As you prioritize your health in preparation for your fresh start in Italy, we understand how important it is to have access to reliable and high-quality healthcare services. The Italian healthcare system is considered to be one of the best in the world, offering a wide range of benefits at a relatively low cost.
If you are planning to make Italy your permanent home (or at least your home for 6+ months out of the year), you should be aware that it is mandatory for all residents of Italy to have health insurance coverage. What does this mean in practice?
It means you can do one of the following:
- Enroll in the National Healthcare System (Servizio Sanitario Nazionale or “SSN”)
- Choose a private health insurance provider
- Select a combination of public and private health coverage
Before choosing the type of insurance that is most appropriate for you, it is important to understand the structure of the Italian healthcare system.
Italy’s healthcare is publicly funded rather than insurance-based like in the U.S. Most residents are mandatorily enrolled in SSN and pay into the system through income tax. Only non-citizen residents who are neither working nor dependents of working residents—foreign students and retirees, for example—are not mandatorily enrolled in SSN.
While the majority of healthcare infrastructure is tied to the National Healthcare System, there are private hospitals and clinics across the Italian peninsula. Private facilities are usually specialized clinics that allow patients to receive treatment more quickly and at a higher cost than public hospitals. They also offer a narrow range of services that are not provided by public hospitals, such as dental care and physical therapy.
Private health insurance can help reduce the financial burden of private health treatment. However, because the public SSN provides a wide range of services at a low cost, private health insurance is often seen as useful but not essential to one’s overall health.
What services does the public Servizio Sanitario Nazionale include?
Enrollment in the SSN entitles you to a number of benefits, including:
- Access to a local Primary Care Physician (Medico di Base)
- Ambulance transportation in case of emergency
- Free Hospitalization at public and private hospitals
- Medical examinations at outpatient clinics
- Specialist visits
- X-rays and ultrasound scans
- Blood tests
- Rehabilitation therapy
- Vaccinations
Some services such as ambulance transportation and emergency care will be available immediately at no cost, while services such as specialist visits, X-rays, and ultrasound scans will require the payment of a small co-pay (often referred to as ‘ticket’) and typically some wait time.
How do you enroll Servizio Sanitario Nazionale?
Italian citizens residing in Italy and long-term residents who are employed or self-employed are legally obligated to enroll in the SSN. Their healthcare premiums are paid through employment taxes. Non-citizen residents without income from employment (e.g. Elective Residency Visa holders) may enroll in the SSN for an annual fee. In order to enroll, you must file a request in person at the Local Healthcare Agency (Azienda Sanitaria Locale, or “ASL”) by bringing the following:
- Personal ID (Passport);
- Codice Fiscale;
- Permesso di Soggiorno (or the PDS request receipt);
- Payment receipt of annual SSN enrollment fee.
The annual enrollment fee is to be paid via Postal Money Order (Bollettino Postale). The amount due depends on your income for the previous calendar year and is calculated as follows:
- 7.5% of your annual income up to € 20,658.28
- 4.0% of your income in excess of € 20,658.28 and up to € 51,645.69
The amount due can be no less than € 387.34 and no more than € 2,788.87 (as of 2023). Enrollment is valid for the current calendar year, regardless of the duration of your Permesso di Soggiorno.
What is the added value of private healthcare?
The most common reasons for using private facilities in Italy include:
- Consulting with a specialist without a referral from a Medico di Base (generally costing less than €200 without insurance coverage);
- Requesting a second opinion on a diagnosis;
- Wanting to receive immediate care rather than waiting for an appointment (depending on the region and urgency of treatment, the wait at public facilities can take weeks);
- Access to treatment not available through the SSN, such as dental care or physical therapy;
- Availability of English-speaking staff.
While the private sector offers a variety of benefits, it is unlikely that one can solely rely on it for all of their healthcare needs. Italians usually turn to the private sector for specific, transitory health needs.
What are private healthcare insurance options?
Among the various private providers of health insurance policies, a handful focus on international clients residing in Italy. Here is a short list of our preferred insurance providers:
The cost of private coverage will depend on a series of factors, including policy details (claim limit, deductible, type of coverage) and policyholder details (age, lifestyle, pre-existing conditions, number of dependents). Monthly premiums can range from €100 to €500.
NOTE: This Healthcare information is provided for information purposes only. Dolce Living is not a health insurance expert and does not directly work with any public or private health insurance provider. Please consult with your local Azienda Sanitaria Locale, or ASL, to learn more about the healthcare system in your area.
