program pertaining to their profession
- Holder of an S1 from (The S1 has replaced forms E106, E109, E120 and E121)
Foreign nationals required to register with the National Health Service (SSN) are those with a residence permit who are:
- Enrolled in the unemployment listings
Also required to register are foreign nationals with a regular residence permit, or those renewing their permits for the following reasons:
- Subordinate work (employee)
- Asylum application
- Foster care
Dependants of foreign family members with a valid residence permit must also register.
Some foreign citizens (and their family members) resident in Italy who are not required or entitled to automatic registration with the SSN may opt to enrol voluntarily, or take out a sickness, accident and pregnancy insurance policy, valid throughout Italy, and extended to their dependent family members. A fee is required and must be paid at a local post office before visiting the ASL office.
Duration of eligibility for the employed and self-employed
Those employed or self-employed in Italy are required to enrol in the National Health Service (SSN), with the cost of coverage paid through tax contributions.
- Those employed on a long-term basis, remain enrolled in the National Health Service for the duration of their employment
- Those employed on a fixed-duration contract of less than one year will be eligible for coverage for the duration of the contract. For longer-term contracts, annual renewal is necessary
- Any employed or self-employed EU national with a seasonal work contract of three months or less is eligible, though not required to register with the ASL and contribute to the National Health Service. Workers who choose to enrol will be covered for the duration of their work contract
Eligibility for retirees
Retirees who are EU citizens and are legally resident in Italy are entitled to register for state health insurance at no cost provided they have a Form S1. Form A1 should be obtained from the national health service of the former country of residence. It proves that appropriate social security taxes have been paid in the former country of residence, the person has reached the official retirement age and that they are receiving a state pension. Retirees not in possession of a Form S1 will be required to obtain private health insurance.
From July 1 2014, UK early retirees can not longer apply for a residual S1 form entitling them to up to 30 months of UK-funded healthcare if living in another EEA country.
Eligibility for students
Foreign students who attend a course of studies in Italy can be registered with the ASL for the duration of their course. The costs of registration are borne by their home country.
The procedures and requirements when registering for a health insurance card in Italy…
To obtain a health insurance card (Tessera Sanitaria) it is necessary to visit the local Health Service (Azienda Sanitaria Locale, ASL). Those who are employed or self-employed can enrol as soon as contributions are paid into the Italian National Insurance system.
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The health insurance card (or SSN card) and health number is issued on registration and must be shown whenever visiting a health service. The SSN card is valid for the same period as a residence permit.
Required documents for compulsory enrolment with the SSN include:
- Identity card
- Fiscal code (codice fiscale)
- Residence permit
- Self-certification regarding your residence or abode
The government’s Stranieri in Italia website offers information for foreigners residing in Italy.
- For more information on the documents needed to apply for national health insurance, see the Stranieri in Italia website
Contribution costs are based on factors such as income level and family size. Contact the ASL for more information.
The ASL will issue the Medical Card (Tessera Sanitaria). In case a card is lost or stolen, contact the ASL for a replacement.