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What is healthcare like in Italy?
Italy offers some of the best healthcare available anywhere in the world. The World Health Organisation ranks Italy in the top 10 countries for its health care provision. This may seem unsurprising given that Italy has the eighth largest economy in the world, and the fourth largest in the European Union (EU). However, to put this in context, the United States, which boasts the world’s biggest economy, ranks just 37th in terms of healthcare.
Italy’s national health service is called the Servizio Sanitario Nazionale (SSN). It is state-funded through national and regional taxes. It is accessible to all legal residents, both Italian and non-Italian, and is free of charge at the point of access. Italy has more doctors per head of population than any other country, with an average of one doctor for every 160 residents. Life expectancy is the second highest of all EU countries, with women reaching on average 84.5 years of age, and men 79.4 years.
The national health service is managed by region, so the standard can vary a little from one area to another. You will generally find superior quality healthcare facilities in the more affluent north and in the centre of Italy, and particularly in major cities such as Milan. Private healthcare is also widely available in Italy, particularly in large towns and cities. If you are staying in a more rural area you will have to travel further to access private healthcare facilities.
Some doctors work in single practices while others are based in group surgeries, known as poliambulatori. These can be either private or state-funded practices. At group surgeries, you will often find additional healthcare services, such as dentistry, physiotherapy and orthopaedic treatments. Some medical centres also offer specialist care such as gynaecology, radiology and cardiology. You can also find specialists based in state hospitals.
Healthcare for tourists
Urgent hospital treatment is always free at the point of access in Italy, but there may be a charge payable for some non-urgent treatments. In the event of a medical emergency arising, you need to call 112. This is the general emergency services numbers, so can also be used to request fire or police assistance if needed.
When the care you require is less urgent you need to make an appointment with a local doctor. If you ask hotel staff to contact a doctor or other healthcare professional for you, take care to specify that you want a national health service doctor. Otherwise, they might arrange for a private doctor to see you, which could prove costly.
Pharmacies are easy to spot as they always display a green cross sign outside. In most towns, the chemists are open on a rotational basis so there will be at least one open in the area on any day, including Sundays and public holidays. Local newspapers and community websites usually publish details of pharmacy opening hours. If you are staying in a hotel, the reception or guest services will be able to help you locate your nearest pharmacy. Many pharmacists speak at least a little English.
How can I find an English-speaking doctor?
In major cities, you should be able to find English-speaking doctors and healthcare professionals. For example, in Milan, you can attend the International Health Centre where there are specialists who speak English. In Rome, you have the option of private healthcare from English-speaking doctors, for example from Doctors in Italy, who provide a walk-in clinic as well as home visits. Many towns offer a specialist medical service for tourists, known as the guardia medica turistica. Even in rural areas, you have a reasonable chance of finding English-speaking health professionals, given that over 30% of Italians speak English.
Transporting your medications
If you take medications regularly you should check for any transport restrictions before you travel. Some medications, such as strong painkillers, sleeping tablets and ADHD treatments may need to be accompanied by a medical certificate when you travel to other countries.
In general, you should bear in mind the following guidelines:
- Carry all medications in their original packaging
- Keep a copy of your prescriptions with you to show that the medications are for your personal use
- Keep a note of the scientific (non-brand specific) name of your medication to make it easier to replenish supplies as necessary
If you take a lot of medication you may find it helpful to carry a European medical passport. This lists all the medications you take regularly and any to which you are known to be allergic. It is very helpful for quickly communicating your medicinal needs to a doctor or pharmacist in Italy or elsewhere.
Healthcare for expats in Italy
When you move to Italy you will need to choose a doctor and register with the SSN for healthcare. The registration contract is called a medico convenzionato. You will need to take your proof of residency documentation with you when you register. If you are not an EU citizen you will need to take your permesso di soggiorno or permit to stay.
You are free to choose a doctor wherever you wish to register, provided that the doctor is willing to accept you as a patient. There is no restriction in terms of catchment areas. When you register you will be allocated a national health service number. If you have other family members with you they will also need to register and they will be given separate numbers. Each patient also receives a tessera sanitaria or health card. You will need to take your health card with you whenever you have a medical appointment in Italy. If you have young children living with you in Italy you will need to register those aged five or under with a paediatrician.
Doctors surgery opening hours vary, but most will be open as a minimum between 8am and 1pm or will open from 8am to 10am and again from 3pm to 5pm. The majority of surgeries are open only from Monday to Friday. In many centres you don’t need to book an appointment – just turn up at the surgery, where patients are seen on a first-come-first-served basis. It’s best to arrive early if you can so that you avoid waiting for a long time to be seen.
Collecting test results is usually the responsibility of the patient in Italy, so make sure you check when they will be ready and pass them on to your family doctor.
Charges are payable for specialist treatments, but there is a maximum charge per treatment. Means-tested concessions are available for children under 6 years of age and for people over 65 years old. Reduced charges are also available for people suffering from one or more listed long-term conditions or chronic illnesses, such as diabetes.
If you require other treatments, including chiropody and physiotherapy, you will need to get a referral from your doctor. Without a referral, you are not eligible for the discounted rates available for these health care services, and you will be charged the full fee.
Fees are usually charged for home visits. This depends on where you live and other individual circumstances. If you become ill while away from your normal place of residence in Italy but still within the country, you won’t need to pay to see a doctor unless you choose private healthcare. The doctor you see will complete a referral form to go back to your usual doctor.
Private healthcare plans are sometimes provided by employers for expats working in Italy. Check the details of your contract so you know exactly what you are entitled to, for yourself and for any other family members you have living in Italy with you.
What is the S1 Certificate?
The S1 certificate, previously known as form E106, offers proof that you, and any dependents living with you, are entitled to healthcare when you are insured in one country but live in another. Civil servants and UK citizens who receive an exportable benefit, such as a state pension can benefit from having the S1 certificate. The S1 certificate needs to be submitted to the health insurance authority in Italy.
What is the EHIC?
EHIC stands for European Health Insurance Card. It is available to all citizens of the European Union (EU) and gives the holder access to free or low-cost state healthcare in Italy and all other EU member states as well as countries in the European Economic Area. It is available free of charge. With the EHIC you are covered for treatment relating to a pre-existing condition, and maternity care is also available. You may have to pay charges up front and then reclaim them afterwards. The EHIC is valid for five years. You can apply for a new EHIC up to six months before your existing card is due to expire.
What is excluded from EHIC?
- Pre-planned healthcare treatment in a foreign country
- Private healthcare costs in Italy – these are not covered
- Cruises – if you fall ill on a cruise the EHIC will not cover you for medical treatment
- Mountain rescue assistance for skiers or hikers
- Return travel to the UK. If you need to be taken back to the UK following treatment in Italy the costs of transport will not be covered by the EHIC.
How can I apply for the EHIC?
All you need to do is complete the application form online at:
If you prefer, you can call the NHS on 0300 330 1350 to apply. If you fill out a paper application form you will need to post it to:
NHS Business Services Authority
European Health Insurance Card Applications
152 Pilgrim Street
Newcastle Upon Tyne
You can expect to receive your EHIC within 7 days of submitting your application, but it is recommended that you allow longer before you are due to travel.
Remember that the EHIC is free and you should avoid websites which ask you to pay a fee with your application.
Do I still need separate travel insurance to go to Italy?
It is strongly recommended that you take out a travel insurance policy which covers you for medical treatment while you are away from the UK. If you have travel health insurance you will be able to access a wider range of services than if you rely on the EHIC alone. The combination of the EHIC and private insurance ensures that you can get the treatment you need without delay and without incurring high medical costs. Some insurance providers now stipulate that you must have an EHIC and will not offer insurance without one.
If you are an expat living in Italy on a long-term basis, you are still advised to take out an insurance policy with a UK company, specifically designed to give you comprehensive cover, so that you can access the best quality care available without restrictions.
What happens if I don’t have my EHIC with me?
If you lose your EHIC or are not carrying it with you when you need healthcare, you can get a Provisional Replacement Certificate by contacting the Overseas Healthcare Service (OHS). This certificate is used as evidence that you are entitled to healthcare and avoids charges being made for medical care. You can contact the OHS on +44 191 218 1999.
Failing to provide your EHIC or obtain the PRC could result in your getting charged in full for the medical care you receive.
What happens to EHIC if the UK leaves the EU without a deal?
If the UK were to leave the EU and had not agreed a deal, the EHIC scheme would no longer be available to UK citizens, and existing cards would become invalid. It is possible that an arrangement could be reached to allow continued access to the EHIC scheme. The EHIC is already available to several non-EU states, but it should be noted that these are all in the EEA. For example, Swiss citizens are able to participate in the scheme even though they are not members of the EU. In the meantime, for as long as the UK remains in the EU, UK citizens can continue to use the EHIC.
Useful medical words in Italian:
General Practitioner doctors (GPs) – medici generici
chemist / pharmacy – farmacia
prescription – ricetta
referral – impegnativa
hospital – ospedale