The healthcare system in Italy

Healthcare coverage is one of the first things to cross off your checklist after moving to Italy. If eligible, you can register with the public system, or take out health insurance for private care. Italy has a well-developed healthcare system that includes a variety of doctors, dentists, specialists at hospitals and clinics across the country. However, the quality of treatment may depend on where you live.

Read on for further information about Italian medical care, including:

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Overview of healthcare in Italy

The Italian healthcare system

Italy has a mixed public-private healthcare system. Since 1978, the National Health Service (Servizio Sanitario Nazionale – SSN) has provided free or low-cost universal healthcare to all citizens and legal residents. Those with additional health insurance, can also access the private medical sector.

The Italian Ministry of Health (Ministero della Salute) coordinates public healthcare and SSN services are handled by the 20 Italian regions. So, while Italy’s public healthcare is among the most efficient in the world, its quality can be uneven. Services in Rome (Roma) and Milan (Milano) are advanced and efficient, whereas they can be underdeveloped further south. Italy ranks only 20^th on the 2018 Euro Health Consumer Index (PDF) due to these regional discrepancies.

Italy is considered one of the healthiest countries in the world, with a high life expectancy and low rates of serious illness. Accordingly, only 1.8% of citizens have unmet medical needs, according to Italy’s European Commission country health profile (PDF).

After COVID-19 hit the Italian health system hard, the Ministry of Health responded with a plan to push public health services toward greater local delivery.

Who can access healthcare

Anyone who lives in Italy can access public healthcare, funded through taxation rather than health insurance. Care is available to all Italian citizens and legal residents as long as they have an SSN health card (tessera sanitaria). Nationals from the European Union (EU) or European Free Trade Association (EFTA – Iceland, Liechtenstein, Norway, and Switzerland) staying less than three months can use their European Health Insurance Card (EHIC) to access services. UK residents can use the Global Health Insurance Card (GHIC), which replaced the EHIC after Brexit.

Short-stay visitors from outside the EU/EFTA/UK cannot access Italian healthcare services without private travel insurance. Nationals from the following countries have mutual healthcare agreements with Italy that allow them access to urgent care medical services:

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

Cost of Italian healthcare

Italy spends nearly 9% of its GDP on healthcare, slightly below the EU average. The SSN is funded by national and regional taxes, and topped up with patient contributions and private insurance fees. The government allocates funding to the regions, which can make additional money by charging for services.

GP (general practitioner) visits, hospital stays for surgery or serious conditions, emergency care, and vaccinations are all usually free of charge. Prescriptions, diagnostic procedures, lab work, and some specialist treatments often require co-payment (where the patient pays part of the cost).

Cosmetic surgery, non-emergency dental work, and non-essential specialist procedures are usually not covered.

Children, seniors, pregnant women, and people with chronic diseases or low incomes are exempt from the co-payment scheme.

Italian health insurance

A tax-funded healthcare system means you don’t need to get health insurance coverage if you plan to use SSN services. After moving to Italy, all you need to do is apply for a health card/tessera sanitaria.

Short-term visitors from the EU/EFTA can use their EHIC to cover standard treatment costs for up to three months. Other visitors need to purchase private health insurance before they arrive in Italy. If you are a non-EU/EFTA national moving to Italy long-term, you will usually need to buy private health insurance for the initial period before you get a tessera sanitaria.

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Some internationals choose to take out private insurance that covers a full range of treatments and all costs. Global companies providing expat-friendly insurance plans in Italy include:

• Allianz Care
• APRIL International
• Cigna Global

How to register for healthcare in Italy as an expat

You can register for public healthcare through your local health authority (Azienda Sanitaria Locale – ASL). EU/EFTA citizens can do this immediately, while third-country nationals need to wait until they receive their Italian residence permit. To register, you will need:

• Valid photo ID, for example, your passport
• Residence permit if you are from a non-EU/EFTA country
• Italian tax number
• Your address, which should correspond to the one on your permit
• Employment details if you have a job or are self-employed
• Family status certificate (certificato di stato di famiglia) to register any dependent family members

If you are neither employed nor a dependent – for example, if you are a student or retiree – you can register with the SSN but must pay an annual flat-rate contribution (in Italian).

Once registered, you should receive your tessera sanitaria through the mail. This is usually valid for the duration of your residence permit, but check the expiration date so that you know when to renew it. You can use your healthcare card to register with a GP or pediatrician if you have children.

Private healthcare in Italy

Private healthcare in Italy can be used as an alternative to the SSN by locals and internationals. Advantages of private treatment include a wider selection of doctors, specialists, and treatments, as well as shorter waiting times and more English-language services. Around €41 billion was spent on private healthcare in Italy in 2021, almost a quarter of all healthcare spending.

Many foreign residents and 10% of Italians opt for private care in medical centers and hospitals across the country. Some providers also have agreements with the SSN, known as Privato Convenzionato, where private treatments are available for tessera sanitaria holders for free or at subsidized rates.

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Here’s what to expect if you have to pay for private medical care without insurance:

Fees for private insurance in Italy can range from €500–3,000 a year. However, many Italian employers offer private health insurance as part of their benefits package.

Italian doctors and specialists

Across the public and private sectors, there are 4.1 doctors per 1,000 people in Italy, slightly higher than the OECD average. Specialists in Italy include cardiologists, gynecologists, urologists, neurologists, and psychologists. You usually need a GP referral for specialist treatment, which may incur a fee if you’re on the SSN.

Women’s healthcare in Italy

The SSN offers many maternity services, including pre-natal and post-natal care, plus public hospital birth options. Alternative birthing centers are only available through private insurance.

You can see a gynecologist for free on the SSN, but you may need to pay all or part of the costs unless you have private health insurance. Birth control pills, shots, and intrauterine devices (IUDs) are all available through prescription, while you can purchase the morning-after-pill at pharmacies. Abortion has been legal in Italy since 1978, ensuring the right to terminate a pregnancy in the first 90 days. However, medical professionals can refuse to perform abortions on moral grounds, which may create a barrier for women who live in certain regions.

The Italian non-profit organization, Laiga, maintains a map of abortion providers, making it more accessible for women.

Children’s healthcare in Italy

Children in Italy have free public healthcare. To register your child, you must name them a dependent when registering with the SSN. If you have a baby in Italy, you should inform your local ASL of the birth. In addition to public services, private medical facilities are available for children in Italy through private health insurance.

You can register your children with a pediatrician or family doctor from birth. Children in Italy are exempt from co-payments until age 16, so their treatments – including dental care – are free.

Healthcare in Italy for seniors

Italy is a relatively long-lived country, with a life expectancy of 82.6 (PDF), higher than the EU average (80.1). People of any age can use the SSN, and there are plenty of specialists in geriatric medicine catering to the needs of older people, including:

• Managing multiple conditions and medications
• Cognitive care
• Physical rehabilitation
• Nutrition
• Pain management and palliative care
• Emotional well-being

Although the SSN covers you for most healthcare expenses, if you’re seeking more comprehensive care, it might be worth considering private international health insurance. This can also give you faster access to specialists and often includes non-essential services. Providers in Italy include:

• Allianz Care
• APRIL International
• Cigna Global – offers a specialized Individual Plan for Seniors

In addition, while many in Italy stay in the family home as they age, there are centers for over-60s who require assistance with their day-to-day lives. Retirement homes (case di riposo or Residenze Sanitarie Assistenziali – RSAs) offer round-the-clock care and accommodation. On the other hand, day centers (centri diurni) provide daytime support and activities but are not residential.

Furthermore, Italy offers a range of helplines for older adults, including a dedicated one for those affected by Alzheimer’s.

Italian dentists

Apparently, Italians maintain good levels of oral hygiene, according to a Qunomedical survey (2020), rating it best in Europe. Italy has over 50,000 registered dentists. However, the SSN only covers non-emergency dental care for children under 16, senior citizens, those with low incomes, and other vulnerable groups. Therefore, you should take out insurance to cover the costs of checkups and treatments. While procedural expenses are cheaper in Italy compared to many parts of Europe, standard health insurance policies sometimes don’t cover dental care. Check your coverage with your provider and take out extra dental insurance if necessary.

Hospitals in Italy

Italy has over 1,000 hospitals; 54% are public, and the rest are private, non-profit, or a public-private mix. Public hospitals are managed directly by local ASL units.

You will also find general and specialist hospitals in Italy, including 12 children’s facilities.

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Italian hospitals provide inpatient and outpatient services, including maternity, pediatric, and emergency wards, where most medical specialists work.

You will usually need a GP referral to access any non-emergency specialist treatment unless you use private facilities.

Health centers and clinics in Italy

Because healthcare in Italy is highly regionalized, facilities tend to vary across the country. Beyond hospitals and GP surgeries, you can also find clinics dedicated to psychiatric services or sexual health. Your ASL can provide details of what is available locally.

The Healthcare Assistance Continuity Center (Servizio di continuità assistenziale) provides out-of-hours, non-emergency care (usually from 20:00–08:00). These centers offer medical checkups and consultations, wound dressings, and prescription top-ups. Services are free, but you need an SSN card and a basic understanding of Italian or a translator. You can call the non-urgent medical assistance line – 116 117 – to find your nearest center or search for one on an online map.

Italian pharmacies

If your Italian doctor writes a prescription, you can pick it up from a local pharmacy (farmacia). Most pharmacies in Italy are small, family-run businesses. You can find them by the large green cross on the sign outside the store. In addition to prescription medication, pharmacies also sell over-the-counter medicine and have qualified professionals offering medical advice.

Most prescription medicine in Italy is heavily subsidized, with children, older adults, and low-income groups usually paying no more than €5. The SSN covers approximately 69% of prescription medication. Depending on the type of medicine, you can expect to pay 10–50% of the costs. However, there are no reimbursements for over-the-counter medication. See more medicine prices on the Italian Medicines Agency (AIFA) website.

Pharmacies in Italy open in the morning (09:00–12:30), close for lunch, and reopen again in the afternoon (15:30–19:30). Your ASL can provide you with details of local pharmacies, including those with extended hours (Farmacie di Turno).

Mental healthcare in Italy

The SSN provides mental healthcare at a community level in local health centers, day centers, residential facilities, psychiatric clinics, and hospitals.

If you need mental health services in Italy, you should first contact your GP. They should be able to refer you to the right specialist and may prescribe medication as necessary. You will likely have to pay a portion of the costs through the co-payment system.

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Another option is to seek private treatment where you don’t need a referral and usually get faster treatment. You can search for specialists and therapists on:

• Doctors In Italy
• MioDottore (in Italian)
• International Therapist Directory

Preventative healthcare programs

Italy offers preventative care through vaccinations, cancer screenings, and healthy lifestyle programs. The National Prevention Plan (in Italian) aims to promote good health in educational institutions, workplaces, and the community. It is supplemented by regional plans (in Italian).

For example, the Gaining Health (Guadagnare Salute) program combats smoking, alcohol, poor diet, and physical activity with advice and well-being activities. You can find out what’s available locally through your ASL. There is also an Italian governmental program called Active School (Scuola Attiva), which promotes sports and physical activity in primary and secondary schools.

Find more information on preventative health on the Ministry of Health website (in Italian).

Other forms of Italian healthcare available

Complementary and alternative medicine (CAM) is a form of Italian healthcare with limited availability through the SSN. In many regions, you will have to get health insurance to cover any treatment costs. CAM is more mainstream in Tuscany, where alternative therapies have been integrated into public healthcare since the 1990s. The most popular alternative medicine in Italy is homeopathy, acupuncture, and herbal remedies.

What to do in an emergency in Italy

The Italian emergency number is 118. You can also phone the EU-wide number 112 to speak to someone in English.

Italian general hospitals have emergency departments (pronto soccorso) that treat everyone in the country regardless of whether or not they are residents. If you don’t have a tessera sanitaria (in Italian) or applicable private health insurance, you will be responsible for any hospital costs.

Useful resources

• Ministry of Health (Ministero della Salute) – Italian government department responsible for healthcare (in Italian)
• National Health Service (Servizio Sanitario Nazionale) – provides public healthcare (in Italian)
• Doctors in Italy – English-language information on Italian healthcare with a search portal for English-speaking health professionals
• Laiga – non-profit organization provides a map of known abortion providers across Italy