How to Navigate the Italian Healthcare System When Moving?
Jun 18, 2025
Navigate Italian Healthcare with Mitos Relocation Solutions
Retiring in Italy means access to stunning scenery, rich culture, and one of Europe’s most valued healthcare systems. But to make the most of it, you’ll need to understand how the system works. Italy offers both public healthcare through the Servizio Sanitario Nazionale (SSN) and a robust private sector for faster or more personalized care. The SSN offers universal coverage for residents, covering essentials like GP visits, hospital stays, and most prescriptions.
We will walk you through every step, from securing legal residency and registering with your local health authority to receiving your Tessera Sanitaria and choosing a general practitioner. With the right information, navigating Italian healthcare can be simple, efficient, and stress-free.
Key Steps For Navigation of the Italian Healthcare System
Whether you're planning to settle in a busy city or a quiet rural village, the key steps from registering with the national system for choosing a doctor will help you avoid confusion. Below is the section that outlines the essential steps every expat should follow to navigate Italy’s healthcare system confidently.
Step 1: Understand Public Healthcare - Servizio Sanitario Nazionale (SSN)
Italy’s public healthcare system, which is known as the Servizio Sanitario Nazionale (SSN), offers universal coverage to all legal residents. Italy’s public healthcare system is widely respected for its strong focus on prevention, high-quality care, and world-class medical research, consistently ranking among the best in Europe.
Registering for public healthcare gives access to GP visits, emergency care, hospital treatment, and preventive care.
Access is offered to citizens in different ways:
Retirees from EU, EEA, Switzerland and UK: those that are eligible to a public state pension in these countries, can get access to Italy's public healthcare system for free by providing evidence of an S1 form, because their own country will pay for such contributions. They will need to register for this benefit.
Retirees from other countries or those that don't have right to an S1 form: in this case, registration is voluntary. There is an annual fee for voluntary registration, which is based on income, with a minimum and maximum cap.
Other cases: registration may be mandatory and free for some categories of new residents, those this is less common for retirees. Examples may include those who are employed (or self-employed), registered job seekers, family members of those with mandatory status, minors, and those with certain types of permits (family, humanitarian, asylum, adoption, etc.).
How much does it cost to sign up for SSN?
As mentioned, public coverage is usually free only for foreign retirees with an S1 form. In practice, you will likely need to pay a fee to qualify for public healthcare if you are:
A non-EU/EEA/CH/UK citizen with an elective residence permit
A EU/EEA/CH/UK citizen that does not yet have right to S1 benefits (for example, early retirees that do not receive State Pension)
The minimum fee is €2,000 per person per year, and it increases with income with a cap at approx. €2,800. Importantly, the fee is the same regardless of age.
Registration is individual, and each person needs to register separately. It is valid for one year and needs to be renewed in January. Coverage is valid within Italy - for travel elsewhere (including in the EU), you will need private travel insurance, unless you qualify for an EHIC or S1 form.
It's also worth mentioning that the registration is done at the Regional service unit. For those relocating to another region of Italy, a new registration (and payment) may be required.
If you qualify for permanent residence after 5 years, you will be exempt from paying the annual fee, and you will be registered automatically in the system.
For those that have free access to public healthcare, it always makes sense to register for it. That said, they may decide to add a private policy for added peace of mind.
On the other hand, those that do not qualify for free healthcare, may want to assess their options in depth before making a decision.
Step 2: Be Aware of Local Differences in Healthcare Quality
Healthcare quality in Italy varies depending on the the area where you live, and understanding these differences is essential when choosing where to live, especially if you’re retiring or relocating long-term. It's important to understand well the quality and ease of access to services in your area before making a decision on whether to get public coverage.
Some differences in regional healthcare are given below:
Healthcare Is Generally More Accessible in the North
Northern Italy is known for offering some of the best public healthcare services in the country, with shorter wait times. Regions such as Lombardy, Veneto, and Emilia-Romagna have modern hospitals, a higher number of doctors, and shorter waiting times. These areas also tend to have better access to both general practitioners and medical specialists, making them a reliable choice for those who want consistent and timely care.
Some Areas of the South Face Some Limitations
In contrast, southern regions such as Calabria and Sicily often face challenges, including outdated infrastructure, a shortage of healthcare workers, and longer delays for non-urgent treatments. While some private clinics offer good care, overall access, especially in rural or inland areas, can be inconsistent.
Choosing the right region has a direct impact on your quality of care, day-to-day comfort, and ability to respond to health issues promptly. Whether you value quicker appointments, English-speaking doctors, or proximity to hospitals, your healthcare experience will be shaped by where you choose to live in Italy.
Prepare for Language Barriers in Medical Settings
While many doctors in Italy speak basic English, especially in private facilities and larger cities, language barriers can still be a challenge, particularly in rural areas. Miscommunication can delay treatment or lead to misunderstandings about diagnosis and medication.
If you’re not fluent in Italian, consider hiring a medical translator, using translation apps, or seeking out expat-friendly practices that are known for their bilingual staff. Additionally, some private insurance companies offer interpretation services as part of their plans. Proactively addressing language concerns ensures that you can effectively advocate for your health and feel confident during medical consultations.
Step 3: Private Healthcare: Faster Access and Added Comfort
When deciding whether to opt for public or private insurance, there are some key things to consider, including possible delays for non-urgent or specialist services, regional differences, language barriers, and costs.
Private healthcare in Italy offers:
Shorter Wait Times: Ideal for quicker access to specialists and procedures.
Greater Flexibility: Choose your preferred doctors, clinics, and hospitals.
Not Covered by SSN: All costs are out-of-pocket unless insured.
Expat-Friendly: Often includes English-speaking staff and international care standards.
Supplement with Insurance: Private plans help manage costs for elective or specialized care.
Clearly, private healthcare always comes with a cost, which increases with age and health conditions. It is possible to register for new policies even after pension (contrary to some other countries where options are limited above a certain age).
Working with a healthcare broker can help understand your options, access, and costs. We work with several local partners and can support you in this aspect.
Step 4: How to sign up for public healthcare
Register with Your Local Health Authority (ASL)
Once you have established legal residency in Italy and have paid for your coverage, the next essential step is to register with your local Azienda Sanitaria Locale (ASL) and Italy’s regional health authority. This process officially enrolls you in the public healthcare system (SSN) and allows you to access public medical services.
Where to Register
You must visit the ASL office in the area where you reside.
Each municipality has its own ASL branch for registration.
In some regions, online registration is available through regional health websites, offering added convenience.
Documents Required
To complete your registration with the SSN, prepare the following:
Residency certificate (proving you are legally living in Italy)
A valid passport or EU identity card
Your codice fiscale (Italian tax code)
Proof of address
Proof of payment
Without this registration, you cannot access SSN benefits, even if you have residency, so it is a critical part of your relocation process.
Obtain the Tessera Sanitaria (Health Card)
After registering with the ASL, you will receive the Tessera Sanitaria, which is your official Italian health card. It functions like an insurance card and is required for all interactions with the healthcare system, including doctor visits, medical tests, and some pharmacy purchases.
This card is sent to your registered Italian address and is typically valid for the duration of your residency. While waiting for the physical card, you can request a temporary certificate to use the services immediately. The Tessera Sanitaria also contains your fiscal code, and in some cases, it serves as your European Health Insurance Card (EHIC), providing coverage across EU countries.
Your health card is more than just a formality; it’s your gateway to the system, ensuring smooth and traceable access to care across Italy.
Choose Your General Practitioner (Medico di Base)
Upon receiving your health card, the next important step is to choose your primary care physician, known as a Medico di Base. This doctor will be your primary point of contact for all non-emergency healthcare needs. They handle routine check-ups, write prescriptions, and refer you to specialists when necessary.
You choose your GP from a list provided by your local ASL. While you’re generally assigned to doctors based on your place of residence, you may have options depending on availability. This relationship is central to your healthcare experience in Italy. Unlike walk-in systems in some countries, Italy’s healthcare model requires that most specialist care begins with a referral from your assigned general practitioner (GP).
Choosing a physician you feel comfortable with will positively impact your experience, especially if language is a concern. In urban centers, you may find English-speaking doctors, while in rural areas, you may require translation assistance.
Know What Services Are Covered Under SSN
Now that you're integrated into the system, it's essential to understand what services are covered by the SSN. The public system typically covers:
General practitioner visits
Specialist consultations (with GP referral)
Emergency treatment
Hospital stays and surgeries
Vaccinations
Prescription medications (with co-payment)
However, not everything is included. Dental care, vision services, and elective procedures are often not covered or require co-payments. This limited coverage leads many expats to consider private insurance as a means to bridge the gap, especially for services where wait times may be longer or access is restricted.
Know What to Do in a Medical Emergency
In case of a medical emergency, you should dial 118, Italy’s national emergency number for medical assistance. This service is available 24/7 and is free of charge. Public hospitals are required to treat emergencies, regardless of whether you’re fully registered with the SSN.
Always keep a copy of your Tessera Sanitaria, ID, and emergency contact information with you. If you're not yet registered with SSN, having travel or private health insurance is essential for covering costs during the transition. Understanding these emergency procedures ensures that you're prepared to respond quickly and confidently in the event of a health crisis.
Wrapping Up
For retirees, Italy offers universal, government-subsidized healthcare with a strong emphasis on preventive care, affordable access to primary and specialist services, and one of the world’s highest life expectancies. Once you establish residency, you’re entitled to the same comprehensive healthcare benefits as Italian nationals, providing peace of mind, low out-of-pocket costs, and a robust safety net for healthy aging in retirement.
Registering for the Italian healthcare system — from getting your SSN to obtaining your Tessera Sanitaria or choosing a private doctor — can seem like a lot to navigate. That’s why at Mitos Relocation Solutions, we don’t just assist with one-off tasks. We support you before, during, and after your move, so you’re never left guessing. From healthcare to visas, housing, and everything in between, we ensure every key step of your relocation is handled with clarity and care.
Book an intro call with Mitos Relocation if you want to learn more about our services to help you retire to Italy.
FAQs
How to access the healthcare system for expats in Italy?
Expats in Italy can use the National Health Service (SSN) by registering with it and getting an Italian health card (Tessera Sanitaria). In most cases, for non-EU & UK citizens an annual fee of €2,000 is required. This allows them to visit doctors, go to hospitals, and obtain prescriptions.
How long must you reside in Italy to qualify for free healthcare?
To access free healthcare, expats must become permanent residents. This typically means having lived in Italy for at least 5 years, but other requirements (such as Italian proficiency and minimum income) are required.
What are the problems with Italy's healthcare system?
While Italy's healthcare is overall excellent, there may be some issues for foreign retirees, including:
Long wait times for non-urgent care or specialist visits.
Regional differences, meaning some areas have better services than others.
Language barriers.
What is Italy’s life expectancy?
Italy is consistently recognized for its high life expectancy, ranking 5th globally for life expectancy at 83.7 years in 2025
What health benefits are available for retirees in Italy?
For retirees, Italy offers a strong, accessible, and cost-effective healthcare system, with particular strengths in quality of life and healthy aging.