Surprising fact: emergency medical care here is given to anyone without upfront payment — call 112 or 118 and you will be triaged immediately.
Why this matters: Italy delivers care through the Servizio Sanitario Nazionale (SSN), a tax-funded public system run by regional ASL offices and public hospitals. The SSN is universal, but many visits carry a co-pay called a “ticket.”
You will learn which statuses — worker, student, retiree, tourist — shape your access and what documents or codes (Tessera Sanitaria, EHIC/GHIC/S1, STP) let you use services. Private clinics can work with SSN agreements (privato convenzionato) to book covered care.
Practical point: registration at your local ASL, choosing a primary doctor, and knowing when to use private insurance can cut waiting times and control cost. This guide gives clear steps and reliable information so you can get covered and find the right staff and services fast.
Key Takeaways
- The SSN provides universal care, but some services require a ticket or have exemptions.
- Emergency care is always available without upfront payment; call 112 or 118 for triage.
- Know which card or code applies to you: Tessera Sanitaria, EHIC/GHIC/S1, or STP.
- Register at your ASL and pick a medico di base to access primary services.
- Private insurance or privato convenzionato options can reduce waits and improve comfort.
Understanding Italy’s Healthcare System at a Glance
Get a quick snapshot of how Italy’s national system funds and delivers essential medical services across regions.
How the SSN works
The SSN is tax-funded and overseen by the Ministry of Health. Regions run local ASL offices and public hospitals that deliver primary and specialist services.
Universal care, but not everything is free
The system guarantees essential care to people present in the country. Many non-urgent visits carry a regional co-pay called a ticket. Exemptions exist for low income and certain chronic conditions.
Key practical points:
- With a Tessera Sanitaria or EHIC/GHIC you get primary doctor visits, ER access, and discounted diagnostics when prescribed.
- Private clinics may work as privato convenzionato, letting you book public slots at private sites.
- Most general doctors operate in Italian; plan for language support if needed.
| Feature | Public SSN | Privato convenzionato |
|---|---|---|
| Funding | Tax-funded | Private + SSN agreements |
| Wait times | Often longer | Shorter for booked slots |
| Language support | Mostly Italian | More likely to offer English |
| Cost to you | Free or ticket | May require private payment |
Who Can Access Public Healthcare: Eligibility by Status
Understand which permits and life situations give you access to public coverage and when voluntary options apply.
Article 34 of the Testo Unico Immigrazione (TUI) grants free SSN registration to people legally residing and working or self-employed, registered job seekers, dependents, and those renewing permits for family, asylum, or special protection.
Employment and job seekers
If you work or run a business, you qualify for free registration. If you lose a job, update the Employment Center to keep continuity of coverage.
EU/EFTA/UK visitors and S1 holders
EU/EFTA/UK nationals may use EHIC/GHIC for medically necessary care. S1 shifts billing to the home country for eligible retirees and posted workers.
Non-EU residents, family, and protections
Non-EU residents who do not qualify can enroll voluntarily (annual fee) or buy private insurance. Family reunification dependents and minors get public care; minors receive care from birth.
“Urgent and essential care is guaranteed to everyone, including those without regular status.”
- Check your permit type and bring proof of family ties at ASL registration.
- Schengen visas require private insurance with minimum emergency coverage.
| Status | Free SSN? | Key documents |
|---|---|---|
| Worker / Self-employed | Yes | Codice fiscale, contract/INPS registration |
| EU/EFTA/UK (short stay) | EHIC/GHIC covers medically necessary care | EHIC/GHIC or S1 |
| Non-EU (voluntary) | Optional (fee) or private | Residence permit or private policy |
Public vs. Private Healthcare: Coverage, Comfort, and Cost
Comparing public system services with private clinics helps you match care to need and budget.
When to use the SSN
You’ll use the SSN for primary doctor and pediatric visits, emergency room treatment, and medically necessary specialist visits or diagnostics when you have a red prescription. Co-pays vary by region and some conditions give exemptions, so your out-of-pocket cost can be low.
When private providers make sense
Private healthcare requires upfront payment but gives faster appointments, easier scheduling, and more comfort. Choose private if you need quicker access for elective procedures, want an English-speaking staff, or prefer to pick a specific doctor or hospital.
Privato convenzionato — the hybrid option
Many private clinics accept SSN bookings as privato convenzionato. You must tell the clinic you will use SSN coverage so they reserve a public slot. If you fail to declare this, you’ll be billed as a private patient.
- The clinical qualifications of doctors are similar across public and private settings.
- For non-urgent cases, private appointments often beat long SSN queues for diagnostics and procedures.
- Always check whether a service carries a ticket and save receipts if you plan to claim insurance reimbursements.
How to Register with the SSN: Step-by-Step
Start your SSN registration at the ASL office that matches your declared residence to avoid delays. Bring ID, codice fiscale, proof of address, and your residence permit or receipt.
Who must register: Workers, dependents, minors, asylum seekers and others listed under Article 34 TUI must register. If you do not fall into a mandatory category, you can opt for voluntary enrollment for an annual fee (students usually pay a flat rate of at least €700).
At the ASL you will select a medico di base. That doctor provides free GP consultations, referrals, and prescription management during office hours.
- Where to go: Your local ASL tied to your residence or declared domicile; there is no separate foreigner registry.
- Timing: Align SSN validity with your residence permit and diarize renewals to avoid coverage gaps during days or months of processing.
- Documents: ID, codice fiscale, proof of address, permit or receipt, and family status papers for dependents.
- Practical tips: Some ASL offices use appointment days; bring paper copies and keep the registration certificate until your Tessera Sanitaria arrives.
Remember: Update the ASL after any change of residence or family status to keep your doctor and access to services current. Ask about local digital services to manage bookings and exemptions.
Tessera Sanitaria, EHIC/GHIC, and STP Code: Cards You Need
Knowing which card or form to show at the ASL, pharmacy, or clinic saves time and avoids surprise bills. Each document controls how your visit is billed, which services you can get, and whether a ticket (co-pay) applies.
Italian health insurance card (Tessera Sanitaria)
After SSN registration you receive the Tessera Sanitaria by mail. If your permit is still processing, keep the temporary certificate with your ID number until the card arrives.
Use it for GP visits, prescriptions, diagnostics, and SSN-booked specialist appointments.
EHIC/GHIC and the S1 form
Visitors from EU/EFTA/UK use EHIC or GHIC for medically necessary treatment during short stays. The S1 form lets your home country fund care here for eligible posted workers and some retirees.
STP code for temporary or irregular stays
If you lack regular status, request an STP code at your ASL. It grants nationwide access to urgent, essential, and preventive care, usually valid for six months and renewable.
“Pharmacists require Italian prescriptions for many antibiotics; telemedicine prescriptions must come from doctors licensed here.”
- Bring the correct card or code to every appointment to avoid unexpected payment.
- Keep digital and paper copies of cards and S1 paperwork for cross-border claims.
| Document | Primary use | Validity / notes |
|---|---|---|
| Tessera Sanitaria | SSN services, GP, prescriptions | Issued after SSN registration; temporary certificate until card arrives |
| EHIC / GHIC | Medically necessary treatment for short stays | Covers public SSN care; not for private unless SSN booking accepted |
| S1 | Home country funds care | For posted workers and eligible retirees; carry original form |
| STP code | Urgent and preventive care for those temporarily present | Usually six months; renewable at ASL; tickets may apply |
Costs, Co-pays, and Exemptions: What You’ll Pay
Out-of-pocket charges depend on region and the type of service. Tickets (co-pays) apply to non-urgent ER visits, specialist consultations, diagnostics, and lab tests. Each region sets its own tariffs and exemption rules.
Exemptions exist for low income thresholds, certain serious illnesses, and some seniors. If your household income qualifies, many fees are reduced or removed.
You can pay tickets via PagoPA online or at partner outlets (post offices, tobacco shops, banks, ATMs, some supermarkets) and often at the facility itself. Keep every receipt: private insurance may reimburse public co-pays if your policy covers them.
Non-registered users may face regional rates for urgent hospital care. Private doctor visits typically range €100–€200, so compare SSN co-pays versus private fees when speed matters.
Quick reference
| Item | Typical cost | Who pays | Notes |
|---|---|---|---|
| Specialist visit (SSN) | Ticket varies by region | Patient (unless exempt) | Red prescription often required |
| Diagnostics / labs | Ticket or full private fee | Patient or insurer | Bundle via SSN can lower total cost |
| Private doctor visit | €100–€200 | Patient or insurer | Faster access; check receipts for reimbursement |
| Urgent hospital (non-SSN) | Regional rates apply | Non-enrolled individuals | Emergencies routed through 112/118; billing varies |
Accessing Care: Primary Care, Specialists, and Diagnostics
Primary care is your first stop: GPs handle routine issues, renew prescriptions, and provide referrals for specialist services.
Seeing your medico di base
Your medico di base offers free consultations and pediatric visits through the SSN. They write prescriptions and refer you to specialists when needed.
Tip: Bring your Tessera Sanitaria or temporary certificate and explain symptoms clearly so the doctor can note any urgent need.
Specialist visits with a red prescription
To get SSN-rate specialist care you must present a ricetta rossa (impegnativa) from your doctor.
Urgent annotations can shorten waits to about 10–30 days. For routine referrals expect waits measured in weeks or months.
Diagnostics and lab tests: booking via CUP
Book procedures and imaging through the regional CUP system online or by phone. Public bookings assign the earliest available appointment rather than a named doctor.
Public facilities usually require in-person pick-up for results. Plan return trips and bring ID plus the red prescription when collecting reports.
- Declare “paziente SSN” at privato convenzionato clinics to use public slots instead of paying private rates.
- Compare options: hospital versus clinic for the same procedure, factoring waiting lists, location, and result logistics.
- Coordinate urgency: ask your doctor to mark urgent conditions accurately to reduce waiting days.
| Service | How to access | Typical wait |
|---|---|---|
| GP consultation | Medico di base | Same week to weeks |
| Specialist visit | Red prescription + CUP | Weeks to months (urgent: 10–30 days) |
| Imaging / labs | CUP booking; red prescription | Days to months |
Emergency and Urgent Medical Care in Italy
When seconds count, dial the correct emergency number and follow dispatcher instructions. Call 112 (EU) or 118 (medical) to reach triage and ambulance dispatch. Give your exact location and describe symptoms calmly.
Calling and ER triage
Operators sort cases by urgency and send ambulances or helicopters when needed. ER triage uses color codes to set priority, so patients are treated by need, not arrival order.
Non-urgent visits and the ticket
Emergency treatment is provided without upfront payment. If your condition is non-urgent, the ER may redirect you and a ticket (co-pay) can apply. Expect long waits for stable cases.
Admissions, transfers, and private rooms
Necessary hospital admissions under SSN or EHIC/GHIC are covered. Extras like private rooms or special amenities carry a quoted fee.
- Keep ID, Tessera Sanitaria or EHIC/GHIC where possible.
- Arrange transfers only after getting written cost estimates and keep receipts for insurance claims.
- Language help speeds communication; try to have someone who speaks Italian assist.
| Feature | SSN / EHIC | Private option |
|---|---|---|
| Emergency treatment | Immediate, no upfront payment | Faster amenities; private billing |
| Hospital admission | Covered if needed | Possible transfer with quoted cost |
| Room choice | Standard ward | Private room for a fee |
Private Health Insurance for Expats: When It Makes Sense
If fast access, broader networks, and direct billing matter to you, private health insurance is worth comparing. Private plans can close gaps that the public system leaves open. They often cover services excluded from basic benefits and cut waiting times for elective procedures.
Corporate vs. voluntary international policies: employer-sponsored plans may subsidize premiums and offer group rates. Voluntary international insurance gives flexible portability and tailored benefits for families or frequent travelers. Check IVASS registration and confirm pre-authorization rules before you sign.
- Why choose private healthcare: direct specialist access, no co-pays, and faster diagnostics.
- Compare whether a plan pays providers directly or requires you to pay and reclaim costs.
- Look for English-speaking networks, hospital comfort options (private rooms), and telemedicine.
Familiar international providers include Allianz Care, APRIL International, and Cigna Global. Balance premiums, deductibles, and emergency coverage against expected use. For many arrivals, a short-term private policy is essential while you wait for public registration.
Healthcare in Italy Expat: Registration, Insurance, and Access
Start by mapping which registration route fits your residence status and how long you’ll stay. This helps you pick mandatory SSN enrollment, voluntary coverage, or a private policy for the first months.
Best-fit pathways for your permit, residence, and income
If you are a worker, dependent, minor, or asylum seeker, mandatory SSN registration applies and gives broad coverage. EU/EFTA/UK nationals can use EHIC/GHIC or an S1 for initial care, but after three months EU/EFTA residents must register at the Anagrafe to preserve rights.
Non-EU and some UK arrivals often need a visa with private insurance first, then full SSN access once the residence permit issues. If you lose your job, register with the Employment Center to avoid losing public access.
Common pitfalls to avoid in the first 90 days
Missing early steps creates gaps and extra costs. Register your residence promptly, confirm EHIC/GHIC/S1 rules for your case, and keep private insurance while paperwork processes.
“Register early, keep copies of receipts and certificates, and update your status after any job or address change.”
| Situation | Immediate action | Why it matters |
|---|---|---|
| Worker / dependent | Register at ASL, get Tessera Sanitaria | Ensures continuous coverage and GP access |
| EU/EFTA visitor | Use EHIC/GHIC; register at Anagrafe after 3 months | Preserves rights and avoids gaps for long stays |
| Non-EU arrival | Secure visa insurance, apply for permit, then SSN | Prevents out-of-pocket costs during processing |
| Job loss | Register with Employment Center | Maintains eligibility and benefits |
Practical tip: gather ID, codice fiscale, permit receipts, and proof of address early. Check local ASL/CUP online services to speed bookings and centralize all coverage documents so you can show proof when accessing services.
Children, Families, and Dependents: Your Coverage Options
Prompt ASL enrollment secures a pediatra di libera scelta and starts public pediatric support for your newborn. Minors are entitled to care from birth, so register at your local ASL as soon as possible.
Newborns and pediatric care
Your chosen pediatric doctor handles routine checkups, growth screens, and vaccinations. Many prevention programs and immunizations are free or exempt for children under public schemes.
Registering dependents and documents
Link dependent family members to your SSN rights by showing family status and residence papers at the ASL. Unaccompanied minors also receive protection and access while permits are processed.
“Register early, pick a pediatra, and keep prescriptions and referrals organized for diagnostics and therapies.”
- Register newborns quickly and select a pediatra di libera scelta.
- Gather family status documents to enroll dependents under your coverage.
- Use public clinics for vaccinations and pediatric prevention schedules.
- Rely on SSN pathways for pediatric hospital treatment; child co-pays are often waived or reduced.
- Coordinate with your doctor for specific conditions and consider private pediatric options if waits are long.
Regional Differences: Tickets, Booking, and Waiting Times
Regional rules shape how fast you get appointments and how much you pay for services. Local health authorities run the booking system, set ticket amounts, and define payment rules. That means procedures vary by region and even by hospital campus.
CUP systems, payment channels, and local procedures
The CUP (central booking) is your gateway for specialist visits and diagnostics. Use the region’s online portal or phone center to check earliest slots. Waits can be measured in days or months depending on priority codes and facility capacity.
Payment follows standardized PagoPA channels. You can pay at on-site desks or partner outlets — tobacco shops, post offices, banks, ATMs, and some supermarkets. Keep every receipt for reimbursements.
“Some regions offer urgent pathways that cut waits to 10–30 days when a doctor marks the case as priority.”
- Confirm whether a clinic is privato convenzionato and tell them you will use SSN slots to avoid full private fees.
- Compare cost and speed across nearby regions if you can legally book elsewhere.
- Plan extra time for hospital visits on complex campuses: check-in, payment, and ward location can add delays.
Tip: Rely on official regional websites for ticket rules and current procedures. Document which CUP hours and facilities gave the shortest waits so your next booking is faster.
Language and Finding English-Speaking Doctors
Clear communication matters for consent, prescriptions, and follow-up. If you prefer care in English, plan ahead so appointments and medication instructions are accurate.
Public vs. private language access
Most SSN primary doctors and CUP booking lines operate in Italian. Bring a bilingual friend, use a translator app, or pick a private clinic that advertises multilingual staff.
Private clinics often list English-speaking staff and international patient services. Fees are higher than public co-pays but can save time and reduce misunderstandings.
Telemedicine with licensed Italian providers
Telemedicine can give same-day advice, issue valid prescriptions, and accept payment through private networks. Controlled substances and some antibiotics cannot be prescribed by video.
- Check provider credentials and reviews before booking.
- Confirm whether your insurance supports direct billing with the clinic or network.
- Keep English summaries, but use the Italian prescription format for pharmacies.
“Use telehealth for quick assessment, and reserve in-person visits for exams or diagnostics that need a physical check.”
Validity, Renewals, and Timelines: Permit and Card Sync
Match your SSN registration to your residence permit dates so you keep access to your doctor, prescriptions, and referrals without interruption.
Aligning SSN enrollment with your permit
SSN registrations usually mirror the length of your residence permit. When you renew the permit, return to the ASL with the renewed permit or the receipt of renewal.
Renewing the Tessera Sanitaria and continuity of care
The Tessera Sanitaria is issued after registration and generally follows the same expiry. If your permit is pending, keep the temporary certificate or renewal receipt to prove coverage while the card is processed — some procedures can take months.
“Submit renewals early and keep proof of submission to avoid service gaps.”
- Keep a copy of your permit, registration number, and card to speed clinic checks.
- Update the ASL if you change residence; this can change your assigned doctor and local office.
- Confirm any fee tied to voluntary enrollment so your insurance and SSN remain synchronized.
Tip: add expiry reminders and bundle renewal steps into annual health planning to ensure continuous coverage.
Documents Checklist and Processes: What to Bring and Expect
A clear checklist speeds registration and helps you show the correct forms at your first appointment.
Bring a valid ID, your codice fiscale, proof of residence, and your residence permit or receipt. If applicable, add your visa, S1 form, EHIC/GHIC, and any immigration notes.
For family or dependents, take marriage or birth certificates to link relatives to your record. For work or study, bring contracts, VAT or social security details, or an enrollment letter.
- Keep certified copies and receipts of every application or payment.
- Seasonal workers should show Immigration Desk clearance and housing contracts when requested.
- Ask which steps are online and which require an in-person visit to save time.
Confirm whether public labs provide digital results. If not, plan a pickup trip. Also prepare income papers if you will apply for fee exemptions.
“Carry temporary certificates while you wait for the Tessera Sanitaria; they act as short-term proof of coverage.”
| Document | Why it’s needed | Where to present |
|---|---|---|
| ID / Passport | Identity verification | ASL counter, CUP, ER |
| Codice fiscale | Tax and registry code for records | All formal forms and billing |
| Permit / receipt | Proof of legal residence or application | SSN registration and doctor assignment |
| S1 / EHIC / GHIC | Cross-border funding or short-stay coverage | ASL, hospital admissions, pharmacies |
Conclusion
This short checklist helps you keep medical access steady while you settle in. The SSN offers universal entry with regional co-pays and exemptions, and private insurance can speed appointments and add comfort.
Match your cards and permits: use Tessera Sanitaria, EHIC/GHIC/S1 or STP correctly and renew ASL registration when your permit changes. Book specialists through CUP with a red prescription to avoid surprises.
Keep emergency numbers (112/118) handy; triage sets priority and ER care is available without upfront payment. Pay tickets via PagoPA and track receipts for claims.
Final tip: plan documents early, use private cover when wait times threaten treatment, and revisit this guide as your status or family needs change to keep health services aligned with the system and your life as citizens and residents of this country.
FAQ
What is the Servizio Sanitario Nazionale (SSN) and how does it work?
The SSN is Italy’s public health system that provides primary and specialist care, hospital services, and preventative programs. You access services through your local ASL (Azienda Sanitaria Locale). When enrolled, you choose a primary care doctor (medico di base) who handles routine care and issues referrals for specialists. Some services are free; others require a regional ticket (co-pay). Registration and coverage depend on your permit, residence status, and income.
Who can access public services under the SSN?
Citizens, residents with a valid residence permit, employed and self-employed people, pensioners, students, and some volunteers are eligible. EU/EFTA/UK nationals can use EHIC/GHIC or an S1 form. Non-EU family members with residence or family reunification permits, asylum seekers, minors, and people with special protections also have access, though the exact rights and timelines vary by status.
Do EU EHIC/GHIC holders need to register with the SSN?
Short-term visitors with an EHIC or GHIC can get care for medically necessary treatment without registering. If you plan to live, study, or work in Italy long term, you should register with the SSN or present an S1 form for pensioners and some cross-border workers to secure full coverage.
What is the Tessera Sanitaria and why do you need it?
The Tessera Sanitaria is the Italian health card linked to your codice fiscale. It proves SSN registration and allows access to public services, prescription drugs, and exemptions. Keep it with you for doctor visits, hospital admissions, and to get refunds or reduced fees via PagoPA when applicable.
How do you register with the SSN and how long does it take?
Go to your local ASL with ID, codice fiscale, residence permit or visa, and proof of address. Employed people are usually registered via their employer; others register directly. Some regions treat initial registration as mandatory within a set number of days; voluntary enrollment is available for some residents and carries a fee. Processing times vary by region but expect a few days to several weeks for full paperwork and a Tessera Sanitaria.
How do you choose and change your primary care doctor (medico di base)?
You pick a medico di base at your ASL. You can change doctors if you move or are dissatisfied. The ASL keeps a list of available physicians; selection is usually free and immediate, though some areas have limited choice. Children are assigned a pediatrician (pediatra di libera scelta) instead of a medico di base.
What are tickets (co-pays) and can you get exemptions?
Tickets are regional co-pays for specialist visits, diagnostics, and some procedures. Amounts vary by region and service. Exemptions exist for low-income individuals, chronic conditions, disability, pregnancy, and certain age groups. To claim an exemption you’ll need documentation of income or medical condition when registering or booking.
How are specialist visits and diagnostics booked?
Use the CUP (Centro Unico di Prenotazione) system—online, by phone, or at regional offices—to book specialist visits and lab tests. Specialists typically require a ricetta rossa (red prescription) from your medico di base. Waiting times differ by region and service; private or privato convenzionato providers can offer shorter waits for a fee.
When should you use emergency services and how does triage work?
Call 112 or 118 for life-threatening emergencies. Emergency departments triage by severity: critical cases first, non-urgent later. If you use ER for non-urgent issues, you may face a ticket. Ambulance transfers and hospital admissions follow clinical need; you can request private room options where available, often for an extra cost.
What is the STP code and who needs it?
The STP (Stranieri Temporaneamente Presenti) code gives temporary access to essential health services for foreigners without residency or a regular permit. It covers urgent and basic care and is issued by the ASL. It does not replace full SSN registration but ensures immediate treatment while your status is sorted.
Should you buy private or international health insurance?
Private insurance makes sense if you want faster specialist access, private hospitals, international coverage, or to fill gaps not covered by public services. Employers often provide corporate plans; you can also buy voluntary international policies for family travel, repatriation, or comprehensive coverage if you’re not eligible for full SSN benefits.
How do regional differences affect access, costs, and wait times?
Regions set many operational rules—ticket levels, CUP systems, booking channels, and wait-list management—so services vary. Northern regions often have shorter wait times and different payment procedures than southern areas. Check your local ASL website for precise rules and procedures where you live.
How do you align SSN enrollment with your residence permit and renewals?
Enroll soon after getting your residence permit to avoid gaps in care. Keep your Tessera Sanitaria updated whenever your permit or address changes. Renew the card and SSN registration alongside permit renewals to maintain continuity of care and avoid administrative issues with prescriptions or specialist bookings.
What documents do you need when registering or booking care?
Bring a valid passport or national ID, codice fiscale, residence permit or visa, proof of address, employment or study documents, and family status papers if registering dependents. Bring EHIC/GHIC or S1 where relevant. For exemptions, bring income statements or medical certifications. Local ASL sites list exact requirements.
How do families and children get covered?
Register newborns promptly with the ASL for pediatric care and a Tessera Sanitaria. Dependents can be registered under a primary registrant’s status if family documents and permits are in order. Pediatricians handle routine child care; school-age children may need vaccinations or documentation for enrollment.
Where can you find English-speaking doctors and telemedicine options?
Larger public hospitals and private clinics often list English-speaking staff. Private providers and international clinics advertise language access. Telemedicine platforms with licensed Italian doctors offer appointments in English and can be convenient for follow-ups, prescriptions, and minor issues, especially if you have private or international insurance.
How do you pay and get reimbursed for services?
You can pay co-pays and private fees via PagoPA, bank transfer, or at ASL counters. If you have private insurance, collect receipts and detailed medical reports to submit for reimbursement. International insurers usually require itemized bills and evidence of payment to process claims. Keep all documentation and your Tessera Sanitaria details handy.
