An introduction to the Italian health system

27 August 2018

Food, wine and sun are just a few of the things that bring both holidaymakers and expats to Italy year after year. Steeped in history and recognised globally for its contributions to the worlds of art and science, Italy also boasts the second longest life expectancy in Europe. If you’re soon to be in Italy and want to make sure you get the best out of its healthcare system, read on for our top tips!

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Choosing a family doctor

First of all, you should register at the local health offices where you live, or with ASL (Azienda Sanitaria Locale), which will allow you (and any dependant family members) to choose a family doctor, get medical certificates, book vaccinations, and ask for any other medical assistance you might need.

Once you’re registered, you can book free consultations with your chosen doctor during their clinic’s opening hours.

In Italy, there’s also a doctor on duty (guardia medica – servizio di continuità assistenziale) service you can call for urgent but non-life-threatening illnesses out of hours (weekends or after 8pm). You can find the number for your local guardia medica in the phone book or sometimes online.

When you call, the doctor on duty will advise you on your condition and visit you at your home for an examination and treatment if needed (and you don’t need to be registered with the local health authorities to use this service).

Seeing a specialist

If you need to see a specialist, you’ll have to go to your regular doctor and get them to write you a referral.

Before your appointment, you may need to settle a fee ticket and co-payment depending on your personal income and insurance policy (as well as bringing proof of payment to the appointment when you go).

The specialist will then organise any further tests or treatment you need.

Emergencies

For accidents and emergencies, call 118 for Italy’s emergency medical service.

Once you arrive at hospital, you'll be assigned a colour code depending on the severity of your condition.

If you're classed as red (the most serious), yellow, or green, all of your treatment will be free of charge. However, if your reason for admission is classed as blue or white, you'll need to pay €25 unless you’re pregnant, have been awarded a government-approved exemption or the patient is under 14 years old.

Without medical insurance, you may need to pay for your emergency medical fees up front. If you have medical insurance, your insurer may be able to pay the hospital directly, so you don’t have to. Or if you pay the hospital you may be able to get the costs reimbursed. . 

Paying for healthcare

If you're an EU or EEA citizen and you don’t have a European health insurance card (EHIC) you'll have to pay for the entirety of your treatment unless you're, pregnant, need urgent medical attention or the patient is under 14 years old.

If you’re an EHIC holder and/or have been granted a residence permit you can register with the SSN (Servizio Sanitario Nazionale) at the nearest ASL (Azienda Sanitaria Locale) and get public healthcare under the same, cost-free conditions as Italian citizens.

As a non-EU citizen coming to Italy you’ll need to apply for a permit to stay to be allowed in the country beyond your first 90 days. Once granted (a process that can take around three months), this will provide equivalent access to having an EHIC.

You don’t need to take out private health insurance to get a permit to stay in Italy, but it is highly recommended for at least the first 90 days, just in case you need to visit a doctor unexpectedly.  . Many expats in Italy choose to go private as there is a wider choice of medical facilities and easier access to faster and higher quality care but it’s worth factoring in the additional cost of care in private facilities.

Getting prescriptions 

If your doctor decides you need medication they’ll write you a prescription, which you can collect and pay for at a pharmacy (farmacia).

If you need a repeat prescription, ask your doctor for a “cross-border prescription”, which means it can be collected anywhere in Italy as well as any other European country.

Friends or relatives can collect prescriptions for you, but they’ll need to fill out a formal document of delegation and give it to your doctor to prove they've been given permission to do so.

Pharmacies and over-the-counter drugs

As with many countries, the pharmacy – or farmacia – is a good place to start if you’re suffering from non-serious issues such as minor aches and pains or a cold, and all pharmacies in Italy are state-regulated.

However, make sure not to confuse farmacias with parafarmacias – the latter don’t actually sell any medication and instead stock herbal and homeopathic medicines as well as toiletries and other non-medical items.

Dentists

All dental care is private in Italy, so dental insurance is a good idea if you want to make sure you’re covered.

Some bigger dental procedures, including tooth removal and even the fitting of Invisalign braces, are a lot cheaper in Italy than they are elsewhere in Europe. Urgent dental work such as surgery and tooth removal is offered in hospitals, but prices can depend on factors like the severity of the issue and your income.

The Italian system lacks a convenient centralised list of dentists, however there are plenty of official SSN directories (Servizio Sanitario Nazionale) – search for “elenco dentisti” (dentist list) to get started.

Don’t be surprised if…
  • you’re transported to the hospital by helicopter if you need emergency surgery (which may not be free depending on the nature of your emergency, the distance of your flight and regional prices)
  • you find that many medications, including antibiotics, can be purchased without a prescription
  • you’re able to call a doctor and have them recommend medication without an in-person appointment
Sources
  1. https://ec.europa.eu/health/sites/health/files/state/docs/chp_it_english.pdf 
  2. https://internationalliving.com/countries/italy/health-care-in-italy/ 
  3. http://international.commonwealthfund.org/countries/italy/