Fra Noi Embrace Your Inner Italian
Moving to Italy is a dream for many — and not just for the food or the sunsets over Tuscany. But between housing, residence permits, and endless paperwork, one question always comes up sooner or later: “What happens if I get sick?”
Italy’s healthcare system — the Servizio Sanitario Nazionale (SSN) — is often ranked among the best in the world. According to the World Health Organization, Italy consistently places in the top 10 for quality of care, accessibility and life expectancy.
The SSN is public and universal, funded through taxes and designed on one simple principle: healthcare is a right, not a privilege.
All legal residents — Italians and foreigners alike — are eligible to register. There are two ways to do it:
- Mandatory registration (free): for those working in Italy, for family or humanitarian reasons.
- Voluntary registration: for those residing with an elective residence visa or study visa.
Since 2024, the voluntary registration fee has been set at a flat €2,000 per year, with reductions for students and au pairs.
Once you’re registered, you’ll receive your Tessera Sanitaria, the national health card that grants access to doctors, hospitals, and subsidized prescriptions.
To apply for your Tessera Sanitaria, visit your local ASL (Azienda Sanitaria Locale) — the local health authority — with:
- your passport,
- Italian tax code (codice fiscale),
- residence permit (permesso di soggiorno) or the receipt showing you’ve applied for it,
- proof or self-declaration of residence.
You’ll also be asked to choose a family doctor (medico di base), who will be your main contact for general healthcare, prescriptions, and specialist referrals.
Many services are completely free, but others require a small co-payment (ticket), depending on the region and the service. Visits to your family doctor and true emergency care are free of charge.
Many expats — especially Americans — choose to take out private health insurance, either to complement or replace SSN coverage.
The advantages are clear:
- shorter waiting times,
- freedom to choose your doctors and clinics,
- English-speaking staff in international facilities.
In some cases, private insurance isn’t just a choice but a requirement: for example, it’s mandatory for those applying for an elective residence visa.
Costs vary widely — from about €400–€700 per year for basic national coverage, to €2,000–€3,000 for comprehensive international plans that also cover care abroad.
The comparison is striking: according to the OECD, per capita healthcare spending in the United States exceeds $12,000 per year, compared to roughly €4,000 in Italy — with better outcomes in many health indicators.
Life expectancy in Italy stands at 82.7 years, among the highest in the world, compared to about 76 years in the U.S.
Italy’s healthcare system may seem complex at first, but it offers a rare balance of quality, cost, and accessibility. Yes, the paperwork can be a test of patience — consider it part of the Italian initiation — but once you have your health card, you gain access to a system that truly works: efficient, human, and based on the idea that caring for people is a collective responsibility, not a market transaction.
Information is current as of 2025 and is intended for general guidance only. For individual cases, it’s always best to check with your local ASL office or a legal professional.
Send your questions regarding Italian law to cbortolani@aliantlaw.com and I’ll be glad to answer them.
The content provided in this Q&A column is intended solely for general informational purposes and does not constitute legal advice. The information presented here is not tailored to any specific situation or transaction and should not be relied upon as a substitute for professional legal counsel. Legal issues can vary widely based on individual circumstances and jurisdictional nuances. Therefore, it is crucial to consult with a qualified legal professional regarding your specific case or concerns. Please be aware that no attorney-client relationship is established by accessing or interacting with the information provided in this column. The column’s author and publisher disclaim any liability for actions taken based on the information contained herein.
