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HEALTH

Which foreign residents have to pay for healthcare in Italy?

Italy's government wants to charge a €2,000 annual fee for some foreign nationals to register with the Italian national health service - but many already pay this much, or more. What are the rules and what would change under the plans?

Published: 17 October 2023 16:34 CEST
Updated: 19 October 2023 11:08 CEST
Who has to pay to access Italy's national health service?
Who has to pay to access Italy's national health service? Photo by Fred TANNEAU / AFP.

There was concern this week about new proposals from the Italian government to charge non-EU nationals higher fees to use Italy’s national health service (servizio sanitario nazionale, or SSN).

Under the 2024 budget plan, a €2,000 charge for registering with the health service would apply to “foreign residents who are citizens of countries that are not members of the European Union”, according to a statement published by the Italian economy and finance ministry (MEF) on Monday.

READ ALSO: What we know about Italy’s plan to charge non-EU residents €2,000 for healthcare

Italy’s health ministry later clarified that the 2,000-euro charge would not in fact apply to all non-EU nationals, but only to those who already pay an annual fee to use the SSN.

Though a number of questions about the proposal remain, this still appears to mean a steep cost increase for many of Italy’s international residents who are not eligible for free healthcare.

Who will the new rules apply to?

For many foreign nationals resident in Italy, enrolling with Italy’s SSN means paying an annual registration fee under what’s called ‘voluntary’ registration.

For others, registration is deemed ‘mandatory’ and is therefore free, and healthcare services are then paid for at the same rates as for Italian nationals.

“The rule contained in the 2024 budget refers to specific categories, not entitled to compulsory registration, who can voluntarily register with the SSN through the payment of an annual flat-rate contribution,” the health ministry stated.

“The rule is limited to updating the stipulated lump-sum contribution,” it said, suggesting that the new charge would replace existing fees.

Registration fees could therefore increase for people who are now paying a rate below €2,000 a year – though it remains unclear whether it could also be revised down for those who are already paying more.

Who can currently register for free?

Certain people are entitled to iscrizione obbligatoria, ‘mandatory registration’ or ‘registration by right’, in the national health service, which means you can register with the SSN for free.

Iscrizione obbligatoria applies to the following categories, according to current health ministry guidelines:

  • Residents who have a regular ongoing contract with an Italian employer, are self-employed, or are registered on Italy’s unemployment lists (liste di collocamento).
  • People who are waiting for their residency permit to be issued on the basis of employment or family reasons.
  • People who are waiting for their residency permit to be renewed on the basis of employment or self-employment, for family reasons, for asylum, for subsidiary protection, ‘special cases’, or special protection; for medical treatment, for those waiting to adopt or foster children, and for those in the process of acquiring citizenship.
  • All minors, including unaccompanied foreign minors, regardless of their legal basis in Italy.

The health ministry’s statement indicates that people in these categories would continue to be able to register with the SSN for free even if the €2,000 charge remains in the final draft of the budget law.

Who needs to pay to register?

Anyone who doesn’t fall into any of the categories listed above can opt in to the SSN through iscrizione volontaria, or voluntary registration.

This includes pensioners on elective residence visas, diplomatic and consular staff working for foreign governments, employees of international organisations, volunteer workers, and people over the age of 65 in Italy for family reunification reasons (who arrived after November 5th, 2008).

People in this situation must pay a fee of at least €387.34, rising to as high as €2,788.87 based on income calculations.

However foreign students in Italy who have no income besides scholarships or financial aid provided by Italian public institutions pay a flat fee of €149.77, while au pairs pay €219.49.

The MEF said in its statement on Monday that students and au pairs would continue to pay a discounted fee, without giving further details.

The registration is valid for the calendar year starting on January 1st and running to December 31st, regardless of when the payment is made.

If the rule is included in the final draft of the budget, it’s people who fall into this ‘voluntary registration’ category who would pay the €2,000 charge.

Member comments

  1. Replying to paying into health service. I am copying an email received regarding the EU declaration protecting rights for those that had residency before

    It won’t let me copy the text. So will try and summarise… if resident in Italy before Brexit. You are classified as having permanent residency after 5 years. That means article 23 of the withdrawal agreement and article 24 of the directive 2004/38 apply.

    It therefore follows that, as permanent residents, you should be entitled to access the Italian public healthcare system free of charge under the same conditions which apply to Italian nationals (referred to as compulsory affiliation ).

    Hope this helps and you can update the topic to share

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For members

TOURISM

Flights, hotels, beaches: How the cost of travel to Italy is rising this summer

Inflation may now be falling but the price of a summer holiday in Italy has risen again - by up to 20 percent compared to last year.

Published: 24 June 2024 10:53 CEST
Flights, hotels, beaches: How the cost of travel to Italy is rising this summer

Italian consumer rights groups said last year that the summer of 2023 would be remembered as “the most expensive ever” for travel. But 2024 has already smashed that record, according to the latest price surveys.

The rising cost of air fares, ferry tickets, hotels, restaurants and beach clubs add up to mean a holiday in Italy will be 15-20 percent more expensive this summer compared to last year, according to a survey conducted by the Assoutenti consumer research centre in June.

While price rises in recent years have been attributed to Covid and rising inflation, which is no longer thought to be a factor, this year Assoutenti said high demand was pushing up prices amid the post-pandemic tourism boom.

Prices in Italy were “out of control as a consequence of the resumption of tourism, after the stop imposed by Covid, and the record number of foreign visitors recorded in the last year,” the survey’s authors wrote, calling on the government to take measures to contain price increases.

READ ALSO: ltaly set for summer tourism boom as bookings increase again

They warned that more Italian families were likely to “give up the summer holidays this year, not being able to face an expense that increases from year to year,” and that those who do travel may book shorter trips to keep costs down.

Some 6.5 million Italians say they won’t be going on holiday this summer at all, with half citing economic difficulties, according to a separate survey commissioned by price comparison website Facile.it.

Meanwhile, there had been a nine percent increase this year in applications for personal loans for travel purposes, the survey found.

Flight prices

One of the biggest factors was the cost of air fares, as both domestic and international flights to and from Italy were found to be more expensive again this year.

While the cost of flights between European countries had fallen slightly following inflation-driven price hikes in 2023, Italy was bucking the trend.

Italy’s flight costs had risen instead, according to recent analysis in Italian newspaper Corriere della Sera, with the average price of a summer flight between Italy and the rest of Europe up by seven percent and domestic flights by 21 percent.

READ ALSO: Why are flight prices higher in Italy than the rest of Europe this summer?

Industry sources suggest the price increase is again down to unprecedented demand, while consumer groups say the main culprit is a lack of competition on the Italian market.

Transport costs

There were price hikes too for those using other modes of transport, with the rising cost of fuel and motorway tolls in Italy named as another contributing factor in the Assoutenti survey.

Ferry tickets were also more expensive, it found, with the average increase this August at +6.3 percent compared to 2023.

Hotels and B&Bs

For a family of four, the Assoutenti survey found the most expensive place to stay in Italy this summer was Porto Cervo, Sardinia, where the average price of a week’s three-star accommodation in August came to 3,500 euros.

The cheapest options were found to be Bibione, outside Venice (872 euros) and Rapallo in Liguria (909).

READ ALSO: Tourist tax: How much is it increasing in Italy’s cities this year?

The cost of accommodation at coastal destinations had risen by 23 percent on average overall, a separate survey by consumer group Altroconsumo found.

Hotels in cities were found to be a less expensive option, with most Italian families heading for the beach or mountains to escape the heat.

Restaurants

Adding to the overall cost, prices also continued to rise this year at restaurants in holiday resorts and at beach clubs: Assoutenti recorded an average increase for the catering sector of +3.5 percent on 2023.

Beaches

Renting sunbeds and umbrellas at Italy’s beach clubs is seen as a necessity by many Italian families – and often by international visitors too, given the lack of free options in many areas.

This too was becoming more expensive in 2024, with the average daily rate for a slot at one of Italy’s private beach clubs up by more than five percent on last year. Prices had also risen by as much as 11 percent between 2022 and 2023.

Beachgoers can now expect to pay around €30-35 for two sun loungers and a beach umbrella for the day on average, though prices can rise as high as €90 in Salento and €120 in parts of Sardinia.

Both private and free-access beaches in Italy also increasingly require advance booking due to higher demand.

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