Healthcare System in Italy: Servizio Sanitario Nazionale
The Italian healthcare system, Servizio Sanitario Nazionale (SSN), was established in 1978 and provides universal coverage to Italian citizens and legal foreign residents. It offers comprehensive healthcare services, with free choice of providers and free care at the point of service.
While national authorities set overall standards, healthcare delivery is managed regionally by Italy’s 19 regions and two autonomous provinces. This decentralized structure allows regional flexibility but can result in differences in healthcare quality across the country.
International rankings consistently place Italy’s healthcare system among the best in the world. The Organisation for Economic Co-operation and Development notes high life expectancy alongside relatively low healthcare spending, while the World Health Organization has ranked Italy second globally for healthcare system performance.
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Private vs Public Healthcare in Italy
Italy offers universal healthcare through its public system, which is widely regarded as one of the best in the world and covers most patient costs.
The system emphasizes both preventive and curative care. While public healthcare facilities are generally efficient and affordable, their quality can vary by region. Hospital crowding and long waiting times are common concerns, particularly at public hospitals.
Italy’s private health insurance market is more limited than in many other countries. Residents cannot opt out of the public system, so private insurance is always supplemental to coverage provided by the Servizio Sanitario Nazionale (SSN). In addition, private health insurance premiums are not tax-deductible, which leads most Italians to rely primarily on public healthcare.
Private health insurance in Italy generally falls into two categories. Corporate insurance is offered by some employers as a workplace benefit, covering employees and, in some cases, their families, though coverage is often more limited than in other countries. Non-corporate insurance is available through for-profit and nonprofit providers and may be purchased individually or through group plans. Foreign residents may also choose to purchase international health insurance before moving to Italy.
Private insurance is more common in southern Italy, where public healthcare facilities are often less developed than in the north. Key advantages include shorter wait times for specialists, access to more modern and comfortable facilities, and a higher likelihood of English-speaking medical staff.
Challenges for Patients
In the Italian public healthcare system, patients may face challenges due to the high number of patients requiring treatment.
Local general doctors’ offices (medici di base) typically don’t operate on an appointment system. Patients are seen in the order they arrive in the office, so doctors’ surgeries are often overcrowded and have long waiting times.
Those new to the Italian healthcare system are often surprised to learn that they must register with a single general practitioner within their Local Health Authority and cannot freely switch between doctors. This can seem restrictive to patients who have come from countries with a strong emphasis on personal choice.
In Italy, waiting times for specialist appointments can be as long as several months. Part of the problem is that patients from the south, frustrated by the modest public health facilities, travel north for better, quicker services.
Because of this, the public facilities in the north have even longer wait times, since they are (unofficially) serving more than one region.
Costs of the Italian Healthcare System
The cost of using Italy’s health insurance system is low. Inpatient care, primary care, and doctor visits are all free. However, the public health system uses a “co-pay” system (cost-sharing between the SSN and the patient) for specialist visits, diagnostic procedures, and prescription medication.
Co-pays are typically not expensive, and the percentage the patient is expected to contribute varies by region and treatment. The elderly, pregnant women, children, and the poor are exempt from co-pay requirements.
The Italian Public Healthcare system’s funding reflects the national, regional, and local structure of the SSN’s administration. It is mainly funded through national and regional taxes, supplemented by private expenditure and insurance plans.
The regions are also allowed to generate their own additional revenue, which creates further interregional financing differences. Local health units are funded mainly through “capitated” budgets (in which a medical provider is given a set fee per patient, regardless of the required treatment).
Currently, Italy faces the challenge of funding additional programs to care for its rapidly aging population.
Although the funding process may seem complicated, the distribution is even more complex. The Ministry of Health provides funding to different regions within Italy. The exact amount they receive is calculated using a formula that factors in past spending and other relevant factors.
The regions then allocate their funds to the local health authorities, where they are spent. This system aims to keep health insurance costs in Italy affordable.
Who is Eligible for the Italian Health Care System?
All Italian citizens and legal residents are eligible to benefit from the Italian public healthcare system. European Union citizens can also access the SSN’s services if they hold a European Health Insurance Card (EHIC).
This card is issued to EU citizens in their home countries and allows them to receive benefits in other EU countries at no additional cost. However, if they remain in Italy for more than 3 months, they will have to register with a family physician at their local health authority.
People who have recently moved to Italy, including expats and retirees from non-EU countries, are not immediately eligible for Italy’s public health system. First, they must finalize their residency status before applying for coverage.
Expats must have both their residency status finalized and hold an Italian identity card before applying for an Italian health insurance card, known as the “tessera sanitaria.”
While their paperwork is being processed, or if they are moving to Italy as non-European Union citizens, travelers must prove they have private health insurance coverage.
Upon arrival, they have 8 days to visit the local police station and present a valid health insurance policy that covers their stay.
Non-residents must carry proof of private medical insurance. Later in this article, you can find recommendations for the best international medical plans for expats in Italy.
How to Access and Receive Healthcare in Italy
There are several different ways to access healthcare in Italy: public medical practices, groups of private doctors working at medical centers (poliambulatori), and, of course, hospitals and specialists. Some online services offer virtual doctor’s consultations in English.
General Medical Care
You can take advantage of the National Health Service, but you must register with the Servizio Sanitario Nazionale. When you register, you will be asked to choose a family doctor, with whom you will be required to remain.
You will be asked to sign a social security agreement (medico convenzionato) that confirms your relationship with that doctor. If you have children aged below six, you will also need to select a pediatrician (pediatra).
Emergency Medical Care
Some Italian general practitioners will make house calls if the patient is unable to visit a doctor’s office or clinic due to illness.
On the weekend and late at night (from 8 pm until 8 am), or if you cannot see your usual doctor, you can find primary care assistance at a Healthcare Assistance Continuity Center (usually known as Servizio di continuità assistenziale), where a National Public Healthcare doctor will see you.
These doctors’ services may be limited to prescribing and refilling medications, conducting medical consultations, and dressing minor wounds.
This may also require a fee, depending on local and regional regulations. These public centers may also offer telephone consultations, though you will likely need to speak Italian to use this option.
Emergency Services
In an emergency requiring immediate attention, or to call an ambulance, dial 112 from any telephone in Italy. No country code is necessary if you are calling from within Europe.
If possible, go to a hospital emergency department (pronto soccorso). All foreigners in Italy have the right to receive emergency treatment, regardless of whether they have proof of insurance.
Specialist Services
You may ask your GP to refer you to a specialist, or you can choose one yourself. However, if you do require attention from a specialist and want to take advantage of social security benefits, you must take your doctor’s referral with you when you go to the specialist.
Specialists who work within the SSN have their consulting rooms (ambulatorio) in state hospitals, local health authority buildings, or other centers.
Some private specialists (privati accreditati) also treat patients covered by social security. It is essential to note that if you have X-rays or laboratory tests performed, you must collect the results yourself and present them to your doctor or specialist.
How to Pay for Italian Healthcare
If you’re registered with the SSN, then find the cashier (cassa) to pay your subsidized fee (ticket). Payment is typically made in cash, so please don’t forget to bring Euros. They will provide you with a receipt, which you must then give to the specialist.
Certain patient categories are eligible for a maximum amount of specialist treatment, including children under 6 and those aged 65 and older. Income is also a factor.
If your family income or your annual income is below a certain threshold, you will qualify for the minimum amount. The lower fees also apply to those who have disabilities or long-term, chronic illnesses, such as rheumatoid arthritis, diabetes, or epilepsy.
Insurance Options for Expats and Foreigners Living in Italy
Foreigners must have private medical insurance in Italy while they are waiting for residency to be granted. Proof of insurance is one of the required documents that have to be submitted with the residency paperwork.
For US and Non-US Citizens Living in Italy
Cigna Global Insurance Plan
- Flexible plans tailored to your needs and budget
- 1.5M+ providers in 200+ countries
- 24/7 multilingual customer support
IMG Global Prima Medical Insurance
- Five flexible plan levels with optional add-ons
- Choose your coverage area based on where you live or travel
- Freedom to select your healthcare provider anywhere in the world
For US Citizens Living in Italy
BCBS Global Solutions Worldwide Premier
- Unlimited annual and lifetime coverage
- Pre-existing conditions covered with prior insurance
- For U.S. citizens abroad or foreign nationals in the U.S.
Healthcare Options for Travel to Italy
It is strongly recommended that tourists and other short-term travelers to Italy who are not from an EU member country have travel insurance that includes medical coverage.
Although tourists occasionally report being treated for minor illnesses at no cost in hospitals, this is the exception rather than the rule. If travelers to Italy need diagnostic tests, hospital admission, or surgical care, they can expect to receive a large bill.
Best Travel Plans for Visitors to Italy
Single Trip Platinum Travel Insurance
- For U.S. citizens and residents up to age 95
- Includes pregnancy coverage, baggage loss, trip interruption & more
- 24/7/365 service and assistance
Patriot Platinum Travel Insurance
- Maximum limits up to $8,000,000
- IMG pays 100% of medical expenses in-network
- Evacuation due to Natural Disasters & Political Unrest
If a visitor’s travel time in Italy includes adventure activities or extreme sports, such as hiking and climbing in the Alps or scuba diving in the south, then they must ensure they are appropriately insured.
Adventure Sports Travel Medical Coverage
World Nomads Travel Insurance
- Coverage for 200+ adventure activities
- Generous benefits for lost and stolen bags and gear
- 100% Trip Cancellation and Trip Interruption
- 24/7 emergency assistance
Mackenzie is the Director of User Experience at ICI, creating intuitive, user-centered digital solutions for global insurance clients. With expertise in UX design and content strategy, she simplifies complex offerings to improve accessibility for expatriates, travelers, and international employers.
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