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Healthcare abroad for Italians

A guide on healthcare abroad for Italians: all the requirements and procedures to receive health assistance in EU and extra-EU countries.

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The Italian National Health system is a public service, accessible to everyone, without discrimination of income, gender or age. However, Italian citizens who transfer their residence abroad lose their right to healthcare access, upon cancellation from the Italian civil registries.

However, there are exceptions for certain categories of workers such as posted workers, who are entitled to maintain healthcare.

For an overview on the Italian National Healthcare System, take a look at our guide on Healthcare in Italy.

Who is entitled to healthcare abroad?

As a general rule, Italian citizens registered with the National Health System are eligible for healthcare when they are in EU countries, Iceland, Liechtenstein, Norway and Switzerland.

Italian citizens temporarily residing in these countries are in fact entitled to receive urgent or medically necessary healthcare services by showing their European Health Insurance Card (EHIC).

Such assistance is provided according to the conditions and modalities set in the host country, including possible costs of the service. In the event that the Italian citizens have had to pay a sum to the host institution, they may then submit a refund request to the competent AUSL office, according to the principle of cost-sharing between the two countries.

Italian citizens who fall into the category of posted workers, students or retirees who reside for a long period in EU countries or Iceland, Liechtenstein, Norway and Switzerland can instead obtain full healthcare, by submitting the relevant S1 form or equivalent form (Forms E106, E104). This is again subject to the conditions and modalities foreseen in the host country.

The case of Italian citizens traveling to countries outside the EU, Iceland, Liechtenstein, Norway and Switzerland is different. In this circumstance, in fact, it is possible to obtain healthcare only in countries where there are bilateral agreements with Italy.

How does the Italian health card work abroad?

The EHIC card is issued to Italian citizens upon enrolment in the National Health System.

What does the EHIC cover abroad?

The EHIC guarantees access to clinically necessary national healthcare in all EU countries (and those considered as such within this jurisdiction).

However, it may not cover all travel-related risks (i.e. mountain rescue), so it may be advisable to take out a travel policy as well.

Which countries does the EHIC cover?

The EHIC guarantees access to medical care in each of the 27 EU Member States, Iceland, Liechtenstein, Norway and Switzerland, provided that this case is medically necessary and provided by that State.

As mentioned, the provision of such services is done according to the procedures applied by the host state, including any cost participation.

Who is not entitled to healthcare abroad?

Italy has entered bilateral conventions with several foreign countries to facilitate access to healthcare for its citizens living abroad.

However, most countries do not have conventions in place, so no form of protection is foreseen by the Italian National Health system, in case of temporary stay in one of those countries.

Therefore, before leaving for a non-EU country, it is advisable to check whether there are bilateral conventions in place or not. In the absence of bilateral conventions, it is advisable to arrange a private health insurance.

How to get healthcare abroad?

Italian citizens – and their family members – who stay for work or study in a non-EU country where no bilateral agreement on healthcare is in force are entitled to assistance in an indirect form.

To check the complete list of beneficiaries identified by Presidential Decree 618/1980, articles 1 and 2, read our guide on healthcare abroad in countries without an agreement with Italy.  

To avail of indirect assistance, it is necessary to follow a specific procedure.

What happens if I go to the hospital abroad?

If you are admitted to a hospital during your stay in another country covered by the EHIC or in a non-EU country with an agreement with Italy, you will be able to get access to public health care.

How to get reimbursed for medical expenses abroad?

Reimbursement for any costs incurred in countries covered by the EHIC can be requested directly through your relevant AUSL office.

In case of hospitalization in a non-EU country not covered by the EHIC, however, you will be entitled to reimbursement for services only if you fall into the category of beneficiaries identified by Presidential Decree 618/1980. The request for reimbursement should be submitted to the Italian diplomatic representation abroad following the procedure above described.

Documents for reimbursement for healthcare abroad

Reimbursement procedure: before departure

The first step to be reimbursed for any medical expense incurred abroad is to apply for the Certificate of Healthcare Abroad coverage under Article 15 of Presidential Decree No. 618 of July 31, 1980. This certificate must be requested before departing from Italy to the competent AUSL office.

This certificate is part of a set of documents that must be submitted in the event of incurring medical expenses abroad, in person or electronically, to the Italian diplomatic representation in the foreign country.

Reimbursement procedure: after receving medical assistance

In case you incur in medical expenses abroad, the other documents to be submitted to the Italian diplomatic representation are:

  • Indication of residence address in Italy and competent AUSL office;
  • Reimbursement application request signed by the applicant;
  • Copy of the Certificate of Healthcare Abroad coverage under Article 15 of Presidential Decree No. 618 of July 31, 1980.
  • Opinion by the head of the diplomatic representation about the price adequacy of the assistance paid, specifying whether the applicant was forced to turn to private facilities in the absence or inadequacy of public facilities;
  • Social security number of the applicant;
  • Medical certificate with diagnosis and/or health report;
  • In case of hospitalization: statement from the health facility about the cost of ordinary hospitalization applied in that facility;
  • Proof of expenses incurred, in original, showing the breakdown of the individual costs of the services;
  • Possible translation into Italian language of the documentation;
  • Applicant’s bank account.

After verifying the documentation, the Italian diplomatic representation forwards it to the competent AUSL office. The latter, after further verification, prepares the reimbursement of medical expenses or rejects the application where not deemed compliant.

Halthcare in Italy for Italians living abroad

As anticipated, Italian citizens who transfer their residence to a foreign State lose their right to healthcare both in Italy and abroad, upon cancellation from the municipal registry office and the simultaneous AIRE registration.

Exceptions are made for those individuals identified by Presidential Decree 618/1980, Articles 1 and 2.

How to obtain the health card for Italian citizens residing abroad?

AIRE registered citizens who temporarily return to Italy can apply for enrolment with the local Health Care system, for a maximum of 90 days per calendar year, with issuance of the health card but without assignment of a family doctor.

The health card, in this case, gives the right to use only urgent hospital services, as identified by Ministerial Decree of February 1st, 1996.

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Regulatory Framework

Presidential Decree n. 618 of July 31st 1980

Reference (Italian only)

Ministerial Decree of February 1st 1996

Reference (Italian only)

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