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The guide · Italy

Healthcare

Registering, the European Health Insurance Card, the S1 form.

In Italy

Checked on 23 October 2026

How to access the public health service (SSN) when you settle in Italy

In Italy, public healthcare goes through the Servizio Sanitario Nazionale (SSN), managed locally by the ASL (Azienda Sanitaria Locale, the health agency for your area). Once you are registered with your municipality's civil registry and have your codice fiscale, you register with the SSN at the ASL and choose your medico di base (general practitioner). During the first few months, your European Health Insurance Card covers the medically necessary care of a temporary stay.

Costs
SSN care free of charge apart from the ticket set by each region
Timeframes
Varies depending on the ASL

Steps

  1. Before leaving: request your European Health Insurance Card (EHIC, TEAM in Italian) from your insurer. If you are a pensioner with a pension from your country of origin, or posted by your employer, request the S1 form.
  2. The first few months: with your EHIC and an identity document, you are treated in public and contracted private facilities, on the same terms as Italian insured people.
  3. Sort out your paperwork: registration with the Comune (sheet IT-SEJOUR-TOUS-001) and codice fiscale (sheet IT-NIF-TOUS-001). The Agenzia delle Entrate states that the codice fiscale is needed to register with the ASL and choose your doctor.
  4. Register with the SSN at the ASL of your municipality of residence:
    • employee or self-employed in Italy: compulsory registration;
    • pensioner or posted worker with S1: present your S1 to your municipality's ASL with your residence permit (if you have one) and your codice fiscale; the exact documents are to be requested from your ASL;
    • other situation (neither employee nor S1): you are not entitled to compulsory registration; you must either have private insurance valid in Italy (sickness, accident, maternity), or register voluntarily with the SSN by paying an annual contribution (see "Costs and timelines"). It is paid by F24 form, code tributo 8846, for the calendar year.
  5. Choose your general practitioner (medico di base) from those registered with the ASL; for a child, a paediatrician.
  6. Receive your tessera sanitaria (health card), sent by the Agenzia delle Entrate. Its back is your European card, if you are entitled to compulsory SSN registration.

Documents

  • Valid identity document.
  • Codice fiscale.
  • Proof of your registration with the Comune (residence).
  • Depending on your situation: employment contract or proof of activity, S1 form.
  • During a temporary stay: EHIC (or provisional replacement certificate) and identity document.

Costs and timelines

  • Care with an EHIC or SSN registration: free in the public and contracted private sectors, apart from the ticket (co-payment). Its amount is set by each region.
  • Hospitalisation: no ticket. Some emergency room visits, depending on the code assigned, are subject to a ticket.
  • Out-of-hours medical service (guardia medica): free at night and at weekends. In summer, the guardia medica turistica in tourist regions charges for the visit, at the rate set by the region.
  • SSN registration: free for employees, self-employed people and S1 holders. The timeline depends on each ASL: ask yours.
  • Voluntary SSN registration (neither employee nor S1): annual contribution calculated on the total income of the previous year, in Italy and abroad. It is paid by F24 form to the region where you register (law 213/2023, art. 1, para. 241), is valid for the calendar year, cannot be split and is not retroactive. The amount depends on your nationality:
    • If you are not an EU citizen (British nationals who arrived after 2020, Americans, etc.): minimum of €2,000 per year. It is set by the Testo unico sull'immigrazione (art. 34, para. 3 of legislative decree 286/1998), as amended by the 2024 budget law (law 213/2023, art. 1, para. 240), in force since 1 January 2024. Lower floors: €700 for a student, €1,200 for a young au pair (art. 34, para. 5). The Minister of Health may revise these floors each year according to inflation (art. 34, para. 6-bis); no revision decree was found, to be confirmed with your ASL.
    • Rates applied by the ASLs: 7.50% of income up to €20,658.28, then 4% from €20,658.28 to €51,645.69. With these rates, the €2,000 minimum applies up to an income of about €31,900 and the contribution is capped at about €2,789 (calculation based on the notices). These rates come from the notices of the Sassari and Asti ASLs: the law requires the same percentage as for Italian citizens, set by a ministerial decree (the decree of 8 October 1986, according to the Veneto guidelines) whose text could not be verified. To be confirmed with the ASL.
    • If you are an EU citizen: the Testo unico does not apply to EU citizens (art. 1, para. 2), so the €2,000 minimum is not written for you in national law. The Veneto guidelines (2019) provide for them a contribution as a percentage of income, with no minimum amount indicated. The Sassari ASL, for its part, applies to EU citizens the same calculation as for non-EU nationals, with the €2,000 minimum (notice of February 2024). The amount of your minimum is therefore to be confirmed with your ASL before paying.
  • Emergencies: 112 or 118.

Common pitfalls

  • Using the EHIC with a private doctor who is not under contract. It only works in the public sector and contracted private sector. Elsewhere, you pay and claim a refund from your home fund.
  • Forgetting your EHIC. Without it, you pay all costs upfront, even in the public sector; an "occasional" visit to a general practitioner is also paid and reimbursed on your return.
  • Staying on the EHIC once you have settled. It is designed for temporary stays. When you live in Italy, your cover goes through SSN registration (work, S1 or other).
  • Waiting for the tessera sanitaria to choose a doctor. It is registration with the ASL that opens the choice of doctor; the card arrives afterwards by post.
  • Paying voluntary registration without checking the calculation. The €2,000 minimum is written in the law for non-EU nationals. For an EU citizen, it is only confirmed by some ASLs. Ask your ASL for your exact amount before paying: the F24 payment covers the calendar year, cannot be split and is not retroactive.

What changes by country of origin

  • EU and EEA citizens: EHIC for the first few months, then SSN registration at the ASL (compulsory if you work, with S1 if you are a pensioner or posted worker). The ministry confirms that EU citizens compulsorily registered with the SSN receive the tessera sanitaria with the European card on the back. Neither employee nor S1: private insurance or paid voluntary registration (see "Costs and timelines").
    • After 5 years of regular and continuous residence (permanent residence, diritto di soggiorno permanente; legislative decree 30/2007, art. 14): you no longer have to prove health insurance or the resources required for a stay of more than 3 months (art. 7). The municipality issues the certificate (art. 16). For the SSN, the official texts read do not agree. The Ministry of Health note of 4 October 2022 (written for British nationals under the withdrawal agreement) allows registration on a compulsory basis, that is without the voluntary contribution, for those who have acquired permanent residence, even without an S1. The Veneto guidelines (2019, which apply the 2012 State-Regions agreement) reserve this compulsory registration for those who were already registered on a compulsory basis: a citizen registered on a voluntary basis remains so (and continues to pay), unless they work. Before you stop paying, confirm with your ASL, with your permanent residence certificate.
  • Swiss nationals: the Swiss EHIC is accepted in Italy (EFTA countries cited by the ministry). SSN registration once settled follows the same path as for EU citizens (compulsory if you work, otherwise private insurance or voluntary registration); the ASL tells you which documents to provide.
  • British nationals (Scots included): non-EU nationals since Brexit.
    • Legally settled in Italy before 1 January 2021 (beneficiaries of the withdrawal agreement): their rights of access to the SSN remain those of EU citizens. GOV.UK (page of 05/10/2026, note of 08/03/2024) states that the Italian government has decided that they can register free of charge on a compulsory basis (iscrizione obbligatoria) and therefore do not have to pay the voluntary contribution; the corresponding Italian text was not found. The British S1 is accepted, and the Ministry of Health note of 4 October 2022 allows compulsory registration, even without an S1, once permanent residence is acquired. This note lists the documents proving settlement before 2021 (residence certificate, permanent residence certificate, Italian identity card, etc.): ask your ASL which ones it accepts, and cite the note if it asks you for the contribution.
    • Arrived afterwards: with a regular residence permit, they register with the SSN at the ASL of their municipality of residence (or of the domicile shown on the permit if they are not yet resident). Registration is compulsory or voluntary depending on the reason for the stay. Voluntary registration applies in particular to students and au pairs (art. 34, para. 4 of the Testo unico) and, according to the Sassari ASL notice, to holders of a residenza elettiva permit (elective residence, without professional activity). It is paid: minimum €2,000 per year (art. 34 of the Testo unico, law 213/2023), €700 for students, €1,200 for au pairs, calculated on income as above. It is not possible with a permit for medical treatment (Prefettura di Roma).
Official sources (17) ›
  • Normattiva, legislative decree 286/1998 (Testo unico on immigration), art. 34, version in force: voluntary SSN registration contribution "not less than 2,000 euros per year" (para. 3), €700 for students and €1,200 for au pairs (para. 5), annual revision possible by decree of the Minister of Health (para. 6-bis)
  • Normattiva, legislative decree 286/1998, art. 1: the Testo unico applies to citizens of non-EU States and "does not apply to citizens of the member States of the European Union" (para. 2)
  • Gazzetta Ufficiale no. 303 of 30/12/2023, ordinary supplement no. 40/L, law of 30 December 2023, no. 213 (2024 budget law), art. 1, para. 240 (amends art. 34 of legislative decree 286/1998: minimum of €2,000) and para. 241 (payment to the region by F24 form); art. 21: in force on 01/01/2024
  • Ministero della Salute, Direzione generale della programmazione sanitaria, note prot. 19514-P of 04/10/2022 on healthcare for British nationals after the withdrawal agreement (compulsory SSN registration after acquiring permanent residence, without S1; referring to the 2012 State-Regions agreement for EU citizens)
  • Normattiva, legislative decree 30/2007, art. 14: after 5 years of legal and continuous residence, the Union citizen has the right of permanent residence, without the conditions of art. 7 (including health insurance); art. 16 provides for the certificate issued by the municipality
  • Veneto Region, Giunta resolution 753 of 04/06/2019, annex A, "Linee guida in materia di assistenza sanitaria ai cittadini appartenenti all'Unione Europea e ai cittadini extracomunitari" (point 2.4.1 holders of a permanent residence certificate; point 4.2 voluntary registration of EU citizens: contribution as a percentage of income, ministerial decree of 08/10/1986)
  • ASL no. 1 Sassari, "Aggiornamento contributo, ai sensi della legge n. 213 del 30/12/2023, art. 1, commi 240 e 241, per l'iscrizione volontaria al SSN per i cittadini comunitari ed extracomunitari" (local notice of February 2024: 7.50% up to €20,658.28, 4% up to €51,645.69, minimum €2,000, students €700, au pairs €1,200, code tributo 8846)
  • ASL AT (Asti), "Voluntary insurance to the S.S.R. foreign citizens" (local notice posted online in July 2026, file created on 18/03/2026: same rates, minimum €2,000, code tributo 8846; it writes €20,657.28 instead of €20,658.28, probably a typo)
  • Prefettura di Roma (Ministry of the Interior), "Assistenza sanitaria cittadini stranieri" (compulsory and voluntary registration, documents to provide)
  • Ministero della Salute, "Cure urgenti e necessarie in Italia – EHIC" (updated 23/12/2024)
  • Ministero della Salute, "Tessera europea assicurazione malattia – TEAM" (updated 20/01/2026)
  • Ministero della Salute, "Cure in Italia e negli altri Paesi dell'Unione Europea: cosa sapere" (updated 20/01/2026)
  • Ministero della Salute, "Assistenza ai cittadini dei Paesi extra UE in Italia" (updated 23/12/2024; voluntary registration is presented there for non-EU foreigners, referring to art. 1, para. 240 of law 213/2023 but without an amount)
  • Agenzia delle Entrate, leaflet "Tax code for foreign nationals" (codice fiscale needed for ASL registration and choice of doctor)
  • Your Europe, "Health insurance cover in your host country" (last checked 19/08/2026)
  • Your Europe, "Health cover for temporary stays" (EHIC free from your insurer, same rights as the country's insured people, only in the public system)
  • GOV.UK, "Living in Italy" (page updated 05/10/2026; health section: note of 08/03/2024 on free compulsory registration of British nationals settled in Italy before 1 January 2021)
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The European framework

These European rules also apply in Italy.

Checked on 23 October 2026

Health insurance required for visas and permits: what EU rules ask (short and long stays)

For a Schengen short-stay visa, you must show travel medical insurance covering urgent medical care, emergency hospital treatment and repatriation (including in case of death), valid in all Schengen countries, with at least €30,000 of cover (Visa Code, Article 15). For long stays, the EU directives ask for sickness insurance covering the risks normally covered for nationals of the destination, for example for students, family members, Blue Card holders and long-term residents. The exact proof, and whether you must buy private insurance or can join the public system, depend on the destination.

Who decides
Consulates (Schengen visas); the immigration authority of the destination (long stays)
Costs
Set by insurers; Schengen visa insurance must cover at least €30,000 (Visa Code, Article 15)

Before you act

  • No promise. The consulate or immigration authority decides whether your insurance is acceptable. This page is general information, not legal advice.
  • Scams. Buy insurance only from a real, identifiable insurer, and check the policy before paying. A fake or inadequate insurance certificate can lead to refusal of your application.
  • Ask a professional (the insurer, the consulate or a lawyer) if you have a chronic illness, are pregnant, or are over the age limits of standard policies.
  • Be honest in insurance forms about your health and your plans.

Steps

  1. Short stay with a visa: buy travel medical insurance that meets Article 15 of the Visa Code (below) for the whole trip; for a multiple-entry visa, it must cover the first trip, and you sign a statement that you know you need insurance for later trips. Exceptions: the requirement may be considered met where adequate cover can be presumed from the applicant's professional situation (for example seafarers, Article 15(6)), and holders of diplomatic passports are exempt (Article 15(7)).
  2. Visa-exempt short stay: insurance is not among the entry conditions listed in the Schengen Borders Code (Article 6), but medical care abroad can be expensive: travel insurance is your choice.
  3. Long stay: read the destination's list for your route. Denmark and Ireland did not take part in the five directives below and are not bound by them (see the recitals of each text), so their rules are purely national. In the other EU countries, the directives ask for insurance "for all risks normally covered for nationals" for:
    • students and researchers, valid for the whole planned stay (Directive (EU) 2016/801, Article 7(1)(c));
    • family reunification, for the sponsor and the family, if the country requires it (Directive 2003/86/EC, Article 7(1)(b));
    • Blue Card and seasonal workers, for periods not already covered through the job (Directive (EU) 2021/1883, Article 5(1)(e); Directive 2014/36/EU, Article 5(1)(b) for stays up to 90 days and Article 6(1)(b) for stays over 90 days);
    • EU long-term residents, for themselves and for dependent family members (Directive 2003/109/EC, Article 5(1)(b)).
  4. After arrival: ask whether your permit gives access to the public health system, and from when (see the destination's health fiche).

Documents

  • An insurance certificate in the name of each person, with dates, cover, amount and territory.
  • For a Schengen visa: proof that the cover is valid in all Schengen countries and is at least €30,000 (Article 15(3)); for a visa with limited territorial validity covering several Member States, the cover must be valid at least in the Member States concerned.

Costs and timelines

  • Price: set by insurers. The Visa Code asks you to take insurance, in principle, in your country of residence, or in another country if that is not possible (Article 15(4)).
  • Check: consulates verify that claims against the insurer can be recovered in an EU country (Article 15(5)).

Common pitfalls

  • Cover too low or not valid everywhere. For a Schengen visa: at least €30,000 and valid in all Schengen countries.
  • Wrong dates. The insurance must cover the whole stay or transit (Article 15(3)).
  • Travel insurance for a long stay. A short-trip policy may not meet the "all risks normally covered for nationals" standard required for long-stay permits, and what each country actually accepts varies: ask the immigration authority directly before you buy.
  • Gaps between the visa and the permit. Keep cover until you are registered in the public system or have the insurance the permit requires.

What changes by profile

  • Workers may be covered through their job; the Blue Card and seasonal directives ask for insurance only for periods not covered by, or resulting from, the work contract.
  • Retirees and people living on passive income follow national rules for national visas (for Portugal, see PT-VISA-TIERS-050).

Official links

  • Visa Code (consolidated), Article 15: https://eur-lex.europa.eu/legal-content/EN/TXT/HTML/?uri=CELEX:02009R0810-20240628
  • Commission, applying for a Schengen visa: https://home-affairs.ec.europa.eu/policies/schengen/visa-policy/applying-schengen-visa_en
Official sources (9) ›
  • European Commission, « Applying for a Schengen visa » (medical insurance covering emergency medical care, hospitalisation and repatriation, including in the event of death), page dated 2 December 2025
  • Regulation (EU) 2016/399 (Schengen Borders Code), consolidated text of 12 October 2025 (latest consolidated version in the Publications Office database on 23 October 2026), Article 6(1) (entry conditions for short stays: no insurance condition)
  • Regulation (EC) No 810/2009 (Visa Code), consolidated text of 28 June 2024 (latest consolidated version in the Publications Office database on 23 October 2026), Article 15 (travel medical insurance)
  • Directive (EU) 2021/1883 (EU Blue Card), Article 5(1)(e) (sickness insurance) and the recitals on the position of Denmark and Ireland
  • Directive (EU) 2016/801 (students and researchers), Article 7(1)(c) (sickness insurance, valid for the duration of the planned stay; same text in the consolidated version of 17 November 2021) and the recitals on the position of Denmark and Ireland
  • Council Directive 2003/86/EC (family reunification), Article 7(1)(b) (sickness insurance for the sponsor and his or her family) and the recitals on the position of Ireland and Denmark
  • Directive 2014/36/EU (seasonal workers), Article 5(1)(b) (stays up to 90 days) and Article 6(1)(b) (stays over 90 days) (sickness insurance), and the recitals on the position of Ireland and Denmark
  • Council Directive 2003/109/EC (long-term residents), consolidated text of 12 June 2026 (latest amendment: Regulation (EU) 2024/1347, which leaves Article 5(1)(b) unchanged), Article 5(1)(b) (sickness insurance, for the person and dependent family members)
  • Council Directive 2003/109/EC (long-term residents), text as adopted, recitals 25 and 26 (position of Ireland and Denmark)

These guides give the general rules. Your situation can change the answer: Moovy looks at it with you and tells you when you need a professional.

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