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Health insurance in Italy for foreign expats

If you’re planning on living in Italy whether it’s for work, retirement, or a different pace of life, it’s important to consider your healthcare options. We understand that it can seem overwhelming at first, but it doesn’t have to be. 

To start, you have two main options: registering with the public health service (‘Servizio Sanitario Nazionale’, the SSN) or getting private health insurance. The SSN provides you with low-cost, or free, access to specialists, tests, prescriptions, general practitioners (GPs) and emergency care. However, the cost of access depends on your official status in the country and your employment¹. 

Recently, Italian companies have started offering workers private medical insurance at an affordable price, with many expats choosing private cover because there is a wider choice of medical facilities that are easier to access. This also makes dental care more straightforward as the majority of dentists and dental surgeons are private in Italy. 

The following sections answer questions about Italian healthcare access in more detail and explore the benefits of choosing private healthcare cover.


Italy has one of the highest life expectancies in all of Europe. The healthcare in Italy is considered high-quality and is reasonably accessible to all its residents. Those over 70 or with low-income status have almost completely free healthcare. It is a mixed ‘public and private’ system, meaning only some healthcare is universally free. Emergency medical assistance is provided to anyone in need, without asking for an upfront payment, and all pharmacies are regulated by the government. However, the standards of public and private health facilities differ by region, with the north of Italy providing a better standard of healthcare overall. 

The ‘Servizio Sanitario Nazionale’ (SSN), the official name of Italy’s national healthcare system, is a mix of private and public. This means you will always need to pay a part of your medical expenses. There are 3 ways of accessing Italy’s public healthcare system:

Registering with the ‘Servizio Sanitario Nazionale’ (SSN)

If you are employed or self-employed in Italy, you can register for free, known as ‘iscrizione obbligatoria’. If you’re not working or paying social security contributions, you can register voluntarily by paying an annual fee, known as ‘iscrizione volontaria’ (however, you won’t be entitled to a European Health Insurance Card for travelling). 

Using a European Health Insurance Card

If you are a European citizen, you can use an EHIC (European Health Insurance Card) for temporary stays, when studying in Italy, or as a ‘posted’ (detached) worker on a short-term basis. Depending on the duration of your stay (usually over 90 days in a 180-day period), you will then have to register with the Italian public health service (the SSN) for longer-term care. Remember, an EHIC does not always guarantee free medical services. 

Non-EU citizens, who are legally residents in the EU state and are covered by social security, can also be covered by an EHIC when travelling in parts of Europe. However, you will need to check if the health authorities of your host country offer this.

An ‘S1’ Form

For posted workers (residing less than 2 years), cross-border workers, pensioners seeking residence and civil servants (and their dependants), you can request an S1 form (issued by your government or national health authority) and register it with the Italian government. This will grant you access to the 'Servizio Sanitario Nazionale'. 

Hospital Admissions

If you are an Italian resident, hospital admission and emergency medicines are free for ‘necessary procedures’. Elective procedures (such as preventive check-ups) are not free. 

Emergency Care

There is a single European emergency number, ‘112’, where you can report anything and will be transferred to the relevant service. To reach the Italian police, dial ‘113’ (you can also report any emergency to the police operator, and you will be transferred). To reach the fire service directly, dial ‘115’. To report a medical emergency, call ‘118’. 

When you arrive at a hospital, you'll be assigned a colour code depending on the severity of your condition. If you're classified as red (the most serious), yellow, or green, your treatment is free. However, if you’re classed as blue or white, you'll need to pay a fee, unless you’re pregnant, have a government-approved exemption, or the patient is under the age of 14.

You may be required to pay emergency medical fees up front if you do not have medical insurance or access to Italy’s public health service, the SSN. If you have medical insurance, your insurer may be able to pay the hospital directly or reimburse you (depending on your coverage).

GP Appointments and Prescriptions

As a resident, you will first need to register at your local health office, or ASL (Azienda Sanitaria Locale). Once you’re registered, you can schedule free consultations with your chosen family doctor (during their clinic’s opening hours), get medical certificates, book vaccinations, and request any other medical assistance you or your family need.

There is also an out-of-hours medical service you can call for urgent but non-life-threatening illnesses. You don’t need to be registered with the local health authorities to use this service.

If you need medication, you will be given a prescription by your doctor. You will need to collect and pay for it at a pharmacy, ‘farmacia’, unless you’re registered as exempt (for example, because of a chronic medical condition). For repeat prescriptions, ask your doctor for a ‘cross-border prescription’, which can be collected anywhere in Italy (as well as any other European country).

Remember, make sure not to confuse ‘farmacias’ with ‘parafarmacias’. Parafarmacias only stock herbal and homeopathic products (as well as toiletries).

Specialist Referrals and Diagnostic Tests

If you need to see a specialist or have diagnostic tests done, you will need a referral from your doctor. Before the appointment, you will often need to settle a fee, or co-payment, called a ‘ticket’ (depending on your personal income and insurance policy). You will also need to bring proof of payment to the appointment.

If you’re a European citizen, your ‘EHIC’ (European Health Insurance Card) will allow you access to ‘necessary healthcare’ when staying temporarily (up to 90 days) or studying in the country. As a non-European citizen, you will have to check if your country of residence has an equivalent to the EHIC and follow the guidance of your government or national health provider. This may involve purchasing private medical insurance.

If you wish to stay longer than 90 days, you will need to register for a permit/visa to extend your stay (a process which can take up to 3 months). Although you don’t need private medical insurance to get this permit, you do need proof of healthcare coverage (private or with the ‘Servizio Sanitario Nazionale’) to apply. 

If you choose private medical insurance with us, you will have access to a number of benefits. These include admission to more facilities (as well as cover for overnight stays in hospitals), reduced waiting times, and faster access to expert medical support and surgeries. No matter where you are in Italy, all our plans include emergency transport, evacuation and repatriation. So, if you can’t get the treatment you need locally, we’ll help get you to another hospital and bring you back again. With some of our plans, you even have the option to cover outpatient treatments that are not normally covered by Italy’s national health service - giving you some extra reassurance.

Need cover for more than 11 months?

Long-term cover

Although a move abroad can be complicated and exhausting, our annual cover plans are designed to give you the peace of mind you deserve. Ranging from mental health services to 24/7 personalised support, you’ll be protected. It’s time to start your new life in sunny Italy.

Virtual Doctor service

Virtual Doctor Service from AXA. See a real doctor, virtually anywhere.

With the Virtual Doctor service, you can have a medical consultation with a real doctor wherever you are in the world – from the comfort of your home, hotel or office. Better still, there are doctors on call and available 24/7.2


With renowned Roman architecture and perfect sandy beaches, Italy is an unforgettable place to live in. We want to make sure you enjoy every minute by offering you personalised and comprehensive health insurance. 

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Virtual Doctor service

Getting an in-person appointment can be difficult, especially when you are in Italy, and you don’t speak the local language or are familiar with local processes. Our Virtual Doctor service allows you to get in touch with a real doctor, whenever it suits you² and from wherever you are through video or phone.

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Claims and Compensation

Compensation should be simple. Provided we have all the right information, around 80% of all eligible claims are paid within 48 hours³. So, you can get back to enjoying fine Italian dining.

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Emergency Cover

We offer a range of comprehensive cover plans, with dental and medical scans (CT, PET, MRI) as standard. Choose the right level of cover that suits your new Italian lifestyle.

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Evacuation and Repatriation

Whether you’re on the Cortina D'Ampezzo slopes or in the rural countryside, our team can arrange evacuation and repatriation services to get you the help you need.

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Mind Health service

Moving away from your support network and settling in a new country can be a challenging experience. Connect with qualified psychologists from our dedicated Mind Health service, no matter where you are in Italy4.

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Second Medical Opinion service

If you feel unsure about a diagnosis or treatment plan, want a better understanding of local healthcare practices, need details explained to you in another language, or you’d like to make sure you’ve explored every option – our Second Medical Opinion service can help bring you peace of mind.5

Who we help

Whether you’re moving for a peaceful life in Palermo or beautiful Sardinia, our plans can be tailored to your needs, wherever the journey takes you. Here are some examples of who we cover:

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For professionals planning to work anywhere in Italy, we give you one less thing to think about. Many of our plans include eye tests, prescriptions and a range of outpatient services.

Father with young daughter on his back

If you’re looking to start a new chapter in Italy, our annual plans are perfect for families with different budgets. We offer coverage that includes routine and non-routine dental check-ups, vaccinations, asthma treatments and prescription glasses. Our annual international health insurance packages also offer maternity and pregnancy benefits. 

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For retirees wanting some extra safety and security, we offer cover with annual health check-ups, palliative care and disability compensation, giving you and your family financial peace of mind.

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Give us a call on +44 (0)1892 596418*.

*Lines are open Monday to Friday, 8am-5pm (GMT).

Calls may recorded and/or monitored for quality assurance, training and as a record of the conversation.

The Virtual Doctor, Mind Health and Second Medical Opinion services are provided by Teladoc Health.

The Virtual Care from AXA service is now available to all Individual and SME members (excluding those whose health plan is insured by AXA General Insurance Hong Kong Limited). 

All Information in this article was correct at the time of publishing

Local insights have been provided by Oban International’s LIME (Local In-Market Expert) network’ - 

1. Cost is dependent on employment relating to income and relative prescriptions/exceptions, not type of employment.

2. The Virtual Doctor service is part of our Virtual Care from AXA service. Appointments are subject to availability. You do not need to pay or claim for a consultation but you will be charged for the cost of the initial phone call when using the call back service. You won’t be charged if you request a call back using the app or online portal. Telephone appointments are available 24/7/365 and call-backs are typically within 24 hours. Video appointments in English, Spanish and Mandarin are available between 08.00 and 00.00 UK time, Monday to Friday. Video appointments in German are available between 08:00 -20:00 CET, Monday to Friday

3. 80.6% of eligible claims submitted online between July 2022 and June 2023 were paid within two days. 

4. Mind Health psychologist appointments are available in English and Spanish between Monday and Friday, 09.00 - 17.30 (UK time). If you are calling from the UAE, appointments are available between Saturday to Thursday, 09.00 – 20.00, and Friday 09.00 – 16.00 (UAE time). The service, provided in partnership with Teladoc Health, provides access to six sessions with a psychologist, per mind health concern, per policy year. The Mind Health service is part of our Virtual Care from AXA service.

5. Our Second Medical Opinion service is here for you anytime you’re unsure over a diagnosis or recommended course of treatment. It’s part of our Virtual Care offering, along with the Virtual Doctor and Mind Health services, so you might have already seen it on your plan or on the Virtual Care from AXA <app> or <portal>. Provided in partnership with Teladoc Health, the service unlocks access to a network of over 50,000 world-leading specialists and connects you to a doctor who will review your case alongside an expert. They’ll work with you to help you understand your diagnosis, make sure you know your options and support you throughout any treatment, wherever you are in the world.