Health Insurance and Healthcare in Italy Explained

How Healthcare Works in Italy

This section covers all you need to know about Italy’s healthcare system, from how to register with the Servizio Sanitario Nazionale (SSN), to what is covered by public healthcare in Italy.

Healthcare Facts about Italy

According to the Bloomberg Healthiest Country Index of 2019, Italians are some of the healthiest people in the world, likely due to their healthy diet and lifestyle.

In contrast, the Italian healthcare system sometimes falls short on quality and efficiency. Even though Italy ranked among the top countries for their healthcare system’s performance on the World Health Organization report, this ranking is based on overall health expenditures and life expectancy, not necessarily the quality or efficiency of medical services and facilities. Some public hospitals in Italy are, in fact, overcrowded and lack funding.

Despite this, Italian hospitals and medical facilities are more than capable of treating medical needs and emergencies. In general, you will find better quality services in the north and bigger cities than in the south of the country.

How does Healthcare Work in Italy?

If you want to know if Italy has public healthcare, you can rest assured it does. The country provides a mixed public-private healthcare system, so you can choose between the two at any time as long as you are eligible.

All legal residents, both Italians and foreigners, have the right to public healthcare. These services are usually free-of-charge or subject to a symbolic cost and are provided by the Servizio Sanitario Nazionale (SSN).

How to Sign-Up for Italy’s Public Healthcare System

The first step to being eligible for public healthcare in Italy is to register with the SSN. This is done at the Azienda Sanitaria Locale (ASL), your local health unit.

At your ASL office, you can carry out the following formalities:

• Registering with the Italian National Healthcare Service
• Obtaining a Tessera Sanitaria
• Choosing a public primary care physician (medico di base)
• Choosing a pediatrician for your children, if applicable
• Requesting medical leave or medical care at home, etc.

Registering with the SSN and Obtaining a Tessera Sanitaria

You receive your Tessera Sanitaria when you first register with the SSN. There are two types of registrations, mandatory and voluntary­. The first applies to most residents, workers, family members, etc., while voluntary registration is typically for visitors of shorter stays, such as students, au pairs, religious staff, etc.

The first step is to visit the ASL to know which requirements apply to you and receive instructions on how to fill the application form. This form is the Bollettino Postale. It is obtained, filled, and paid for at the Post Office, for which you will be given a receipt.

Required Documents

Then you must present both the form and the receipt at your ASL along with the following documents:

• passport;
• your tax code (Codice Fiscale);
• residence permit (or proof you have requested one, such as the receipt);
• self-declaration of address (which must match the residence permit);
• receipt of payment of the registration with the SSN.

The health card is then sent to your home address. In the meantime, hold on to a copy of the receipt.

Your health card is valid as long as you have permission to stay in the country. If you renew your residence permit, make sure you renew your Tessera Sanitaria as well. This is done at the ASL, with:

• passport;
• proof that you have requested the renewal of your residence permit;
• your tax code;
• certificate or self-declaration of residence.

Once you are properly registered with the SSN and have your Tessera Sanitaria, you will be asked to register with a family doctor. This process is spelled out for you later in this section of the guide.

What does Public Healthcare Cover?

Italy’s healthcare covers most medical procedures for all legal residents. Dental care is free in emergency cases and for all children up to 16 years of age. Other procedures, such as orthodontics or laser eye surgery, are generally not covered but may be subsidized to some extent on a case-by-case basis. Cosmetic surgery is not covered by public healthcare.

Prescription medication is typically subsidized but may cost you a fraction of the price depending on the type of medicine and your level of income.

Healthcare Costs in Italy

As mentioned, you don’t pay to visit your family doctor or pediatrician. Treatments that require surgery or hospitalization in public hospitals are also free of charge. However, you are asked to copay some prescribed procedures and specialist visits. This copayment is around 36 EUR (39 USD) for every prescription. For example, for an MRI and a cardiology appointment, you would pay 36 EUR (39 USD) for each service.

You may deduct many medical expenses for tax purposes, so always keep the receipts even if you are not sure it is deductible.

Pros and Cons of the Italian Healthcare System

Pros

• Seeking medical care with the public system is very affordable—most procedures and appointments are free-of-charge or subject to a small fee.
• Medical staff and professionals in Italy are highly skilled and trained.

Cons

• Family doctors’ offices (medico di base) generally don’t allow appointments. Patients are seen in order of arrival, which often means crowded offices and long waiting times. At worse, you may need to go back another day if the office is too full.
• You may have difficulty finding medical professionals in the public healthcare system who speak English or another language other than Italian.
• Even if you have an appointment at a hospital, you may still have to wait.
• You cannot choose specialists when being referred by your family doctor.
• Seeing a specialist in Italy may take months, which can delay both diagnosis and treatments.

An Overview of Private Health Insurance

As mentioned, Italy has a mixed public and private healthcare system. Keep reading to know how private health insurance works. Italians rely mostly on public healthcare but a portion still opts to complement it with private insurance, whether to avoid long waiting times or to have an overall more comfortable medical care.

How does Private Health Insurance Work in Italy?

If you have private health insurance in Italy, you can book an appointment with any doctor available at private practices depending on availability. As an expat, you shouldn’t pay more for private services than nationals, so keep that in mind to avoid possible scams.

Some private hospitals have agreements with public hospitals. These are called Privato Convenzionato, and can be accessed through referrals from the public healthcare system. In some cases, you can access private clinics using your Tessera Sanitaria—make sure you state that well in advance, so you are not charged as a private patient.

Do I Need Private Health Insurance in Italy?

Overall, you don’t need health insurance in Italy to have all your medical needs met. Your decision to take out private health insurance comes down to how long you are willing to wait for appointments, tests, diagnosis, and procedures, and whether you want more personalized and attentive care. Expats have a greater chance of finding doctors and staff who speak English or their language if they opt for private healthcare.

Types of Health Insurance Plans

No matter what type of health plan you opt for, health insurance in Italy can be expensive. Below are the three most common types of health insurance and their average cost.

• The first and most basic level is usually aimed at applicants for residency to show their local commune they are covered by healthcare of some sort. These insurances cost between 300 and 500 EUR (330 and 550 USD) yearly and won’t cover any serious medical condition.
• The second works as a supplement to the SSN, the national healthcare system, and is the most common type of insurance in Italy. This insurance allows you to visit private doctors or specialists for speedier consultations and treatment of elective procedures in the private sector, which would take much longer to treat in public hospitals or physicians. This type of insurance has an average cost of 1,000 EUR (1,100 USD) annually.
• The third is the all-encompassing health insurance plan and should cover most if not all your medical needs. Some may even cover medical care abroad. It is also the most expensive and could cost up to 3,000 EUR (3,300 USD) a year.

If you don’t take out insurance, private medical care is going to cost you. An appointment with a general practitioner in the private sector costs between 50 and 120 EUR (55 and 130 USD) and the cost will depend on the urgency, time of day, and even regions. Specialists consultations may go from 80 to 200 EUR (88 to 220 USD). Dental care is likely not going to be covered by health insurance in Italy.

Here are some costs of private medical care in Italy:

Medical Care Cost EUR Cost USD General Practitioner 50—120 55—130 Specialists 80—200 88—220 Dentists 100 (approx.) 110 (approx.) Hospitalization (bed in a single room) 400 440

Best private and public hospitals

How to Find a Doctor or Dentist

Knowing how to find a doctor or dentist in Italy will ensure you have all your health needs met even in the most critical of times. Read on to know how to find general practitioners, dentists, specialists and possible waiting times to see doctors or get elective surgery.

How to Find a Family Doctor

You are entitled to a family doctor (Medico di Base or Medico di Famiglia) as part of public healthcare in Italy. This will be your first point of contact with the national healthcare system, which you will need for routine prescriptions, medical checkups, exams, specialist referrals, among other procedures.

Once you have registered with the SSN and have your Tessera Sanitaria, you will be asked to choose a family doctor. This is also done at the ASL (Azienda Sanitaria Locale). You will be shown a list of primary care physicians to choose from.

Things to Keep in Mind

Make sure to do your research in advance to know which doctors speak your language and where they are based, so you don’t accidentally choose a doctor whose practice is too far from your residence. Doctors are likely to work at small practices, each with its own office hours, so consider those as well. Keep in mind your doctor has to be a medico convenzionato, which means they have an agreement with social security.

Once you have chosen your family doctor, you should show them your registration papers with the SSN. You can always change your family doctor at any point by visiting your ASL.

How to Find Specialists

If you wish to be seen by a specialist in the public healthcare system, you will need a referral from your family doctor.

You can also see a specialist in the private sector. You can find doctors in both private hospitals and clinics. You can search online or go to one of these facilities directly.

To find a dentist, you can also look up practices or doctors online, or ask your local health authorities. Asking for recommendations is also always a good idea if you know anyone in Italy.

Average Waiting Times to See a Doctor in Italy

The average waiting times to see a doctor in Italy will largely depend on the specialty, but you can expect waiting times of several months. For example, a neurological visit would take around ten months, while for an eye examination, you would have to wait eight months.

When it comes to elective surgeries, the longest waiting time is 15 months for cataracts surgery, followed by ten months for hip replacement, and between nine and eight months for carpal tunnel and knee replacement surgeries.

Giving Birth in Italy

Giving birth in Italy for nonresidents should not be a problem. Even if you do not have a residence card, having a baby as a foreigner in Italy should be mostly cost-free. You won’t have to worry about paying for any pre- or post-natal medical care, or for the birth itself.

Giving Birth in Italy without Health Insurance

Giving birth in Italy without health insurance should not be an issue, since you can always rely on public healthcare. Keep in mind that alternative birthing centers are not covered by public healthcare, so be prepared to pay for all expenses out-of-pocket or to take out health insurance that covers those alternative services.

Costs of Having a Baby in Italy

The only costs of having a baby in Italy should be for the things you might need while in the hospital: diapers, baby clothes, and clothes for you as well. Not only that, some expats report needing to take their own toilet paper, towels, blankets, extra pillows, even cups and cutlery for your meals in public hospitals in Italy.

As always, make sure you consult the local authorities or health offices to know which specific conditions apply to you and your immigration status before giving birth in the country.

Benefits of Giving Birth in Italy

When giving birth in Italy as an employee, you have the right to maternity benefits. Maternity benefits are equal to 80% of your pay for a total of five months—two months before and three months after the birth or one month prior and four months after the birth.

Future mothers are also entitled to what is called (precisely) a voucher for future mothers. This is a one-off lump sum of 800 EUR (880 USD). This is attributed to mothers who are giving birth, adopting, or fostering. This amount can be claimed after the 7th month of pregnancy and within a year of having the child.

Giving Birth in Italy for Residency or Citizenship

If you are wondering whether you can give birth in Italy to gain citizenship, you should know that Italy does not allow birthright citizenship. If a child is born in Italy to foreign parents, they do not gain citizenship rights automatically. However, the child has the right to apply for citizenship before their 18th birthday.

If you are giving birth in Italy as a permanent resident, you should enjoy the same rights as any national. You are entitled to maternity benefits and free healthcare during your maternity.