Health Insurance for Expats in Italy

Overview

Italy offers excellent healthcare through its national system, the Servizio Sanitario Nazionale (SSN). For expats, the path to coverage depends on your visa type, employment status, and how long you plan to stay.

Most expats follow this pattern: private international insurance for the visa application and initial period, then transition to SSN once residency is established. Some keep international coverage alongside SSN for shorter wait times, English-speaking providers, or coverage when traveling.

Italian Healthcare System

Italy's healthcare system consistently ranks among the world's best—the WHO ranked it 2nd globally. The system is regionally managed, which means quality and wait times vary by location.

How Italian Healthcare Works

The SSN provides universal coverage to residents. Care is largely free at the point of service, with small co-pays (ticket) for some services.

• Tessera Sanitaria: Your health card for accessing SSN services
• Medico di base: Your assigned general practitioner (GP)
• ASL (Azienda Sanitaria Locale): Local health authority where you register
• Ticket: Small co-pays for prescriptions and some services

Regional Differences

Healthcare quality varies significantly by region:

• Northern Italy (Lombardy, Emilia-Romagna, Veneto): Generally considered the best healthcare regions
• Central Italy (Tuscany, Lazio): Good quality, Rome has many international-friendly hospitals
• Southern Italy: Good care available but longer wait times and fewer resources

Public vs Private Care

Many Italians use a mix of public and private care. Common patterns:

• GP visits, emergencies, hospitalizations: Public (SSN)
• Specialist visits, diagnostics: Often private to skip wait times
• Routine care: Public with ticket co-pays

SSN Enrollment

Enrolling in the Italian public health system requires legal residency and registration at your local ASL.

Who Can Enroll

• EU/EEA citizens: Immediate enrollment with residency registration
• Employed workers: Enrolled automatically through employer contributions
• Self-employed: Can enroll by paying contributions (around €400/year)
• Retired expats: Can enroll voluntarily (Elective Residence visa holders)
• Students: Can enroll or use private insurance

Enrollment Process

1. Obtain your permesso di soggiorno (residence permit)
2. Register residency at your local Comune (town hall)
3. Go to your local ASL with documents (permit, codice fiscale, proof of address)
4. Complete enrollment and receive your Tessera Sanitaria
5. Choose a medico di base from the available list

Visa Requirements

Health insurance requirements vary by visa type. Most non-EU applicants need to show proof of coverage.

Elective Residence Visa (Retirement)

Popular with retirees and those with passive income. Requirements:

• Proof of income (typically €31,000+/year minimum)
• Comprehensive health insurance valid in Italy
• Coverage for entire visa duration
• Plan must cover hospitalization and emergency care

Digital Nomad Visa (New in 2024)

Italy's new remote worker visa launched in 2024. Requirements:

• Proof of remote work for non-Italian employer
• Minimum income requirement (€28,000+/year)
• Health insurance meeting Italian standards
• Coverage must be valid for visa duration

Student Visa

• Health insurance required for visa application
• Can enroll in SSN once in Italy (around €150/year for students)
• Many use travel insurance initially, then switch to SSN

Work Visa

• Employer-sponsored visas may not require separate insurance proof
• SSN enrollment comes through employment contract
• Some employers provide supplementary private coverage

Recommended Plans

The best insurance choice depends on your visa type, length of stay, and healthcare preferences.

For Visa Applications

You need comprehensive coverage that meets Italian consulate requirements:

• Cigna Global Gold/Platinum: Widely accepted, English support, meets requirements
• Allianz Care: Good for those wanting high-deductible savings
• IMG Global: Budget-friendly option that meets visa requirements

For Digital Nomads

If you're on the digital nomad visa and may move between countries:

• SafetyWing: Affordable, designed for nomads, but travel medical (not comprehensive)
• Cigna Global: Comprehensive worldwide coverage, portable if you relocate
• World Nomads: Travel insurance option for shorter stays

For Long-Term Residents

Once you have SSN access, international insurance becomes optional but useful for:

• Skipping public system wait times for specialists
• Access to private hospitals and English-speaking doctors
• Coverage when traveling outside Italy

Expected Costs

Public Healthcare (SSN)

• Employed workers: Free (funded through payroll contributions)
• Self-employed/Voluntary: ~€400/year
• Students: ~€150/year
• Ticket co-pays: €0-50 for most services
• Prescriptions: €2-5 for most medications

Private International Insurance

• Budget plans (IMG, SafetyWing): €45-120/month
• Mid-range (Allianz, Cigna Silver): €150-220/month
• Comprehensive (Cigna Gold, BUPA): €200-350/month

Private Italian Insurance

• Basic plans: €50-100/month
• Comprehensive plans: €100-200/month

Local Italian insurers like UniSalute, Previmedical, or Generali offer plans but typically require Italian language skills and have more restrictions than international plans.

Out-of-Pocket Private Care

• GP visit (private): €80-150
• Specialist visit: €100-200
• MRI scan: €200-400
• Hospital stay (private room): €300-600/night

Common Questions

Do I need private insurance if I have SSN?

Not required, but many expats keep it for faster access to specialists, private hospital options, English-speaking care, and travel coverage. It's a personal choice based on budget and preferences.

How long until I can enroll in SSN?

Timing varies. EU citizens can enroll quickly after residency registration. Non-EU citizens need their permesso di soggiorno, which can take 3-6 months or longer. Keep private insurance until you have your Tessera Sanitaria.

Is SafetyWing enough for Italy?

SafetyWing is travel medical insurance, not comprehensive health insurance. It may not meet visa requirements for long-stay visas. It works well for digital nomads on shorter stays or as supplementary coverage, but verify with your consulate.

Can I see an English-speaking doctor?

In major cities (Rome, Milan, Florence), you'll find English-speaking doctors in private clinics and international hospitals. In smaller towns and through the public system, Italian language skills are more important.

What about pre-existing conditions?

SSN covers pre-existing conditions once you're enrolled. International insurers vary—BUPA Global is known for better pre-existing condition coverage. Review policy terms carefully before purchasing.