Healthcare Rights in Italy For Foreign Expats & Visitors

Mar 03, 2017

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ITALIAN HEALTHCARE SYSTEM AT A GLANCE

• The SSN is a regionally organized service, each region (such as Lombardy, Tuscany, etc.) is responsible for organizing and delivering health care through local health authorities (Aziende Sanitarie Locali/ASL – often referred to by their former name Unità Sanitaria Locale/USL)
• the SSN provides hospitalization and treatment (including tests, surgery, and medication during hospitalization), visits to family doctors/ pediatricians (GPs), specialist medical assistance, discounted medicines, laboratory services, appliances, ambulance services.
• Urgent and essential services are guaranteed to anyone, also to irregular immigrants. Temporary visitors can receive health services by paying for the costs of treatment.
• The Italian National Health Service is funded through taxes and through co-payment of the cost of medicines and health services (the ‘ticket’). As far as the Italian social security system is concerned, this is funded by contributions paid by employers, employees and self-employed workers, as well as through general taxation. For an overview of social security rights in Italy, please visit the website of the European Commission: Italy – Employment, Social Affairs & Inclusion

HEALTHCARE RIGHTS IN ITALY FOR FOREIGN EXPATS

In Italy, healthcare is considered a right. As a general rule, every foreign citizen can enjoy public health benefits in Italy. The comprehensive national health system is designed to provide assistance for all Italian citizens and residents, including foreign citizens who are legal residents of Italy. Foreigners registered with the National Health Service (Servizio Sanitario Nazionale – SSN) are guaranteed full assistance under the same conditions as Italian citizens.

1. Free registration
   Generally speaking, the following categories are entitled to free registration:  
   • Foreign citizens in possession of a permit who regularly work as employees/self-employees (lavoro subordinato, lavoro autonomo) in Italy or are enrolled with government employment agency;  
   • Foreign citizens in possession of or waiting for the renewal of a permit for employment, self-employment, family reasons, asylum, adoption/custody, citizenship acquisition, religious reasons;
   • Dependent family members of all the above categories.
2. Voluntarily registration
   If you are not eligible for “free” registration, an alternative to the private health coverage is  “voluntary” registration with SSN. Once registered you will be guaranteed full assistance under the same conditions as Italian citizens. The registration requires the payment of a yearly lump sum calculated as follows:  
   • 7,50% rate up to an income equal to € 20.658,28;  
   • 4% rate on any amounts exceeding € 20.658,28 and up to a limit of € 51.645,69.

Medical care is provided through a network of hospitals, which can be either public or accredited private providers. Those registered are entitled to:

1. To choose a general practitioner whom you can consult/visit the during medical office opening. The GP shall also be contacted for:
   (1). medical certificates;
   (2). Prescription for specialist and diagnostic examinations;
   (3). Request for non-emergency hospital admission;
   (4). Prescription of medicines;
2. to be hospitalized free of charge if needed
3. to undergo free outpatient and in-home medical examinations and to obtain prescriptions for medications and specialist services.

Most care is free or low-cost. All patients (including foreigners legally resident) are asked to pay a co-pay fee (called “ticket”) before undergoing specialist examinations and for medicines. Exemptions exist for reasons such as chronic diseases, low-income patients, etc.. Co-payment is required for visits and medical examinations as well as for medicines, calculated on the basis of the individual’s income.

Healthcare facilities may vary in terms of quality in different regions of Italy. Foreigners may experience difficulties when attempting to register with or even obtain information from the Health authorities. This is because rules are often applied unevenly throughout Italy or even within the same region, sometimes due to the lack of clarity and sometimes because the public office staff is insufficiently trained.

VISA/PERMIT FOR MEDICAL CARE (VISTO/PERMESSO PER CURE MEDICHE)

Foreign nationals residing abroad may organize planned medical treatment in Italy, for instance, if they need to undergo a special therapy available in the country. Italy offers a special visa for “medical care”, this type of visa can also be issued to an accompanying person.

After the applicant has organized the medical treatment and has made contact with the hospital or clinic of choice (it may be a public or private facility, provided it is acknowledged by Italian health authorities), next step is to collect the relevant documents and prepare the visa application that can be applied for by the applicant or by a family member or another representative on behalf of him/her.

In general, the visa application package includes the following documents

1. An official statement from the medical facility indicating duration and details of the therapy;
2. Proof of payment of at least 30% of the total cost of the therapy;
3. Health certificate, to attest the applicant health conditions and as evidence of the need for medical care;
4. Evidence of availability of funds to financially support the stay in Italy, the costs of the therapy, and the travel back to the home country at the end of the medical treatment.

Once the visa is issued the foreigner can travel to Italy and must apply for the relevant residence permit within 8 days from arrival. The residence permit for medical care can be extended for the whole duration of the medical treatment.

MEDICAL CARE IN ITALY FOR TOURISTS

As required by the Schengen rules, any foreign visitors traveling to Italy must ensure he/she is covered by a medical insurance valid for Schengen area covering medical fees, hospitalization and repatriation cost up to €30,000.

You have certain health care rights during a temporary stay. You can access both emergency and standard healthcare services. In the first case, payment must correspond upon hospital discharge. In case of “non-emergency” treatment, advanced payment is required.

In case of need for medical assistance, foreign visitors in Italy can seek medical treatment either from public or private hospitals. Public hospitals provide both emergency and non-emergency services while private hospitals do normally provide non-emergency services only and do not have first aid service.

At public hospitals, emergency services are provided at no cost or upon payment of a limited fee, while non-emergency services are subject to a fee set locally by the Regional Health Authority. Private hospitals normally charge much higher fees than public hospitals. Of course, it is also possible to visit a private doctor by arranging an appointment directly with him/her.

When leaving the medical facility, the hospital will issue an invoice for the payment of the service:  make sure to obtain a receipt as you can claim reimbursement from the private insurance plan that covers you.

The emergency number (for immediate medical attention or to call an ambulance) is 118. Otherwise, you can access the first aid station (Pronto Soccorso) directly.