The Italian National Healthcare System is public and accessible to all Italian citizens, but also to some categories of foreign citizens.
This article will list all the information on healthcare in Italy for foreigners, how to access it, and the differences with private healthcare.
Is healthcare in Italy free for foreigners?
Non-EU citizens who decide to move to Italy and obtain certain types of Italian residence permits can access public healthcare for free and obtain a health card. Health assistance is provided through the National Health System (NHS).
However, not all residence permits give access to the NHS for free. Therefore, before moving to our country, it is important to inquire about the requirements for accessing the NHS.
In case the requirements are not met, foreigners may choose to take out a private health insurance policy, either through the NHS or through independent insurers.
Do foreigners need health insurance in Italy?
If the foreigner does not qualify for free NHS registration, it is recommended to subscribe a private health insurance policy, before travelling.
How to get health insurance in Italy for foreigners?
The possibility to get free health insurance in Italy depends on the foreigner’s status – i.e. whether the foreigner is:
- an expat residing in Italy, or
- a tourist, or
- a foreigner temporarily present in Italy, or
- an international student, or
- a EU citizen.
Furthermore, it is important to consider the country that the foreigner comes from. In fact, specific treaties will apply for countries that have signed healthcare bilateral agreement with Italy. On the other hand, a different procedure will apply in the case of foreigners coming from a country without bilateral agreements with Italy.
In the next chapters of the present article, we will discuss the specific procedures applicable to each category of foreigners.
Can expats get healthcare in Italy?
Article 34 of the TUI defines the categories of foreign citizens who are entitled to free registration with the NHS. This provides full equality of treatment with Italian residents in regard to contribution obligations.
Citizens included in this category are:
- Foreigners legally residing in Italy who are engaged in regular employment or self-employment activities or are registered in the list of unemployed people;
- Foreigners legally residing in Italy who have applied for renewal of their residence permits for employment, self-employment, family reasons, asylum, subsidiary protection, special cases, special protection, medical treatment, asylum application, pending adoption, fostering and acquisition of citizenship;
- Unaccompanied foreign minors, even while waiting the issuance of a residence permit;
- Dependent family members.
Moreover, in line with the principle of child health protection, health assistance is guaranteed for minor children of foreigners enrolled in the NHS. Such assistance is guaranteed from birth, even while the child is not yet enrolled.
Health insurance in Italy for expats
As for the NHS enrolment procedure for expats, there is no separate enrolment registry for foreigners. Thus, expats must follow the same enrolment procedure as for Italians.
To enroll into the NHS, one must apply to the local health office, to be identified according to the registered residence address or on the municipality of domicile indicated at the residence permit application.
The NHS registration has the same validity as the duration of the residence permit. Upon expiration, the applicant whose residence permit has been renewed will have to apply again at the local health office, to renew the health enrolment.
As for the documents to be provided for the enrolment, they include:
- Valid identification document;
- Tax identification number (“Codice Fiscale”) issued by the local tax agency or by the competent immigration office;
- Residence permit or receipt of application for issuance or renewal of residence permit (and the relevant documents, such as entry visa and/or the contract of stay signed with the local immigration office);
- Documents proving family status, for the purpose of registration of the dependents.
Medical care in Italy for tourists
Health is a fundamental right defined by Article 32 of the Italian Constitution, without limitations based on citizenship. Therefore, in the case of non-EU citizens not registered with the NHS, health treatment is still guaranteed, subject to certain conditions.
Article 35 of Legislative Decree 286/1998 – “Testo Unico Immigrazione” (TUI) – defines the criteria for the provision of healthcare to non-EU citizens not registered with the NHS. It stipulates that healthcare services are provided subject to payment by the person receiving the service, of the rates defined by the regions and autonomous provinces, pursuant to Article 8, paragraphs 5 and 7, of Legislative Decree 502/1992.
Therefore, non-EU citizens legally residing in Italy but not registered with the NHS can access urgent hospital services (i.e. hospitalization), but upon payment of the relevant rates, as determined at regional level.
What to do if you get sick while travelling in Italy?
Article 53, paragraph 3, of the TUI established the types of healthcare guaranteed to foreign nationals who are present on the Italian territory but are not compliant with the rules of entry and residence.
Such citizens are assured urgent or otherwise essential care, even continuous care, due to illness or injury. This is guaranteed through public and accredited facilities.
Preventive medicine care and care aimed at safeguarding individual and collective health are also guaranteed, in particular:
- The social protection of pregnancy and maternity, with equal treatment with Italian citizens;
- The protection of the minor’s health;
- Vaccination according to the regulations and as part of collective prevention campaigns authorized by the regions;
- Interventions of international prophylaxis;
- Prophylaxis, diagnosis, and treatment of infectious diseases.
These treatments are provided to foreign citizens without a residence permit, at no charge, if they lack sufficient economic resources. In any case, they are subject to the payment of the relevant “ticket” on an equal basis with Italian citizens.
Can a tourist see a doctor in Italy?
Therefore, non-EU citizens temporarily present in Italy for tourism reasons, for a period not exceeding 90 days, can take advantage of emergency healthcare services upon payment of the relevant regional rates.
We recommend, in any case, the subscription of a private health insurance policy, valid for the duration of the stay.
Do tourists pay for healthcare in Italy?
The case of non-EU citizens subject to visa requirements who intend to travel to Italy for tourism purposes is a bit different.
Such categories of citizens will have to apply for a Schengen Visa before their departure.
The visa must be applied for at the diplomatic or consular representation in the applicant’s country of origin. Among the documents required for the issuance of the visa, it is necessary to present a private health insurance with a minimum coverage of €30,000 for emergency hospitalization expenses and possible repatriation expenses, valid throughout the Schengen area and particularly in Italy.
Therefore, the applicant is obliged to take out the insurance policy, prior to departure to Italy, for the purpose of obtaining the consular visa.
How much does it cost to see a doctor in Italy as a tourist?
A doctor visit in Italy, when not included in the preventive medicine care and care aimed at safeguarding individual and collective health as mentioned in the above sections, can cost between €100 – €200, depending on the specific fee applied by the doctor.
Foreigners temporarily present (STP)
As anticipated, foreign nationals who are present in the country but not in compliance with regulations regarding entry and stay are still guaranteed certain types of care.
Healthcare for foreigners without a residence permit is provided through the issuance of a card with an individual STP regional code. The card is issued by the local health office by submitting a statement with the applicant’s biographical data. Its purpose is to identify the assisted person for all services that can be provided.
The STP card will allow the foreigner to receive essential health services, on equal terms with Italian citizens with regards to cost participation (health ticket). The card is valid throughout the country and is usually issued for six months, renewable on a case-by-case basis.
Italian Health insurance for students
Expats who do not fit into the categories of foreign citizens who have the right to free registration with the NHS, as provided for by Article 34 of the TUI, must ensure themselves against the risk of illness and accident by taking out an appropriate private insurance policy.
How to get health insurance in Italy as an international student?
The private insurance policy can be purchased from an Italian or foreign insurance institution. However, the insurance must be valid on the Italian territory.
Alternatively, they can enroll into the NHS by paying the relevant annual contribution. Its amount is based on the applicant’s total income earned in the previous year in Italy and abroad. The minimum amount of the contribution was recently increased by the Italian government, as determined by decree of the Ministry of Health, in consultation with the Ministry of Treasury, Budget and Economic Planning. This process is called voluntary NHS enrolment.
How much is student health insurance in Italy?
In case of voluntary NHS enrolment, students are subject to an annual flat-rate contribution amounting to not less than €700 per year.
Health insurance in Italy for EU Citizens
EU citizens in possession of the European Health Insurance Card (EHIC) can use it in Italy to obtain all medically necessary treatment.
Such services are provided under the same conditions as Italian citizens, thus paying the relevant contribution to the system (ticket) and benefitting from free services where available.
However, the concept of “necessary” care is very flexible. It must be evaluated on a case-by-case basis, according to a medical criterion and on the duration of stay in Italy.
The EHIC card also allows Italian citizens to access healthcare, when in EU countries. Learn more in our guide on healthcare abroad for Italians.
Healthcare in Italy for UK citizens
UK citizens are considered non-EU citizens at all effects, with regards to access to the Italian health system. Therefore, the same rules as for non-EU citizens apply in their case.