Italy’s public healthcare system is often said to be one of the best in the world, but that doesn’t mean everyone in the country can receive treatment for free.
Healthcare is free for Italian citizens (who are registered as resident in Italy) and for many, but not all, non-Italian citizens resident in the country. Other foreign residents instead can access the system for a fee.
But in any case, to use Italy’s public healthcare – beyond basic emergency treatment – you’ll need to register with the national health service (servizio sanitario nazionale, or SSN), which is only possible if you’re legally registered as a resident in Italy.
READ ALSO: Who can register for national healthcare in Italy?
Becoming a legal resident comes with various rights and obligations, and the status does not come automatically with owning property in Italy, even though homeowners are required to pay certain taxes.
This means second-home owners and other regular visitors who spend extended periods of time in Italy are usually unable to sign up with the SSN even for a fee, and may be unclear about what exactly their healthcare rights and options are.
Dual nationals
Those who split their time between two or more countries may also wonder whether obtaining Italian citizenship would make them automatically entitled to free healthcare in Italy.
While it is often thought that all Italian citizens are entitled to free treatment in Italy, this is in most cases only guaranteed for those who are ordinarily resident in Italy and registered with the SSN, according to the Italian foreign ministry.
So if you already have dual citizenship, or obtain it in future, your healthcare rights still depend primarily on your residency status.
Generally, the information below will also apply to dual nationals who are ordinarily resident outside of Italy. Seek advice from the Italian consulate in your country of residence for more details on how the rules apply in your circumstances.
Urgent care
The first thing to know is that visitors and non-residents can always access both emergency and standard healthcare services in Italy – though this may come at a cost.
“At public hospitals, emergency services are provided at no cost or upon payment of a limited fee, while non-emergency services are subject to a fee set locally by the Regional Health Authority,” explains immigration law expert Marco Mazzeschi, head of the Mazzeschi law firm.
If you require emergency treatment during your stay, payment must be made upon discharge from hospital, Mazzeschi explains, while “in the case of non-emergency treatment, advance payment is required.”
You should be able to later have these payments reimbursed by your insurer.
As Italy has a dual-track public and private healthcare system, you also have the option of being treated at a private hospital or making an appointment with a private doctor, though private healthcare fees will of course be much higher.
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EHIC and GHIC
If you are an EU citizen, or you are registered as a resident in another EU country, you may have the costs of medically necessary, state-provided healthcare during a temporary stay in Italy covered by the European Health Insurance Card (EHIC). The costs and conditions vary by EU country.
UK nationals may apply for either the EHIC or GHIC.
In either case, this doesn’t replace a full insurance policy; travellers with either the EHIC or GHIC are advised to take out comprehensive travel health insurance as well.
What type of insurance policy will you need?
The type of coverage you should take out will obviously vary depending on your personal circumstances, though the basic rules of EU travel health insurance apply:
“As required by the Schengen rules, any foreign visitor travelling to Italy must ensure he or she is covered by medical insurance valid for the Schengen area covering medical fees, hospitalisation and repatriation costs up to €30,000,” explains Mazzeschi.
But for extended and regular stays, a basic travel insurance package probably won’t fit the bill and you may need a ‘long stay’ policy – though be careful to check the maximum duration covered.
READ ALSO: Which are Italy’s best hospitals and where are they?
Readers who spend longer periods of time in Italy tell us they sometimes combine policies: for example, one popular option with second-home owners is to use a combination of both Allianz and Medjet insurance – although this may not necessarily be cheap.
As well as getting free quotes from individual providers’ websites, it’s a good idea to try the numerous price comparison sites out there generating quotes for longer trips: one such site is Visitors Coverage, while for US nationals there’s also American Visitor Insurance.
It’s also advisable to check the official advice on obtaining travel insurance from your country of origin: see for example the guidance from the UK government, the US State Department, or the Government of Canada.
Do you have recommendations for longer-term travel health insurance coverage? Please share any advice you have for other readers in the comments section below.
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Australians can access emergency care in Italy thanks during stays of up to six months thanks to a reciprocal agreement. You will need to show your Medicare card, and (probably) explain the arrangement. You can find an Italian-language version of this agreement on line and we carry a hard copy with us.