Health has been identified as a fundamental human right by Italian law. The Ministry of Health offers public health services that become available after registering with the Italian National Health Service.
National Health Service (NHS), also known as Servizio Sanitario Nazionale (SSN), offers residents and expats staying in Italy for more than 3 months basic health care for free, or for a fee through the local health agency known as Azienda Sanitaria Locale (ASL). Registration with the SSN can either be mandatory (free) or voluntary (annual fee).
Expats registered with the National Health Service (NHS) are guaranteed the same healthcare and assistance as Italian citizens. As an expat, it is important to understand the varied aspects of health care provided in Italy to ensure you understand the medical insurance benefits and receive timely treatment when the need arises.
Public Health Care Service
In Italy, it is a legal obligation to register with the SSN after 90 days of residency. Registration with the SSN is free if you:
- Have a work agreement;
- Are self-employed in Italy;
- Are a family member of someone who is registered;
- Are a family member of an Italian citizen;
- Have been an official Italian resident for five years or more;
- Are unemployed, registered on the employment lists, or registered for a professional training course.
If you're not eligible to register for free, you can pay an annual fee to register voluntarily. You can contact your local Azienda Sanitaria Locale (ASL) to receive state health care.
The SSN offers the following services:
- Access to general practitioners
- Treatment at a hospital
- Access to specialists
- Lab services
- Emergency services
- Free or low-cost prescription medicines
Eye tests are available to those with residency status. Dental care treatment, however, is practiced privately.
When submitting the application to your local health agency, you will need to submit your social security number, stay permit, personal ID, and a residence certificate. The full process, from submitting an application to its acceptance, could take 2-3 months before you are issued a medical registration card.
Private Health Care Service
Although public health care is affordable and offers good service, the wait time at public medical facilities usually takes up to a few months at big facilities and up to a few weeks at the smaller ones.
On the other hand, private hospitals offer impressive facilities, shorter wait times, and world-renowned doctors. The cost of treatment varies, but all prices are regulated by the Ministry of Health.
Even though you receive a higher level of care and good facilities, a private treatment without insurance is expensive and paid completely out of pocket.
Private Medical Insurance
Expats who do not meet the eligibility criteria for public health care services and require treatment before 90 days are advised to opt for private medical insurance, as being without health insurance can prove extremely expensive.
Even if expatriates in Italy are eligible for public health care, many still prefer to complement it with private health insurance. Private medical insurance helps cover a broad range of conditions, specialists, a share of fees that are not covered by the SSN, and treatments at private hospitals.
Expats also prefer private medical insurance, as it provides access to English-speaking doctors, remarkably high standards of care, and comfortable facilities, as well as cutting down significantly on waiting times.
Private treatment facilities are accessible even without insurance; however, the costs incurred will be detrimental. Therefore, a full-service expat medical insurance plan would be much more financially viable.
The cost of medical insurance can vary depending on your age, the level of coverage, and pre-existing medical conditions.
Quality of Health Care Service in Italy
The standard of health care service and doctors is good throughout Italy. However, the quality and availability of facilities differ from region to region between the north and south of Italy. The wealthy northern region of Italy provides better facilities compared to the more basic facilities in the poorer southern region of the country.
Private medical insurance will provide access to better facilities and quicker service.
Insurance Coverage and Cost
Depending on the kind of insurance package you opt for, private hospital treatment and primary care are covered. Ensure you and your family get maximum coverage for a minimum of five years, limiting the insurance company’s right to cancel or refuse renewal. You should also check that the insurance will cover you and your family against the loss of earnings due to accidents or sicknesses.
Expatriate insurance is intended for people that live outside the U.S. Some plans allow for a choice of coverage area, whether worldwide, worldwide excluding the U.S., or sometimes worldwide excluding the U.S. and a handful of other countries. If the coverage selected is worldwide, and the insured is eligible for coverage in the U.S., the insured would have access to PPO networks in the U.S. even while residing in Italy.
The cost of private medical insurance for a nuclear family will cost you €1,300 to €2,300 (about $1,445 to $2,560 USD) per year. Most plans offer flexible payment options, paying in monthly, quarterly, semi-annually, or annual installments. Depending on the plan, there might be optional add-ons like dental & vision coverage, sports coverage, terrorism coverage, life insurance coverage (including accidental death & dismemberment), or additional prescription benefits. Expatriate plans provide varying levels of coverage that allow potential insureds to best match the plan to their individual needs. For example, a 60-year-old probably wouldn’t need a plan that includes maternity coverage.
As an expat, you have the freedom to choose among public health care, private medical insurance, or a combination of national health care services along with the services covered under private health care insurance.
Your decision should be based on your needs, the quality of care provided, the quality of medical personnel, and the facilities offered. The relief of having adequate insurance when you need it for private medical care is priceless.