Healthcare System in Italy - Servizio Sanitario Nazionale
Since 1978, the Italian National Health Service (Servizio Sanitario Nazionale, or SSN) has been guided by the principles of universal coverage, solidarity, human dignity, and health. In principle, it serves as Italy's public health system.
From an organizational point of view, the system is regionally based. There are responsibilities at the national, regional, and local levels. Italy has 19 regions and two autonomous provinces that are responsible for delivering health services through local health units. Each region has significant independence and flexibility to determine its own priorities and goals.
Italy's public health system has worked well for the country. The Italian healthcare system is ranked second in the world by the World Health Organization, just after the French healthcare system. Italians enjoy the 11th highest life expectancy in the world, as well as very low levels of infant mortality.
Since 1978, the Italian National Health Service (Servizio Sanitario Nazionale, or SSN) has been guided by the principles of universal coverage, solidarity, human dignity, and health. In principle, it serves as Italy's public health system.
From an organizational point of view, the system is regionally based. There are responsibilities at the national, regional, and local levels. Italy has 19 regions and two autonomous provinces that are responsible for delivering health services through local health units. Each region has significant independence and flexibility to determine its own priorities and goals.
Italy's public health system has worked well for the country. The Italian healthcare system is ranked second in the world by the World Health Organization, just after the French healthcare system. Italians enjoy the 11th highest life expectancy in the world, as well as very low levels of infant mortality.
Costs of the Italian Healthcare System
Those who use Italy’s health insurance system are unlikely to experience high costs. In-patient care and primary care are free, plus there are no costs associated with visiting a doctor.
However, there is a co-pay for diagnostic procedures and prescription medication. Co-pays can be as high as 30% of the cost. Thankfully, the elderly, pregnant women and children are exempt from these co-pay costs.
The free appointments and limited co-pays are products of how Italy's public health system is funded. The system is primarily financed through a payroll tax system. A tax of 10.6% is applied to the first €20,660 of income. The rate drops to 4.6% for income between €20,51 and €77,480.
The system is also financed through federal and regional general taxation, like income tax and value-added taxes on goods and services. Between 1995 and 2003, healthcare spending rose by 68% in Italy. Currently, the country struggles with how it will further fund programs to care for its rapidly aging population.
Exactly how all this funding is distributed is a bit more complicated. The Ministry of Health provides funding to different regions within Italy. How much they receive is based on a formula that takes into account past spending and other factors. The regions then allocate the funds to the local health authority, where they are spent. This system keeps the cost of health insurance in Italy affordable.
The Differences Between Italian Private and Public HealthCare
Does Italy have universal healthcare service? Yes, it does and its health system is hailed as one of the best worldwide.
In general, Italy's public health system and medical care are excellent, as almost all patient costs are covered. The system focuses on both preventative and prescriptive care. And while there are occasional problems with hospital crowding and long wait times at public facilities, overall, the system is efficient and affordable.
Italy's private health insurance system is not as standard as it is in other countries. In addition to the fact that it is impossible to opt out of the public system, medical insurance premiums in Italy are not tax-deductible; this is why most Italians stick with Italy's public health system.
The private health insurance system in Italy can be classified into two categories. The first is corporate insurance. Just as the name suggests, this is private insurance paid for by companies. This covers employees and sometimes their families. In Italy, private health insurance is occasionally offered by employers as a perk, but not at the same level as it is provided in other countries.
The other one is non-corporate insurance. This type of policy is supplied by either for-profit or non-profit organizations and can be individual or collective. And, of course, non-Italians also hold international health insurance, which they purchase in their home country before they move abroad.
As with all countries, private health insurance in Italy means patients have shorter wait times to be admitted into secure and comfortable facilities. Doctors and nurses working in private facilities are also more likely to speak English. In Italy, private medical insurance is also popular for patients in the south of the country. Public facilities are more basic in the south than in the north, and having access to private insurance gives patients the maximum amount of options.
Also Read: Health Plans for Italians Living Abroad
What Care is Covered by Italian National Healthcare
Does Italy have a free healthcare system? Yes, and it provides coverage for the most common medical needs of citizens and legal residents.
The SSN covers the cost of hospitalization and treatment, visits to family doctors and specialists, laboratory services, and emergency ambulance services at 100%. A copay of up to 30% is required for many diagnostic tests and prescription medications. However, this fee is waived for children, seniors, and pregnant women.
Who is Eligible for the Italian Health Care System
All Italian citizens and legal residents participate in the healthcare system. European Union citizens can also access SSN services if they hold a European Health Insurance Card (EHIC). This card is issued to EU citizens in their home countries, allowing them to receive benefits at no cost in other EU countries. If they stay in Italy for more than three months, they will have to register for a family physician at their local health authority office.
Those who have just moved to Italy, including expats and retirees from non-EU countries, are not eligible for Italy's public health system right away. They must first finalize their residency status before they can apply for coverage. Expats must have both their residency status finalized and have an Italian identity card to apply for an Italian health insurance card or “tessera sanitaria.”
While waiting for all paperwork to be processed, non-residents must carry private medical insurance. They will be asked for proof of coverage with their application.
Related: Expat Insurance Plans for Foreigners
Healthcare Options for Expats and Foreigners Living in Italy
For foreigners living in Italy, pursuing legal residency status means that private medical insurance in Italy is not just a mere recommendation but a necessity. Proof of insurance is required among the documents that have to be submitted with the residency paperwork.
Cigna Global Insurance Plan
- The flexibility to tailor a plan to suit your individual needs
- Access to Cigna Global’s trusted network of hospitals and doctors
- The convenience and confidence of 24/7/365 customer service
Healthcare Options for Travel to Italy
Travel insurance which includes medical coverage is strongly recommended for tourists and other short-term travelers to Italy who are not from any EU member country. While tourists occasionally report being treated for minor disorders at no cost at public hospitals, this is an exception and not a rule. Should they need diagnostic tests, hospital admission, or surgical care, they can expect a hefty bill.
Suppose their travel time in Italy is likely to include adventure activities or extreme sports, like hiking and climbing in the alps or scuba diving in the south. In that case, tourists must ensure they are insured appropriately.
Challenges for Patients
In Italy, appointment wait times can be so long that they could last up to several months. Part of the problem is that patients from the south who are frustrated by the modest public health facilities travel north for better and quicker service. Because of this, the public facilities in the north have even longer wait times since they are now unofficially serving more than one region.
Those who are new to the Italian healthcare system are often surprised that they have somewhat limited choices when selecting a general practitioner. They must register with one general practitioner within their Local Health Authority. For patients who come from countries with a strong emphasis on personal choice, this will feel restrictive.
