Italian healthcare system
Italy has a mixed public-private healthcare system. Since 1978, the National Health Service (Servizio Sanitario Nazionale - SSN) has been providing free or low-cost universal health care to all citizens and legal residents. Those who have additional health insurance can also turn to the private healthcare sector.
The Italian Ministry of Health (Ministero della Salute) coordinates public healthcare, and SSN services are provided by 20 Italian regions. So, while Italy's public healthcare is one of the most efficient in the world, its quality can be uneven. Services in Rome and Milano are advanced and efficient, while in the south of the country they may be underdeveloped.
Italy is considered one of the healthiest countries in the world, with high life expectancy and low rates of serious illness. Accordingly, only 1.8% of citizens have unmet medical needs, according to the European Commission's report on the state of health in Italy (PDF).
Who can access healthcare
Anyone living in Italy can access the public healthcare system, which is funded by taxes rather than health insurance. Medical care is available to all Italian citizens and legal residents if they have an SSN (tessera sanitaria) health card. Citizens of the European Union (EU) or the European Free Trade Association (EFTA - Iceland, Liechtenstein, Norway and Switzerland) who stay in Italy for less than three months can use their European Health Insurance Card (EHIC) to access services. UK residents can use the Global Health Insurance Card (GHIC), which replaced the EHIC after Brexit.
Medical care in Italy for tourists
As required by the Schengen rules, any foreign tourist traveling to Italy must have health insurance valid in the Schengen area, covering medical expenses, hospitalization and repatriation costs up to 30,000 euros.
You have certain rights to healthcare during your temporary stay. You can access both emergency and standard medical care. In the first case, payment must be made after discharge from the hospital. In the case of "non-emergency" treatment, an advance payment is required.
In case of need for medical care, foreign visitors to Italy can seek medical assistance in both public and private hospitals. Public hospitals provide both emergency and non-emergency care, while private hospitals usually provide only non-emergency care and do not have first aid departments.
In public hospitals, emergency services are provided free of charge or for a limited fee, while non-emergency services are subject to fees set locally by the Regional Health Department. Private hospitals usually charge much higher fees than public hospitals. Of course, it is also possible to visit a private doctor by making an appointment directly with him/her.
Short-term visitors from outside the EU/EFTA/UK cannot access Italian medical services without private travel insurance.
Citizens of the following countries have reciprocal healthcare agreements with Italy that allow them to access emergency medical care:
- Argentina
- Australia
- Bosnia and Herzegovina
- Brazil
- Cape Verde (temporarily suspended)
- Macedonia
- Monaco
- Montenegro
- San Marino
- Serbia
- Tunisia
- Vatican City
The medical treatment visa allows entry for a short or long stay, but in any case for a specified period of time, for a foreign national who needs to undergo medical treatment in Italian accredited public or private healthcare facilities. A medical treatment visa can also be granted to a person who accompanies and assists a foreign national with a medical condition.
Documents required to obtain a medical visa to Italy:
- Application form with 2 photographs (color photos on a white background, 3.5×4.5 cm in size), filled in in block letters in each column, preferably in Italian or English; must include the applicant's full home address, contact phone number including area code and the applicant's personal signature on pages 3 and 4 of the application form. If the applicant is a minor, the application form must be signed by one of the applicant's parents or guardians.
- A copy of the application form can be obtained free of charge at the Embassy, at the Italian Visa Center or downloaded from the Embassy's website.
- Medical documentation, which contains the following information:
1. Medical documentation issued in the country of residence confirming the disease.
2. A certificate from an Italian public or private medical institution (the latter must be accredited by the National Health Service), which indicates the type of treatment, start date, duration and estimated cost.
3. A certificate from the Italian medical institution confirming the payment of a deposit of at least 30% of the estimated cost of the services or, alternatively, a clear regional resolution or a clear authorization issued by the Ministry of Health for humanitarian programs.
- Documentation confirming the availability of resources in Italy sufficient to cover medical expenses, accommodation and meals outside the medical facility and return to the home country. The following expenses can be covered by the applicant himself or herself, or by private institutions or well-known humanitarian organizations or third parties.
- The accompanying person of a foreign citizen with a disease must provide international health insurance (in original and copy) valid in the Schengen area for the planned period of the first trip and a corridor of 15 days with a planned return date. The minimum amount of insurance coverage is 30,000 Euros.
- The health insurance policy can be purchased directly at the Italian Visa Center.
- Booking a ticket.
- The following documents are required for fixed-date round-trip travel (or one-way travel in case of a long-stay visa) by air, train or bus or by car
1. the original and a copy of the technical passport of the car;
2. original and copy of the "green card" insurance;
3. original and copy of the driver's license;
4. if the car is rented, the original and a copy of the vehicle rental agreement.
1. Foreign passport and a copy of its filled pages. The passport must be valid for at least three months after the expiration of the visa and issued no earlier than 10 years ago (Article 12 of the Visa Code). The passport must have at least 2 free pages (for the visa and stamps when crossing the border). Passports with an extended validity period are not accepted.
2. All other passports of the applicant with a valid validity period (and copies of all pages) and with an expired validity period (and copies of all filled pages).
3. Internal passport and a copy of its filled pages.
NOTE:
All documentation in another language (except Italian and English), except for the internal passport, must be provided with a regular translation into Italian or English. Translation can also be done in a translation agency or other specialized organizations.
The availability of all these documents does not in any way guarantee the mandatory or automatic issuance of a visa.
The Diplomatic or Consular Mission reserves the right to request additional documentation.
If your child was born in Italy, you must declare it in order to register it at the Civil Registry Office (Ufficio di Stato Civile) of the municipality. The Civil Registry Office registers vital events of citizens and residents, such as births, marriages, civil unions, deaths and citizenship. If you need your child's birth certificate for administrative purposes, you can request a birth certificate from the municipality.
Declaration of birth
You must notify the Italian authorities of your child's birth ('dichiarazione o denuncia di nascita' in Italian) in one of the following ways
- To the hospital administration ('direzione sanitaria' in Italian) - within 3 days of the birth. In this case, the hospital is responsible for sending the birth declaration to the registry office of the municipality where the birth took place, or to the municipality of the mother, if you request it.
- To the registry office of the municipality (comune) where the mother is registered or where the child was born - within 10 days from the date of birth.
In both cases, you must bring the birth certificate issued by the hospital and a valid identity document (e.g. passport or ID card) of both parents or the parent who recognizes the child.
If neither you nor the other parent of the child has a valid residence permit, the civil registry office or hospital cannot ask you for a residence permit, nor can they report you to the police if you are in the country illegally.
Do I or my partner have to register my newborn?
Registering the birth of your child also allows you and your partner to recognize the newborn.
- If you and your spouse are legally married, either the mother or the father can register the birth of the child. Both of you will be considered the child's parents.
- If you are not married, you must register the birth to establish maternity and paternity. Basically, if you both want to recognize the child, you must both register the birth. Otherwise, if only you recognize your child, you must register the birth.
- If one of the parents recognizes the child only at birth, the other will always be able to recognize the child by filing a special application after the birth before a civil registrar, a guardianship judge (Italian: Giudice Tutelare) or a notary.
Birth certificate in Italy
For some administrative procedures (for example, to register the birth of a child at your embassy), you may need a birth certificate issued by the commune.
In Italy, there are different certificates that prove a person's birth (copia integrale dell'atto di nascita, estratto di nascita and certificato di nascita), depending on what information you need. You can apply for the certificate in person or online (if the commune has access to an online service), it is free and valid for 6 months.
The most complete certificate is the "copia integrale dell'atto di nascita", i.e. a copy of the birth certificate transcribed in the Civil Registry. However, it is common to request a short extract from this certificate, called the "estratto di nascita" ("birth certificate"). The "certificato di nascita" contains only the first name, surname, place and date of birth, as well as the number of the birth certificate.
What kind of authorization will my child have?
The type of permit your child will have depends on the type of permit you or your partner have and its status (valid or expired).
If you or your partner have a valid residence permit
If both or one of the parents has a valid residence permit in Italy, the child will be granted a residence permit for family reasons (Permesso per Motivi Familiari). This permit will have the same validity period as your permit and can be renewed until your child turns 18 years old.
Your child's authorization will be linked to the authorization of the parent with whom he or she lives. If the child lives with both parents, the child's Permesso will be linked to the Permesso of the parent with the most rights and the longest validity period. For example, if you have a 5-year refugee status and your partner has a 2-year protezione speciale, your child will receive a 5-year family permit.
If you or one of the parents has a long-term EU residence permit (ex Carta di Soggiorno), your child can obtain a long-term EU residence permit after 5 years of residence in Italy.
If you do not have a valid residence permit
If you are pregnant or have recently given birth to a child and you and the child's other parent do not have a valid residence permit, you cannot be deported and can apply for a medical treatment permit (Permesso per Cure Mediche). This permit is only valid for 6 months after the birth.
After that, you can apply for a Permesso per Assistenza Minore, and after receiving it, you can provide your child with a family permit (Permesso per Motivi Familiari). This permit will have the same validity period as your residence permit and you must renew it when you renew your residence permit.
Unfortunately, if you do not meet the requirements for obtaining a permit and receive an expulsion order from Italy, you and your child must leave the country.
Tax code
After you register your child, the municipality will issue a tax code (codice fiscale). The codice fiscale is very important in order to register your child in the healthcare system and to access public and private services.
Generally, a plastic card will be sent automatically to your home address. However, some communes may ask you to go to the Registration Agency (Agenzia delle Entrate) with your child's birth certificate and fill out a form to be sent. The tax code should arrive at your address within about one month.
Medical care for newborns and children in Italy
Foreign newborns and children have full access to the necessary medical care, pediatrician and vaccinations, even if their parents do not have a valid permanent residence permit in Italy.
REMEMBER: Healthcare workers are not authorized to report you to the police if you are in the country illegally.
Tessera sanitaria
After obtaining the codice fiscale, your child automatically receives a health card ("tessera sanitaria" in Italian) at his/her home address, without the need to make a special request or contact any health service. This first tessera sanitaria will be valid for one year.
Within a year of receiving the tessera sanitaria, parents must also register their child with the public health system. After that, a new medical card is sent with a validity period of six years.
Registration in the healthcare system
All children must register with the Italian public health system, or "Servizio Sanitario Nazionale (SSN)". This procedure is free of charge. If you would like to register your child with the SSN, you should contact your local health service, called Azienda Sanitaria Locale (ASL). Most cities in Italy have such offices.
In general, the documents for registering a newborn in the healthcare system are as follows:
- A document with your child's personal data (e.g. birth certificate)
- The child's fiscal code
PLEASE NOTE that you can apply for an exemption for medical expenses ("esenzione ticket" in Italian) for your newborn child under the age of 6.
Pediatrician
Registration in the public healthcare system entitles your child to a pediatrician ("pediatrician" in Italian), i.e. a doctor who specializes in children's health.
The pediatrician is your point of contact with the Italian health care system. If your child is sick, needs medication, or does not require emergency medical care, you should seek the help of a pediatrician. The pediatrician will also advise you on how and when to vaccinate your child.
You can choose or change your child's pediatrician for free from among those available in your local ASL. As each ASL has its own and distinctive procedure, we encourage you to look at your ASL's website to find out how to do this. To find the nearest ASL in your area, type ASL+ [your municipality of residence] into Google.
Immunizations.
All children in Italy are entitled to vaccinations. Many vaccinations are free of charge, while for others you may need to pay a "ticket". Some vaccinations are mandatory, others are only recommended. Your child's pediatrician will advise you on how and when to get vaccinated.
Cost of childbirth and care in Italy
As for the cost of childbirth, it is absolutely free in a public hospital if you decide to give birth with an SSN and agree to a double room. You can also choose a private service and a single room in the same hospital. In this case, we advise you to have a good private health insurance, polizza assicurativa sanitaria, which will reimburse you for the costs, which are usually high. Make sure you get the right information, as not all insurance companies offer the same maternity coverage. If you decide to give birth in a private hospital, again, your birth will be covered if you have insurance.
In the case of giving birth in the private system, there are generally three main categories of costs:
- Costs related to the birth (specialized staff, special care, interventions, etc.)
- Costs associated with the "stay" in the hospital, degenza, which includes a single room, meals and other services
- Expenses for a possible obstetrician or other specialist who will observe you in person at your request.
- Giving birth at home or in a specialized home, casa parto, costs from €2,000 to €3,000. In a private hospital or clinic, prices start at €2,000 and can reach €13,000; it will depend on the clinic you choose, the type of room (shared or single), and other parameters. For example, giving birth at the Mangiagalli or Ospedale Buzzi maternity hospital in Milan costs from 9,000 to 13,000 euros for a full private option (labor, stay and care).
Finally, epidural anesthesia costs an average of 500 euros, but here again it depends on many factors: the facility where you give birth, possible reimbursement from SSN or private insurance. In some hospitals, epidurals are free of charge.