How Healthcare Works in Italy

Who this is for

Key tradeoffs

Important considerations that affect most people in this situation.

The public healthcare system (SSN)

Italy's Servizio Sanitario Nazionale provides universal coverage to legal residents. The system is tax-funded and offers comprehensive care with small co-payments.

• Primary care happens through your assigned family doctor (medico di base or medico di famiglia). You register with the local health authority (ASL - Azienda Sanitaria Locale)
• You choose your family doctor from available doctors in your area. If one isn't accepting patients, try another. The ASL provides a list
• Specialist care typically requires a referral (impegnativa) from your family doctor. This is where wait times build up—non-urgent appointments can take weeks to months
• The tessera sanitaria (health card) is your SSN identification. You receive this after registering with the ASL and it functions like a health insurance card
• Emergency care (pronto soccorso) is available to everyone at hospital emergency departments. Treatment first, paperwork after. No prior registration required for emergencies
• Small co-payments (ticket) apply for prescriptions, specialist visits, and diagnostic tests. Amounts vary by region and income. Some categories (low income, chronic conditions, pregnancy) are exempt

Registering for SSN

Registration happens at your local ASL office. The process requires documentation proving your legal right to reside in Italy.

• First: establish residenza (official residence) at your local comune (municipality). This requires a lease contract or property deed and is a separate bureaucratic process
• Obtain your codice fiscale if you haven't already. This is your Italian tax identification number, required for all official processes
• Non-EU citizens: you need a valid permesso di soggiorno (residence permit) or visa that permits registration
• EU citizens: you need to register your presence (iscrizione anagrafica) and can then access SSN
• Visit your local ASL (find it based on your residential address) with: passport/ID, codice fiscale, proof of residenza, permesso di soggiorno or EU registration
• You'll be asked to choose a family doctor from available options. The ASL provides a list of doctors accepting new patients in your area
• Processing time varies—you may receive your tessera sanitaria immediately or within a few weeks by mail

Private healthcare options

Private healthcare is well-developed in Italy and provides an alternative or supplement to the public system.

• Private health insurance: Italian insurers (Generali, UniSalute, Allianz Italy) and international options (Cigna, Allianz Care, Bupa). Premiums range from €50-200/month depending on age, coverage, and pre-existing conditions
• Direct payment without insurance: GP visits €50-80, specialist visits €80-150, diagnostic tests vary widely. Costs are lower than US prices but accumulate
• Private clinics and hospitals: major options include Humanitas, Gruppo San Donato, and various regional private hospitals. Quality is high, waits are short, English is more common
• Many Italians and expats use both systems: SSN for hospital care, surgeries, and serious conditions; private for convenience, faster access, and English-speaking providers
• Some employers provide private health insurance as a benefit, especially for professional roles in international companies
• Dental care is limited under SSN. Most people use private dentists. Costs are moderate by European standards

Practical realities

These factors shape day-to-day healthcare experience in Italy.

• Language — English proficiency among medical staff varies significantly. In Milan and Rome, finding English-speaking doctors (especially privately) is manageable. Smaller cities and rural areas, much harder. Learning basic medical Italian helps
• Wait times — the key difference between public and private. SSN specialist appointments: often weeks to months. Private: usually within days. For emergencies, both respond quickly
• Prescription transfers — if you take ongoing medications, bring documentation from your home country. Italian doctors can often continue prescriptions but need to understand your history. Some medications may have different names or availability
• EHIC/GHIC cards — EU citizens can use the European Health Insurance Card for temporary coverage. This is for short visits, not a substitute for SSN registration when you become resident
• Emergency number: 112 for all emergencies. Hospital emergency departments (pronto soccorso) provide care regardless of registration status
• Pharmacies (farmacie) — widespread and staffed by trained pharmacists who can advise on minor issues and provide some medications without prescription. Green cross signs indicate locations

Regional differences

Italy's regional healthcare administration creates meaningful differences in quality and access.

• Lombardy (Milan) — well-regarded system with strong hospital infrastructure. Good private options. Shorter waits than average. Strong international expat support
• Lazio (Rome) — adequate public system but bureaucracy can be challenging. Large expat community means English-speaking private options exist. Variable by neighborhood/hospital
• Tuscany (Florence, Siena) — generally good regional system. Medical tourism history means some English capacity. Smaller cities have good local hospitals
• Emilia-Romagna (Bologna) — considered one of Italy's best regional systems. Strong public hospitals, reasonable wait times
• Southern regions — more variable quality and longer waits. Major cities (Naples, Palermo) have good hospitals; rural areas may require travel for specialist care
• Smaller towns and rural areas — local clinics and hospitals handle routine care; complex cases may require travel to regional centers

Healthcare and visa requirements

Your visa type affects healthcare access and insurance requirements.

• Elective Residency Visa — typically requires proof of private health insurance for the application. The insurance must meet Italian standards
• Work visa — if employed, your employer typically handles SSN enrollment through standard payroll processes
• Student visa — students can access SSN by paying an annual fee (around €150) or must maintain private insurance
• EU citizens — automatic right to access SSN once properly registered as resident. EHIC covers temporary visits
• Initial period — many people need private insurance to satisfy visa requirements, then transition to SSN once residency is established. Budget for overlap
• Waiting periods — some visa categories have waiting periods before SSN eligibility. Private insurance bridges this gap

Next steps

Continue your research with these related guides.