One of the many reasons people are attracted to living in Italy is accessing the high-quality national healthcare. In fact, residents in Italy and Italian citizens are entitled to register with the National Healthcare Service (Servizio Sanitario Nazionale, SSN). This article will outline everything you need to know about the Italian Healthcare System, how to register, and use your health insurance card.
Overview of the Italian Healthcare System
The healthcare system in Italy is based on three principles, “universality, equality, and solidarity.” The law establishing the system was first introduced on December 23, 1978 (Law 833), and regulations are in compliance with Article 32 of the Italian Constitution. Funded through general taxation, the healthcare system provides access to healthcare services for Italian citizens residing in Italy, EU workers and their dependents and non-EU citizens holding specific residence permits. Foreigners residing in Italy who do not meet the requirements for free healthcare can also voluntarily enroll in the National Healthcare System for an annual fee. Healthcare coverage includes hospital, emergency, and primary care by general practitioners and pediatricians, as well as a wide range of pharmaceuticals and diagnostic services.
EU citizens that are visiting Italy for temporary stays can also access the Italian healthcare system if they have a European Health Insurance Card, EHIC (Tessera Europea Assistenza Medica) issued by their home country. In this case, EU citizens do not need to register but can use the EHIC in place of the Italian healthcare card (tessera sanitaria).
It’s worth noting that if you are an Italian citizen who has moved abroad and registered with AIRE (the Registry of Italian Citizens Residing Abroad), you will no longer have access to these healthcare services.
How to Register for Italian Healthcare
Italian healthcare is managed at the regional level by local authorities, (Azienda Sanitaria Locale (ASL). For instance, if you live in the Veneto, you may see the abbreviation, AULSS for Azienda Unità Locale Socio Sanitaria. Registration occurs at the local ASL office. Those that fall into the following categories are entitled to register:
- EU citizens who work or study in Italy or have acquired the status of permanent resident.
- Non-EU citizens who have a residence permit or permanent resident status and their family members who legally reside in Italy.
- Those who are seeking asylum, subsidiary protection, or special protection.
- Those waiting for adoption.
- People coming to Italy for medical treatment under Article 19 letter d-bis of Decree Law No. 286/1998.
- Those residing in Italy waiting for the acquisition of Italian citizenship.
In order to register, you will need to have established legal residence in the town where you are living. This entails having a valid rental contract or deed for a property, therefore hotels and Airbnbs are not suitable. You will also need a codice fiscale, or tax code, issued by the revenue agency (agenzia delle entrate).
To begin the registration, you will visit your local ASL (Azienda Sanitaria Locale) and present the required documents which include your identification document (i.e. passport), codice fiscale, proof of residence, and residence permit (if applicable).
During the registration process, you can choose a general practitioner (family doctor). There are usually several options in your area and you can view their hours of operation to choose one that is most convenient.
If you have children, you will also be able to register them in the healthcare system using their own unique tax code. They will receive a health card and you can choose a local pediatrician.
If you are a non-EU citizen on a residence permit (permesso di soggiorno), the validity of your healthcare registration is generally the same length as that of your residence permit. If your permit expires and you receive a renewal, you may be required to return to the ASL office and renew with the healthcare service. Furthermore, if you register with the healthcare service while on a residence permit and then become an Italian citizen, you will need to return to the ASL office to re-enroll, demonstrating your updated status as a citizen.
Accessing Healthcare in Italy
Health Card
Once registration is complete, you will receive a health card (tessera sanitaria) mailed to your residence. In addition to personal details, the health card also includes your tax code, which can be useful anytime residents need to show their tax code. You will usually be asked to present the health card when attending doctor’s appointments and making purchases at the pharmacy.
It’s worth noting that as a tax resident in Italy, medical expenses can be tax deductible. Healthcare expenses over €129.11 in the previous year can be deducted at 19%. Be sure your health card is scanned at the point of purchase and save your receipts to verify the expenses.
The health card is generally valid for 6 years and the Revenue Agency will automatically send you a replacement card before it expires. The back side of the health card is the European Health Insurance Card, which guarantees healthcare in the European Union, Norway, Iceland, Liechtenstein, and Switzerland. Furthermore, many regions also have an online portal or phone application where you can access your personal medical profile, view appointments, lab results, and prescriptions.
Family Doctor and Private Care
Your family doctor will act as the gateway to further healthcare services. They will be able to assess your symptoms and write prescriptions for medications or refer you to the appropriate specialist. Depending on the region where you live, the severity of the condition, and the type of specialist, wait times to see a specialist could be quite short or up to several months. As the healthcare system is managed on a regional level, your options for specialists will be only located in your region.
There is always the option to explore private healthcare, which often reduces the wait time for specialists and allows you to choose from a wider range of doctors that may fit your desired preferences. This can also be convenient particularly for expats, as there may be more English-speaking doctors in the private sector.
Pharmacies and Emergency Care
Pharmacies in Italy are often a great first step for healthcare and medical support. If you have minor symptoms, like a cold, cough, or pain, the pharmacist can offer suggestions and “over-the-counter” products and remedies. Pharmacies, or farmacie, can always be identified by the large green cross outside the building, and while the pharmacists are not medical doctors, they are highly trained in providing medical guidance and assistance. Pharmacies in Italy are generally closed in the afternoon during the lunch break, so it’s important to check the operating hours. Also, there is usually one pharmacy in the area that is open at night, and sometimes the pharmacies will rotate which one will offer the late-night hours, so be sure to check online for the most up-to-date schedule.
Most health services are covered under the National Healthcare Service at no cost or a relatively low fee. This co-pay, or what is called a “ticket”, will be charged for some hospital procedures, diagnostics and lab analyses, prescriptions, or specialist treatments. There are also exemptions to the ticket, for instance, individuals over the age of 65, children under 6, those with certain chronic conditions, and low-income households. Public hospital visits are also covered under the National Healthcare Service. Additionally, if you are in an emergency, you can dial 112 (the general emergency number) or 118 (the health emergency number) or go directly to the emergency room (pronto soccorso). Alternatively, if you need medical assistance outside of the operating hours of your general practitioner, but it is not an urgent matter for the emergency room, you can visit the guardia medica or sometimes called servizio di continuità assistenziale. This is a physician that is available in every city and open during the evening or “out-of-hours” to provide healthcare services.
Conclusion
Understanding the complexities of the Italian healthcare system can be overwhelming. This guide aims to answer commonly asked questions and outline the most important details related to registering and accessing healthcare in Italy. If you have any doubts, you can contact us directly and we’ll be happy to assist!
Helpful Medical Words in Italian
Primary care physician or general practitioner – medico di base
Specialist – specialista
Doctor’s office – studio medico
Emergency room – pronto soccorso
Ambulance – ambulanza
Waiting room – sala d’attesa
Appointment – appuntamento
Hospital – ospedale
Prescription – ricetta
Health –salute
Pain – dolore
Headache – mal di testa
Stomach ache – mal di stomaco
Fever – febbre
Cough – tosse
Help! – aiuto!
