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The Italian National Health Service

Introduction to the Italian Healthcare System. Learn accessibility conditions, differences with private healthcare and more.

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The Italian Healthcare System is a great matter of pride for Italian citizens. It is a public and accessible service to everyone, without any discrimination based on income, gender or age.

The Italian Healthcare System was first introduced on December 23, 1978 with Law No. 833. The founding principles of Italian healthcare are universality, solidarity of financing – through general taxation – and equitable access to services. All the laws that regulate the Italian NHS (Servizio Sanitario Nazionale) are made in compliance with art. 32 of the Italian Constitution.

Below you will find everything you need to know about how healthcare works in Italy, how you can access and the differences with private healthcare.

The Italian Healthcare System

The healthcare system in Italy is based on 3 guiding principles of “universality, equality and solidarity”. The aim is to achieve uniform levels of care throughout national territory, equitable access to services for all citizens and fiscal solidarity as the fundamental way of financing the health system.

This is an extraordinary societal achievement and a key indicator of a country’s social and democratic development.

Only a minority of countries around the world deliver this type of healthcare to all citizens, without any discrimination.

The Italian NHS provides high-quality healthcare to all citizens for hospital care, emergency care and primary care provided by general practitioners and paediatricians. In addition, the NHS covers a wide range of pharmaceuticals and all the hospital and diagnostic services essential for health.

Moreover, Italy’s healthcare system is managed at a regional level by local authorities – Azienda Sanitaria Locale (ASL) – that supply healthcare services.

Regional Health Authorities may have different names, depending on the region. For instance, in Emilia-Romagna is called AUSL – Azienda Unità Sanitaria Locale.

Enrollment procedure for the Italian Healthcare

The enrollment in the National Health Service offers access to hospitals and medical examinations.

The enrollment in the Italian national health service is mandatory for all Italian citizens.

When citizens enroll in the NHS, they are also granted a family doctor. Family doctors are particularly useful when in need of prescriptions for drugs and/or medical examination.

In fact, citizens need a prescription for booking an appointment with a specific specialist. In this case, a small fee applies. Moreover, each specialist doctor has a waiting list that varies based on the type of examination.

As regards the prescription of drugs, this is mandatory for specific categories (i.e. antibiotics), but not for others (i.e. paracetamol).

Italian Healthcare Cost

Access to the Italian Healthcare is public. This means that anytime citizens need a medical examination, therapy or surgery, they can go to a public hospital and access the service through a relatively low fee.

With “relatively” we mean that obviously the perception of the fee service changes based on the individual. However, with “low” fee we mean a true difference in price, as opposed to other health services abroad.

Ticket is the term used in Italy that refers to the fee payment to access the medical examination. The ticket depends on the citizen’s income.

For the treatment of serious and chronic diseases, the Italian NHS offers drugs free of charge, including last-generation innovative medicines.

Cost of Italian Healthcare for children

Italy is the only country in Europe that allows families to choose their paediatrician at no cost to them for all children aged 0 to 14 years.


Italy’s health system is at the forefront in terms of prevention of cancer and chronic illnesses, offering medical screenings for free.

Italy also reached important achievements for what concerns the fight against smoke and the abuse of alcohol. In addition, it constantly promotes a healthy lifestyle for people of all ages, highlighting the importance of physical exercise and a balanced diet.

Organ transplant in Italy

Italy has one of the best national organ transplant networks in Europe in terms of quality of procedures, donor database management and organ availability. In fact, when applying for the Italian identity card, citizens are required to express their preference about organ donation by saying “yes”, “no” or “I don’t express myself”. This decision can always be modified with the help of the family doctor.

Blood donation in Italy

Italian healthcare particularly stresses the importance of blood donation. It can be done by everyone aged 18 to 60 at AVIS centres (Associazione Italiana Volontari del Sangue – Italian Association of Blood Donors).

These centres are present in every Italian city, usually inside hospitals.

Italian health insurance card

The Italian Revenue Agency issues the National Health Card (Tessera Sanitaria Nazionale) to all Italian residents that have the right to receive health assistance by the NHS. The Card is also valid in all the EU member states.

The Italian Health Insurance Card includes the tax code issued by the Italian Revenue Agency. Citizens mainly use it to see doctors and to buy medicines. It may be also useful anytime residents have to show their tax code.

The back of the Italian Insurance Card represents the European Health Insurance Card (EHIC).

Before it expires, the Italian Revenue Agency automatically sends Italian residents a new Insurance Card.

In general, the Card validity is usually of 6 years but may be shorter in specific cases (i.e. for foreigners with a limited residence permit).

In June 2022, through Resolution No. 25/E, the Revenue Agency provided clarification regarding the assignment of a tax code to undocumented and unaccompanied foreign minors, for the purpose of their registration with the National Health System.

Private healthcare in Italy

Unfortunately, sometimes the waiting lists to access Italian public health services are quite long. Therefore, more and more people decide to turn to the private healthcare, which can be really expensive because citizens have to pay for the entire fee.

Regardless of the cost, Italian private healthcare is highly considered. For this reason, an increasing number of people choose to stipulate a private healthcare insurance. Private healthcare insurance grants easier access to private hospitals or clinics.

Regulatory Framework

Law n. 833, 23rd December 1978

Reference (Italian only)

Art. 32 Italian Constitution

Reference (Italian only)

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