Getting health insurance in Italy

Italy’s healthcare system is unique because it’s tax-funded rather than insurance-based. As such, all working residents have public coverage without making insurance contributions.

Those moving to Italy for study or pleasure (e.g., pensioners) can take out voluntary insurance to access healthcare and other services unavailable through the public scheme.

Here’s all you need to know about health insurance in Italy, including:

Italy’s healthcare system and health insurance
Who needs health insurance in Italy?
- What happens if I am not covered by health insurance?
Private health insurance in Italy
Italian health insurance costs and reimbursements
Health insurance in Italy for unemployed or low-earners
Useful resources

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Italy’s healthcare system and health insurance

Italy’s hybrid healthcare system consists of the large, public-funded National Health Service (Servizio Sanitario Nazionale – SSN) and a smaller network of private healthcare providers.

Public healthcare is funded through taxation rather than health insurance. Therefore, any legal resident can access the SSN if they have registered with their local health authority (Azienda Sanità Locale – ASL) and received a health card (Tessera Sanitaria).

A female doctor is talking with her patients, showing them x-rays on a laptop. Everyone is wearing protective face masks. — Photo: FilippoBacci/Getty Images

Registering with the SSN is mandatory when you work in Italy. If you are neither working nor a dependent – for example, a student or retiree – you can opt-in to SSN healthcare voluntarily by paying a fixed annual fee. While this typically costs around €150 per year, expats from outside the EU must pay an additional €2,000 to access the public care system.

Healthcare

The healthcare system in Italy

If you don’t work in Italy, don’t want to register for the SNN, or simply cannot afford the non-EU charge, you can opt for private health insurance. Regarded as the best options for expats are:

You can also use private health policies in combination with the SSN to help you access extra medical care or cover co-payments.

Who needs health insurance in Italy?

All people must have health insurance to get medical treatment in Italy. Since proof of health insurance is required for most visa applications, you may need international coverage with a company like Allianz to cover the initial period after relocating to Italy.

For short stays of up to three months, nationals from the European Union (EU) and European Free Trade Association (EFTA – Iceland, Liechtenstein, Norway, and Switzerland) can use their European Health Insurance Card (EHIC). UK citizens can use the Global Health Insurance Card (GHIC), which replaced the EHIC after Brexit.

Italy also has mutual healthcare agreements in place with the following countries:

Argentina
Australia
Bosnia and Herzegovina
Brazil
Cape Verde (temporarily suspended)
Macedonia
Monaco
Montenegro
San Marino
Serbia
Tunisia
Vatican City

What happens if I am not covered by health insurance?

If you are not covered by either the SSN or an insurance plan, you may not be able to get non-urgent treatment. While you can still go to the hospital for emergency care, you can expect to pay costs out of pocket.

Private health insurance in Italy

Who should get private health insurance?

Since public healthcare enrollment is mandatory, private health insurance is only necessary for short-term visitors from outside the EU/EFTA or international residents waiting for their SSN card. Regardless, around 10% of the population chooses to take out voluntary supplementary private insurance.

A family of three stands at the front desk of a health clinic — Photo: Capuski/Getty Images

According to the 2022 State of Health report by the European Commission, the quality of public healthcare is uneven across Italy. While Rome (Roma), Milan (Milano), and Florence (Firenze) have state-of-the-art facilities, things are different in rural areas and the south. As such, you may consider private health insurance if you live outside a major Italian city.

Private insurance is also valuable if you need a fuller range of health treatments, such as private specialists, dental care, or alternative therapies.

The advantages of private health insurance

The benefits of taking out private health insurance in Italy include:

Advantage	What to expect
Full access to Italian healthcare	Freedom to use either public or private services across the country
Wider range of care	Access to treatment not freely available through the SSN, for example, dental care or physical therapy
Shorter waiting times	With fewer patients on private care, you can usually see a doctor more quickly
More choice over treatment	Unlike the SSN, private insurance lets you choose your general practitioner (GP) and specialist doctors
Direct access to medical specialists	You don’t need a GP referral to see a private specialist
Co-payment cost coverage	Private insurance plans cover co-payments for SSN services, like prescriptions and specialist consultations
Additional coverage	Includes, for example, private rooms in Italian hospitals
Availability of English-speaking staff	More likely to find English-speaking doctors in private clinics

While Italian public healthcare services are either free or low-cost, private insurance plans require a monthly premium. The more comprehensive the plan, the higher the premium will be. Older adults and those with pre-existing conditions may also pay higher premiums with private insurance.

How does private health insurance work?

There are two types of private health insurance in Italy:

Corporate health insurance – included in some employee benefits packages, where the employer pays part or all of the premium
Voluntary health insurance – taken out by individuals and unrelated to employment, where the insured pays the entire premium

Italy has several national and international health insurance providers. The Institute for the Supervision of Insurance (Istituto per la Vigilanza sulle Assicurazioni – IVASS) regulates the Italian insurance industry. All legitimate insurers are part of the register of insurance undertakings, so be sure to check the provider’s credentials before signing up with them.

Couple sitting on sofa at home using device, woman touching screen and smiling, view through open door. — Photo: Johnny Greig/Getty Images

Depending on your insurance plan, you will pay a monthly or quarterly premium to cover your healthcare costs. Most companies have different plan levels, ranging from basic to comprehensive. Premiums usually depend on the following:

The plan level you choose, and its claim limit (e.g., €1,000,000)
Coverage location (i.e. whether the policy extends overseas)
Extra coverage (e.g., dental care)
Personal information, such as age, health conditions, and lifestyle
Number of insured dependents

Many insurers offer customers lower premiums in exchange for higher deductibles. This is the amount you pay each year to activate your insurance. For example, if you have a deductible of €1,000, then you will usually have to pay this amount each year.

How to choose a health insurance provider

With the number of health insurance options in Italy, it makes sense to shop around and compare plans. Aside from the cost, things you might want to consider include:

Consideration	Questions to ask
Ability to tailor your policy to suit your needs	When it comes to the plan, are you able to select what you need and eliminate what you don’t?
Payment process	Will your insurer settle bills directly or do you have to pay first and then claim reimbursement? How complicated and/or time-consuming is the process?
Options for deductible	Can you lower your premium by increasing your deductible?
Overseas coverage	Is travel insurance offered and do you need it?
Customer feedback	How does the company score on consumer ratings websites?
Special offers and incentives	What additional benefits are offered? For example, do they partner with retailers or service providers to offer discounts elsewhere?
Ethics	How does the company fare on ethics and sustainability rating sites, such as CSRHub, Standard Ethics, and Corporate Knights?
Cancellation policy	How easy is it to change to another provider? Will you have to pay to cancel?

Private health insurance companies

Companies providing international-friendly health insurance plans in Italy include:

Italian health insurance costs and reimbursements

Health insurance costs vary according to the factors mentioned in the table above. Expect to pay anywhere from €100–500 a month.

Healthcare

Best health insurance quotes in Italy

Claim methods can differ between insurance companies and by type of treatment. Some insurance companies in Italy settle bills with healthcare providers directly, whereas others require you to pay upfront. Check with your provider to know which system they use.

Health insurance in Italy for unemployed or low-earners

SSN services are either free or low-cost, with co-payments (health tickets or ticket sanitari) required for some prescription drugs and specialist treatments. Since most residents can access cheap public healthcare in Italy, there are no state special programs or discounts for low earners.

Elderly woman sitting on the steps of the Scala Santa Sanctuary in Rome, Italy. She's smiling as she's feeding some pigeons. — The Scala Santa Sanctuary in Rome, Italy (Photo: Anastasiya Badun/Pexels)

That said, certain groups are exempt from making co-payments:

Children under 6 and seniors over 65, if their total household income is less than €36,152 per year
Unemployed and retirees over 60, if their household income is less than €8,263.31 per year or €11,362.05 if there is a dependent spouse
- The income threshold is raised by €516.46 for each dependent child
Social security recipients (e.g., social pensioners (pensione sociale)) and their dependent family members
Patients with certain chronic, disabling, or rare diseases and illnesses
Pregnant women
Other patients of social interest (e.g., unaccompanied foreign minors)

You can only get exempted from co-payments when certified by a doctor.

Useful resources

Ministry of Health – Italian government department responsible for healthcare (in Italian)
National Health Service – provides public healthcare
Doctors in Italy – useful English-language information with a search portal for English-speaking doctors
Institute for the Supervision of Insurance – regulatory body for insurance companies