Healthcare in Italy for UK movers

How does Italian public healthcare work?

Italy’s national health service is the Servizio Sanitario Nazionale, or SSN. It covers residents for GP care, hospital treatment and emergencies, largely free at the point of use. Each region runs its own service through local health authorities called ASL (Azienda Sanitaria Locale). Quality and waiting lists vary by region.

Because healthcare is run regionally, your experience in Lombardy may differ from Calabria or Sardinia. Northern regions often score higher on waiting times. Many southern hospitals are excellent too, but some specialities are concentrated in larger cities. It is worth checking what is close to where you plan to live.

Most GP visits and emergency care are free. For specialist visits, tests and many prescriptions you pay a contribution called the ticket. Some groups are exempt, depending on income, age or certain conditions. Your ASL can tell you whether an exemption applies to you.

Which route into the SSN applies to you?

Your route depends on why you are living in Italy. Workers paying Italian contributions register automatically. UK state pensioners usually use an S1. People who arrived before Brexit took effect keep their rights under the Withdrawal Agreement. Most others either enrol voluntarily for a fee or rely on private insurance.

If you live in Italy under the Withdrawal Agreement, you can register with the SSN on the same basis as before. Keep your Withdrawal Agreement residence document safe, as the ASL will ask for it.

If you are employed or self-employed in Italy, your social security contributions to INPS (the national social security institute) give you SSN access. Your family members living with you are usually covered too.

If you live on savings, rental income or a private pension, and are under UK state pension age, you will normally need iscrizione volontaria or private cover. Elective residence visa applicants must show private health insurance as part of the visa application anyway.

• Withdrawal Agreement residents — register on your protected status
• Workers in Italy — covered through Italian social security contributions
• UK state pensioners — register an S1 with the local ASL
• Others — voluntary enrolment (iscrizione volontaria) or private insurance

How does the S1 work for UK pensioners?

The S1 is a certificate that transfers your healthcare entitlement from the UK to Italy. If you receive a UK State Pension, the UK pays for your Italian state healthcare. You register the S1 with your local ASL, and you are then treated like an Italian resident.

You request the S1 from the NHS Overseas Healthcare Service before or after you move. The NHS website explains how to apply. Some people receiving certain UK benefits may also qualify, so check even if you are not yet a pensioner.

Once registered, you choose a GP and receive a tessera sanitaria (health card). Your dependants may be covered by your S1 too. If you later stop receiving the qualifying pension or move away, tell the NHS so the S1 can be cancelled.

What is iscrizione volontaria?

Iscrizione volontaria means voluntary enrolment in the SSN. Residents who are not covered any other way can pay an annual contribution to join the public system. It gives broadly the same access as other residents, including a GP and the tessera sanitaria. The contribution is calculated by law.

The contribution applies to a calendar year, not a rolling year from when you join. Enrolling late in the year can therefore feel poor value. Ask your ASL how the payment works in your region before you pay.

You usually need to have registered residency at your comune and hold a permesso di soggiorno, or its receipt, before you can enrol. That means voluntary enrolment does not help straight after arrival. Private insurance usually covers that early stretch.

When do you need private health insurance?

You need private cover whenever the SSN does not yet cover you. That includes the gap between arrival and registration, and the whole of an elective residence visa application. Many residents also keep a private policy alongside the SSN for faster specialist appointments, dental care and private hospital rooms.

For visa purposes, the consulate expects a policy that covers you fully in Italy. Read the conditions carefully. Travel insurance is not usually enough, because it is designed for holidays rather than residence.

Italian insurers and international expat insurers both sell suitable policies. Compare exclusions for existing conditions, age limits and how claims are paid. IVASS, the Italian insurance regulator, lists authorised insurers if you want to check a company.

How do you register with the ASL?

You register in person at the local ASL office that covers your address. Bring your passport, codice fiscale, proof of residency and your permesso di soggiorno or its receipt. Add your S1, employment contract or voluntary payment receipt, depending on your route. You then choose a GP from a list.

Office opening hours can be limited, and some ASLs use booking systems. Go early and bring copies of every document. An Italian speaker can make the visit far easier if your Italian is still basic.

After registration, the tessera sanitaria arrives by post. It also works as your codice fiscale card and as a European Health Insurance Card for trips elsewhere. Keep it with you, as pharmacies and doctors ask for it.

If you move to another comune later, you re-register with the ASL for your new address and choose a new GP. Your entitlement carries over, but the paperwork does not happen automatically. Bring the same documents again, plus proof of your new residency.

How do GPs, prescriptions and emergencies work?

Your medico di base (family doctor) is your first contact for non-urgent care. They prescribe medicines and refer you to specialists. Pharmacies give useful advice and sell many medicines without a prescription. In an emergency, call 112, the European emergency number, or 118 for medical emergencies.

GPs often run surgeries at set times without appointments. Expect to wait your turn. For specialist referrals, the GP gives you a prescription called an impegnativa, which you book through the regional booking centre, known as the CUP.

Each town has a rota of pharmacies open at night and on holidays, known as the farmacia di turno. The list is posted on every pharmacy door. Outside surgery hours, the guardia medica (out-of-hours doctor service) covers urgent but non-emergency problems.

Bring a supply of any regular medication, along with a letter from your UK GP listing the generic names. Brand names often differ in Italy. Your new GP can then continue the same treatment without delay.

• 112 — European emergency number, works across Italy
• 118 — medical emergencies and ambulance
• Guardia medica — out-of-hours doctor for urgent, non-emergency care
• Farmacia di turno — the duty pharmacy open nights and holidays
• Pronto soccorso — hospital accident and emergency department