Skip to content The Italian National Health Service is a public service, accessible to everyone, without discrimination based on income, gender or age. However, Italian citizens who transfer their residence abroad lose their entitlement to healthcare following their deregistration from the Italian population registers. There are, however, exceptions for certain categories of workers, such as posted workers, who are entitled to maintain their healthcare coverage. Learn more about the European Health Insurance Card (EHIC).
For an overview of the Italian National Health Service, consult our guide to healthcare in Italy.
Who is entitled to healthcare abroad: European Health Insurance Card (EHIC)
How does the Italian health insurance card work abroad?
The European Health Insurance Card (EHIC) is issued to Italian citizens when they register with the National Health Service.
What does the EHIC cover abroad?
The EHIC guarantees access to clinically necessary public healthcare in all EU countries, as well as in countries treated as equivalent for the purposes of this legislation.
However, it may not cover all travel-related risks (such as mountain rescue), so taking out additional travel insurance may be advisable.
In which countries is the EHIC valid?
The EHIC guarantees access to healthcare in each of the 27 EU Member States, as well as in Iceland, Liechtenstein, Norway and Switzerland, provided that the treatment is medically necessary and delivered through the healthcare system of the host country.
The EHIC is also valid in the United Kingdom for medically necessary healthcare during temporary stays, under the applicable reciprocal healthcare arrangements following Brexit. Travellers should check the specific conditions through the Italian Ministry of Health’s “Se parto per…” interactive guide.
As mentioned above, healthcare services are provided according to the procedures applicable in the host country, including any patient contributions to healthcare costs.
Who is not entitled to healthcare abroad?
Italy has entered into bilateral agreements with several foreign countries to facilitate access to healthcare for its citizens residing abroad.
However, most countries do not have agreements in force. In such cases, the Italian National Health Service does not provide any form of healthcare coverage during a temporary stay in one of these countries.
Therefore, before travelling to a non-EU country, it is advisable to check whether any bilateral agreements are in place. In the absence of such agreements, it is recommended to take out private health insurance.
How can you access healthcare abroad?
Italian citizens – and their accompanying family members – who stay in a non-EU country where no bilateral healthcare agreement is in force for work or study purposes are entitled to healthcare through an indirect reimbursement system.
For the complete list of beneficiaries identified under Articles 1 and 2 of Presidential Decree No. 618/1980, consult our guide on healthcare abroad in countries without agreements with Italy.
To benefit from indirect healthcare assistance, these citizens must follow a specific procedure.
What happens if I go to hospital abroad?
If, during your stay, you are in another country covered by the European Health Insurance Card (EHIC) or in a non-EU country with which Italy has an agreement, you can access public healthcare.
How can I obtain reimbursement for medical expenses abroad?
Reimbursement of expenses incurred in countries covered by the EHIC can be requested directly from your competent Local Health Authority (AUSL).
In the event of hospitalization in a non-EU country not covered by the EHIC, you will instead be entitled to reimbursement for healthcare services, but only if you fall within the categories of beneficiaries identified by Presidential Decree No. 618/1980. The reimbursement request must be submitted to the Italian diplomatic representation abroad, following the procedure described above.
Documents required for healthcare abroad
Reimbursement procedure: before departure
First of all, to obtain reimbursement for any medical expenses incurred abroad, it is necessary to request the Certificate of Entitlement to Healthcare Abroad pursuant to Article 15 of Presidential Decree No. 618 of 31 July 1980. This request must be submitted before departure from Italy to the competent Local Health Authority (ASL).
This certificate is part of a set of documents to be submitted if medical expenses are incurred abroad. It must be submitted, either in person or digitally, to the Italian diplomatic representation in the relevant foreign country.
Reimbursement procedure: after receiving healthcare
The other documents to be submitted to the Italian representation if medical expenses are incurred abroad are:
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Indication of residence in Italy and the competent Local Health Authority (ASL);
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Reimbursement application completed by the person entitled to healthcare assistance;
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Copy of the certificate pursuant to Article 15 of Presidential Decree No. 618 of 31 July 1980;
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Reasoned opinion of the Head of the diplomatic representation or consular office regarding the reasonableness of local prices, rates and fees, specifying whether the beneficiary was forced to use a private healthcare facility due to the absence or inadequacy of public facilities;
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Italian tax identification number (codice fiscale) of the person entitled to healthcare assistance, namely the worker;
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Medical certificate containing the diagnosis and/or medical report;
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In the event of hospitalization, a statement issued by the healthcare facility indicating the cost of ordinary hospitalization applicable at that facility;
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Original documentation of expenses, issued in accordance with the tax regulations in force in the country concerned, showing an itemized breakdown of the costs of individual healthcare services;
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Translation of the documentation into Italian, where necessary;
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Address or bank account of the beneficiary in Italy, including the relevant ABI/CAB and IBAN codes, for receiving the reimbursement.
After checking the documentation, the Italian diplomatic representation forwards it to the territorially competent ASL. Following a further assessment, the latter arranges reimbursement of the medical expenses or rejects the application if it is deemed non-compliant.
Healthcare in Italy for Italian citizens residing abroad
As mentioned above, Italian citizens who transfer their residence to a foreign country lose their entitlement to healthcare both in Italy and abroad. This occurs upon deregistration from the municipal population register and simultaneous registration with AIRE (Register of Italian Citizens Residing Abroad).
Exceptions apply to the individuals identified under Articles 1 and 2 of Presidential Decree No. 618/1980.
How can Italian citizens residing abroad obtain an Italian health insurance card?
Italian citizens registered with AIRE who temporarily return to Italy may be entitled to free urgent hospital care for a maximum of 90 days per calendar year, pursuant to the Ministerial Decree of 1 February 1996, provided that they meet specific eligibility requirements.
This entitlement applies to AIRE-registered Italian citizens who are either emigrants born in Italy or recipients of a pension paid by an Italian social security institution. In addition, they must not have any public or private health insurance coverage.
To access these services, eligible individuals must submit a self-certification declaration (dichiarazione sostitutiva di certificazione) stating their date and place of birth, residence and Italian citizenship, as well as confirming that they do not have public or private health insurance coverage.
This entitlement is limited to urgent hospital services only, for a maximum of 90 days per calendar year, and does not provide ordinary registration with the National Health Service or the assignment of a general practitioner.
Reimbursement of any expenses incurred in countries covered by the EHIC can be requested directly through the competent Italian Local Health Authority (AUSL).
In the event of hospitalization in a non-EU country without a healthcare agreement with Italy, reimbursement for healthcare services may be available. However, this applies only to individuals falling within the categories of beneficiaries identified by Presidential Decree No. 618/1980. The reimbursement request must be submitted to the Italian diplomatic representation abroad, following the procedure described below.