Health insurance in Italy grants access to private treatment, and internationals may prefer this option for its quality and convenience.
Italy’s healthcare system is unique because it’s tax-funded rather than insurance-based, so all residents have public coverage without making insurance contributions. However, those moving to Italy can also take out voluntary insurance to access private healthcare and other services unavailable through the public scheme.
Here’s all you need to know about health insurance in Italy, including:
- The Italian healthcare system and health insurance
- Who needs health insurance in Italy?
- 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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The Italian 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 in the country is funded through taxation rather than health insurance. Therefore, any legal resident can access the SSN if they have received a health card (tessera sanitaria) from their local health authority (Azienda Sanità Locale – ASL).
Services on the SSN are either free or low-cost, with co-payments required for some prescription drugs and specialist treatments. However, certain groups, like low-earners, children, and pensioners are exempt from co-payments.
Registering with the SSN is mandatory and free if 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.
In other words, if you do not qualify for SNN services, you can purchase international health insurance before relocating to Italy. Look at reputable providers, such as:
However, private policies can also be used in combination with the SSN to help you access extra medical care or cover co-payments.
Who needs health insurance in Italy?
Anyone without public healthcare coverage needs 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, European Union (EU) and European Free Trade Association (EFTA – Iceland, Liechtenstein, Norway, and Switzerland) nationals 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:
- Bosnia and Herzegovina
- Cape Verde (temporarily suspended)
- San Marino
- 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. You can still use Italian hospitals in emergencies but 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, many expats and 10% of Italians choose to take out voluntary supplementary private insurance.
According to State of Health in the EU report (2019) 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. Therefore, 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 getting private health insurance coverage
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
There are several national and international health insurance providers in Italy. 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 provider’s credentials before signing up with them.
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.
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
Since most residents access public healthcare in Italy, you only need health insurance if you want to use private health services. Therefore, there are no state special schemes or discounts for low earners. However, under the SSN, the following groups are exempt from making co-payments:
- Low-income households
- Children under 16
- Pregnant women
- Patients with chronic diseases
Any person belonging to one of these groups can take out private health insurance, but will have to pay the full premium rate based on their circumstances.
- 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