Italy: healthcare rights for EU and non-EU expats and visitors

Jul 05, 2021

This article is written by Marco Mazzeschi and contributed to our publication on Medium.com.

Follow us on Medium.com/StudioMazzeschi for more latest articles.

ITALIAN HEALTHCARE SYSTEM AT A GLANCE

• Each region (such as Lombardy, Tuscany, etc.) is responsible for organizing and delivering health care through local health authorities (Aziende Sanitarie Locali/ASL or USL)
• USLs provides hospitalization and treatment (including tests, surgery, and medication during hospitalization), visits to family doctors/ pediatricians (GPs), specialist medical assistance, discounted medicines, laboratory services, appliances, ambulance services.
• Urgent and essential services are guaranteed to anyone, also to irregular immigrants. Temporary visitors can receive health services by paying for the costs of treatment.

HEALTHCARE RIGHTS FOR NON EU EXPATS

As a general rule, every foreign citizen can enjoy public health benefits in Italy. The system is designed to provide assistance for all Italian citizens and residents, including foreign citizens who are legal residents of Italy. Foreigners registered with the National Health Service (Servizio Sanitario Nazionale — SSN) are guaranteed full assistance under the same conditions as Italian citizens, that is:

1. Free registration
   Generally speaking, the following categories are entitled to free registration:  
   • Foreign citizens in possession of a permit who regularly work as employees/self-employees (lavoro subordinato, lavoro autonomo) in Italy or are enrolled with government employment agency;  
   • Foreign citizens in possession of or waiting for the renewal of a permit for employment, self-employment, family reasons, asylum, adoption/custody, citizenship acquisition, religious reasons;
   • Dependent family members of all the above categories.
2. Voluntarily registration
   If you are not eligible for “free” registration, an alternative to the private health coverage is  “voluntary” registration with SSN. Once registered you will be guaranteed full assistance under the same conditions as Italian citizens. The registration requires the payment of a yearly lump sum calculated as follows:  
   • 7,50% rate up to an income equal to € 20.658,28;  
   • 4% rate on any amounts exceeding € 20.658,28 and up to a limit of € 51.645,69.

WHAT ASSISTANCE CAN YOU RECEIVE?

Those registered are entitled to:

1. To choose a general practitioner whom you can consult/visit the during medical office opening. The GP shall also be contacted for:
   (1). Medical certificates;
   (2). Prescription for specialist and diagnostic examinations;
   (3). Request for non-emergency hospital admission;
   (4). Prescription of medicines;
2. to be hospitalized free of charge if needed.
3. to undergo free outpatient and in-home medical examinations and to obtain prescriptions for medications and specialist services.

WHAT ARE THE CHARGES?

All patients (including legal foreign residents) are asked to pay a co-pay fee (called “ticket”) before undergoing specialist examinations and for medicines. Exemptions exist for:

• those who have an income lower than €8,500/year
• for reasons such as chronic diseases, low-income patients, etc..

Co-payment is required for visits and medical examinations as well as for medicines, calculated on the basis of the individual’s income.

MEDICAL CARE IN ITALY FOR TOURISTS

As required by the Schengen rules, any foreign visitor traveling to Italy must ensure he/she is covered by medical insurance valid for the Schengen area covering medical fees, hospitalization and repatriation costs up to €30,000.

You have certain health care rights during a temporary stay. You can access both emergency and standard healthcare services. In the first case, payment must correspond upon hospital discharge. In the case of “non-emergency” treatment, advanced payment is required.

In case of need for medical assistance, foreign visitors in Italy can seek medical treatment either from public or private hospitals. Public hospitals provide both emergency and non-emergency services while private hospitals do normally provide non-emergency services only and do not have first aid services.

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. Private hospitals normally charge much higher fees than public hospitals. Of course, it is also possible to visit a private doctor by arranging an appointment directly with him/her.

The emergency number (for immediate medical attention or to call an ambulance) is 118. Otherwise, you can access the first aid station (Pronto Soccorso) directly.

VISA/PERMIT FOR MEDICAL CARE (VISTO/PERMESSO PER CURE MEDICHE)

Foreign nationals residing abroad may organize planned medical treatment in Italy, for instance, if they need to undergo special therapy available in the country. Italy offers a special visa for “medical care”, this type of visa can also be issued to an accompanying person.

After the applicant has organized the medical treatment and has made contact with the hospital or clinic of choice (it may be a public or private facility, provided it is acknowledged by Italian health authorities), the next step is to collect the relevant documents and prepare the visa application that can be applied for by the applicant or by a family member or another representative on behalf of him/her.

Once the visa is issued the foreigner can travel to Italy and must apply for the relevant residence permit within 8 days from arrival. The residence permit for medical care can be extended for the whole duration of the medical treatment.

The European Health Insurance Card

If you are an EU citizen or you are registered in the EU, you can apply for the European Health Insurance Card, a free card that gives you access to medically necessary, state-provided healthcare during a temporary stay in any of the 26 EU countries, Iceland, Liechtenstein, Norway and Switzerland under the same conditions and at the same cost (free in some countries) as people insured in that country.

See European Health Insurance Card — Employment, Social Affairs & Inclusion — European Commission (europa.eu)

USEFUL SOURCES

Italy — Employment, Social Affairs & Inclusion — European Commission (europa.eu)
Inglese (salute.gov.it)
Home (integrazionemigranti.gov.it)

Marco Mazzeschi

Attorney at law.
One of the leading corporate immigration lawyers in Italy. Admitted to the Milan Bar Association (1988) and to the Taipei Bar Association (2016), a member of the American Immigration Lawyers Association (AILA) and an accredited partner of Invest in Tuscany.

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