Italy – Doctors

How does the Italian healthcare system work, and does it cover expats?

Italy’s Servizio Sanitario Nazionale (SSN), introduced in 1978, is a universal healthcare system financed through general tax revenue. It is grounded in three guiding principles — universality, equality, and solidarity — in accordance with Article 32 of the Italian Constitution. Rather than operating like a social insurance model, where entitlement flows from personal contributions as in Germany’s statutory health funds, the SSN ties healthcare access to residency. This means that where you live, not how much you earn or contribute, determines your eligibility.

The SSN provides residents with essential healthcare largely without charge at the point of delivery. Small user fees — referred to as ticket — apply to certain services, including specialist consultations, diagnostic tests, and some medications. Covered services include hospitalisation and treatment, visits to family doctors and specialists, subsidised prescriptions, laboratory analyses, and ambulance transport.

Healthcare delivery under the SSN is decentralised, with regions responsible for organising and managing services through local bodies called Aziende Sanitarie Locali (ASL). In the Veneto region, for example, the equivalent body is called the AULSS — Azienda Unità Locale Socio Sanitaria. This regional structure is a defining feature of the Italian system, and it means that quality, accessibility, and waiting times can vary substantially between the more affluent north and the less-resourced south.

Funding comes from general taxation, and the SSN extends coverage to Italian citizens residing in Italy, EU workers and their dependants, and non-EU citizens holding certain residence permits. Non-EU nationals fall into two registration categories: mandatory (free) enrolment, which applies to those residing in Italy for purposes such as employment, family reunification, international protection, pregnancy, fostering, or adoption; and voluntary registration, open to those holding a residence permit of more than three months who do not qualify for the mandatory category, subject to payment of an annual lump-sum fee.

For authoritative eligibility information, refer to the Italian Ministry of Health website and the Agenzia delle Entrate page on health cards for foreign nationals.

How do you locate and register with a doctor in Italy?

To make use of Italy’s public healthcare services, you must enrol with the SSN through your regional health authority at your local Azienda Sanitaria Locale (ASL). The process shares similarities with registering with a GP practice in countries that operate a list-based family doctor model — you are allocated a primary care physician who acts as your central point of contact for all routine health concerns.

The following steps outline the registration process:

1. Obtain your codice fiscale (Italian tax code). This identifier is indispensable for virtually all official procedures in Italy, including SSN enrolment and medical bookings. It is issued by the Agenzia delle Entrate.
2. Obtain your permesso di soggiorno (residence permit) if applicable. Non-EU nationals must hold a valid permesso di soggiorno before they can apply for SSN registration. Citizens of EU member states generally need to register their residency with the local municipality’s civil registry office, known as the anagrafe.
3. Register your civil residence. You must formally register your address with the anagrafe of the municipality in which you are living. This requires proof of a legitimate residential tenancy or property ownership — accommodation such as hotels or short-term rentals through platforms like Airbnb does not qualify.
4. Visit your local ASL office. To complete SSN registration, you must attend your local ASL in person. Bring your residence permit or its application receipt, codice fiscale, passport, and proof of your current address such as a tenancy agreement or confirmation from the anagrafe. Depending on your circumstances, you may also need to provide evidence of employment, pension income, or university enrolment.
5. Select your medico di base (family doctor). You will be invited to choose a general practitioner from a register of doctors in your area who are accepting new patients. The selection can often be filtered by spoken languages, available appointment times, and current patient capacity.
6. Receive your tessera sanitaria (health card). Your health card will normally arrive by post within one to two weeks of registration. In the interim, the provisional certificate or receipt issued at the ASL is valid proof of entitlement and can be used if you need to access care before the card arrives.

Your medico di base becomes the gateway to the entire public health network — they issue referrals to specialists, arrange hospital admissions when needed, and manage your ongoing healthcare. Should you wish to change your GP at any point, simply return to the ASL office to make the switch.

A number of regional ASL offices now offer online or email-based registration options — consult your local ASL’s website for the latest forms and procedures. For general guidance, the Italian Ministry of Health website is a reliable starting point.

How do you pay for a doctor’s appointment in Italy?

Appointments with your registered GP — including consultations, prescriptions, health screenings, and vaccinations — are provided free of charge. Once you are enrolled with the SSN, routine primary care costs nothing at the point of use, making it effectively equivalent to a fully public system for most everyday health needs. However, co-payments do apply to certain services once you move beyond GP-level care.

A user fee known as the ticket sanitario is levied on some emergency room visits, specialist appointments, diagnostic procedures, and laboratory tests. The amount payable depends on the type of service and the patient’s personal circumstances, with exemptions available for those on low incomes or living with serious chronic conditions.

As of 2025, the principal co-payment amounts are as follows: specialist consultations and diagnostic tests carry a ticket of between €15 and €36.15 across most of the country, with five regions applying an additional €10 surcharge that raises the ceiling to €46. A non-urgent emergency room attendance — classified as a white code — attracts a fixed fee of €25.

Various exemption categories exist for the ticket, including people aged over 65, children under six, individuals with specified chronic or serious conditions, and households below certain income thresholds. Italy introduced a standardised national tariff framework from 1 January 2025, meaning identical services will now carry the same cost regardless of region for the first time in many years. Some regions retain the right to apply their previous tariffs for up to 18 months, particularly for prescriptions issued towards the end of 2024.

If you are employed in Italy and pay income tax, your entitlement to public healthcare comes at no additional cost to you. Up-to-date details on exemption criteria and current co-payment rates are available through the Ministry of Health website or your local ASL.

Do you need private health insurance to see a doctor in Italy?

Private health insurance is not a legal requirement for expats who qualify for mandatory SSN enrolment — typically those in employment or full-time education in Italy. That said, it is widely used alongside the public system, and in certain circumstances it is a formal precondition for accessing the SSN in the first place.

Prior to obtaining residency, you are generally required to hold private health cover. Once residency is established, certain categories — such as employees and the self-employed — become eligible to join the SSN, which provides low-cost or free services. Non-EU nationals applying for specific visa types, such as the elective residency visa, are typically required to demonstrate comprehensive private health insurance valid in Italy before their visa or permit will be approved. Current requirements should be confirmed with the Italian Ministry of Foreign Affairs.

Many expats rely on the SSN for significant healthcare needs while maintaining a private policy for additional convenience. Private insurance complements the public system by offering faster access to specialists and diagnostic tests, the freedom to select your own doctor or clinic, and access to English-speaking practitioners and internationally oriented facilities.

Supplementary private plans typically cost between €300 and €1,000 per year, depending on age and coverage limits, and can reimburse ticket co-payments, provide private rooms during hospitalisation, and extend to dental and vision care. When selecting a policy, prioritise insurers with experience in serving expatriate clients, and scrutinise the terms around exclusions, waiting periods, and pre-existing conditions before committing.

Dental and optical care are only partially included within the SSN. Emergency dentistry and paediatric treatment are generally covered, but routine adult dental care — including check-ups, fillings, and hygiene appointments — falls outside public provision and must be paid for privately. Eye examinations and corrective lenses are also self-funded unless there is a defined medical necessity. This gap in public coverage is among the most common reasons expats invest in supplementary insurance.

How do you transfer your medical records to a doctor in Italy?

No formal bilateral agreement exists between Italy and other countries for the transfer of medical records, so the most reliable approach is to request a comprehensive summary from your existing healthcare provider well before your departure. Most health systems allow patients to obtain copies of their records on request; submit your request in writing and allow sufficient time — ideally several weeks — before you leave.

If you are managing ongoing health conditions, arriving with translated records and details of your current medications will be of considerable practical value. While Italian law does not mandate that documents be translated, giving your new GP a clear summary in Italian — or a bilingual English and Italian format — will greatly facilitate continuity of care. A certified medical translator can accurately render diagnoses, test findings, and medication histories into Italian.

Once you are registered with the SSN, your health information in Italy will be held within the Fascicolo Sanitario Elettronico (FSE) — Italy’s national Electronic Health Record platform. The FSE is the mechanism through which residents can track and review the full history of their healthcare interactions, and through which medical professionals can access the information they need to deliver more effective and efficient treatment.

All regions now operate FSE 2.0, funded under the EU Recovery Plan. Laboratory results, vaccination records, and every new electronic prescription are added to your file automatically. Access is available using SPID — Italy’s national digital identity system — or your electronic identity card (CIE), and emergency responders can retrieve your file when you contact the 112 service.

SSN-registered patients can access their Electronic Health Record by selecting their region or autonomous province on the interactive map at the dedicated portal. Visit fascicolosanitario.gov.it for login instructions and regional guidance.

Test results are typically uploaded to your FSE and made accessible via the official regional application. By December 2024, all healthcare providers were required to generate documents in native digital format for automatic inclusion in the FSE, with full nationwide implementation of the system expected by 2026.

What should expats know about language barriers and finding an English-speaking doctor in Italy?

Language can present a real and tangible obstacle within the Italian healthcare system, particularly during consultations where precision and nuance are essential. Italian is the standard working language across virtually all public health facilities. While numerous doctors — especially specialists and those with international training backgrounds — speak a degree of English, this cannot be assumed as a given.

In major cities you are more likely to encounter English-speaking practitioners, whereas in rural or smaller communities, you may need to arrange translation support. Private healthcare is one option that can ease this challenge — beyond shorter waiting times for specialists, it often provides access to a broader pool of doctors and tends to attract more English-speaking practitioners than the public sector.

The following resources can assist in finding a doctor who consults in your preferred language:

• Your country’s embassy or consulate in Italy typically maintains a vetted directory of local practitioners who consult in the relevant language. These lists are generally a dependable starting point.
• Expat community groups and forums — such as those on Internations or city-specific Facebook groups for expats in Rome, Milan, Florence, and other major centres — regularly share first-hand recommendations for bilingual GPs and specialists.
• The ASL register of local GPs in your area may allow you to filter results by language spoken, available hours, and current patient availability.
• Private telemedicine services operating in Italy offer consultations in English and other languages and can be useful for minor or non-urgent concerns.

If your Italian is limited, consider engaging a medical interpreter, making use of translation tools, or seeking out practices known for their multilingual staff. Some private insurers include interpretation services within their policy benefits.

Even a working knowledge of basic Italian can make navigating the public health system considerably easier. In your early months before you become familiar with the local setup, it is worth preparing a brief written summary in Italian of your existing conditions, current medications, and any known allergies to bring to appointments.

What do expats need to know about prescriptions and medication in Italy?

Italian doctors issue prescriptions electronically, and you simply present your tessera sanitaria at any pharmacy to collect your medication. The electronic prescription system eliminates the risk of losing a paper document — the relevant data is linked directly to your health card and codice fiscale.

Prescriptions written by your SSN doctor are generally subsidised by the state, meaning you pay only a modest co-payment that varies according to the drug’s classification and your income level. As of 2025, the principal prescription cost categories are as follows:

Where a branded medicine is priced above the reference reimbursement amount, the difference must be paid by the patient. Your pharmacist will ordinarily suggest the lowest-cost equivalent unless your doctor has specifically indicated that substitution is not permitted. Generic drugs undergo the same quality controls as branded products and appear on the regularly updated AIFA Transparency List, published monthly. For current reimbursement classifications, consult AIFA (Agenzia Italiana del Farmaco), Italy’s national medicines regulator.

Prescriptions issued in another country are not accepted at Italian pharmacies. If you are taking ongoing medication when you arrive, bring an adequate supply to carry you through until you can attend your first GP appointment, and ask your new medico di base to review and re-prescribe the treatment under the Italian system. Bear in mind that some medicines available elsewhere may not be licensed in Italy, or may be marketed under a different brand name — your pharmacist can help identify the appropriate local equivalent.

Italian pharmacies serve as an excellent first port of call for straightforward health concerns. For minor ailments such as a cold, cough, or pain, the pharmacist can recommend suitable over-the-counter products and offer practical guidance. Pharmacies — farmacie — are easily identified by the green cross displayed outside the premises. While pharmacists are not medical doctors, they hold extensive professional training and are well placed to provide useful medical advice for everyday complaints.

Most local pharmacies operate approximately from 08:30 to 12:30 and from 15:30 to 19:30. Outside these hours, a notice on the door will direct you to the nearest farmacia di turno — the designated on-call pharmacy — which may apply a small out-of-hours surcharge on top of the standard ticket.

Frequently asked questions

What do I do in a medical emergency in Italy?

In an emergency, call 112 (the general European emergency number) or 118 (Italy’s dedicated health emergency line), or make your way directly to the emergency department — the pronto soccorso — at your nearest public hospital. Emergency treatment in Italy is available to everyone, irrespective of insurance cover or residency status.

Will my pre-existing conditions be covered once I register with the SSN?

The SSN offers solid protection for emergencies and ongoing conditions that private insurers might decline to cover. The public system does not exclude patients on the basis of pre-existing health issues in the way that many private policies do. Once you are registered, raise any existing conditions with your new GP, who can arrange specialist referrals and prescriptions within the public network.

How long does SSN registration take, and can I see a doctor while I wait?

Registration typically takes between one and two weeks, after which your tessera sanitaria will arrive by post. In the meantime, you will be given a provisional registration certificate or receipt slip, which serves as valid proof of entitlement and can be used to access care while you await the card. If you require attention before the process is complete, private GP clinics are available across Italy on both a walk-in and appointment basis.

What happens to my healthcare access if I change jobs or become unemployed?

Provided you are registered as a resident and enrolled in the SSN, you retain coverage for the majority of healthcare needs. If you lose your job and your SSN registration was conditional on your employment status, you may be required to re-enrol under a different category. Individuals who are unemployed, registered with Italian employment services, and entitled to relevant benefits are generally able to maintain SSN access. Contact your local ASL as soon as your employment status changes.

Can I choose any GP, or am I limited to doctors in my local area?

After registering with the SSN, you may select a GP from the approved list maintained by your local ASL. Catchment restrictions apply — you must ordinarily choose a practitioner who accepts patients within the municipality where you are officially registered as a resident. If you relocate to another municipality or region, update your anagrafe registration first, then visit your new ASL to transfer your SSN enrolment and register with a new GP, taking proof of your new address along with your identity documents and codice fiscale.

Is there out-of-hours GP cover in Italy?

If you need medical attention outside your GP’s normal surgery hours but your condition is not serious enough to warrant an emergency room visit, you can use the guardia medica — also known as the servizio di continuità assistenziale. This on-call medical service operates in every municipality during evenings and at weekends to provide care when your regular GP is unavailable.

Do I need to get my foreign prescriptions re-issued in Italy?

Yes — prescriptions written abroad are not accepted at Italian pharmacies. Carry sufficient supplies of any existing medication to last until your first appointment with an Italian GP, who can assess your current treatment and issue the appropriate local electronic prescriptions. Certain drugs may be available under a different name or in a different formulation in Italy; both your GP and pharmacist can assist in identifying the correct local equivalent. Current reimbursement status for any given medication can be verified through AIFA.

What is the tessera sanitaria and do I need it for every appointment?

The tessera sanitaria is your primary access document for Italy’s public healthcare system. It carries your personal details and codice fiscale, enabling you to book appointments, collect prescriptions, and receive treatment under the SSN. You do not need it when consulting a private doctor — whether a GP or a specialist — or when purchasing medication or arranging tests on the basis of a private prescription.