If you’re planning to buy in Italy, understanding how healthcare works for expats is just as important as choosing the right property. From registering with the SSN to comparing it with the NHS, here’s what you need to know about costs, access and day-to-day care as a new resident.
If you’ve spent years holidaying in Italy and are now planning to buy, healthcare is probably high on your checklist – especially if you’re planning a permanent move. The good news is that Italy’s system consistently ranks well internationally. The World Health Organization has previously placed Italy among the top health systems globally, and life expectancy remains one of the highest in Europe – 84.2 years at the beginning of 2026 [1]. That longevity tells you something important about day-to-day healthcare access and preventative care.
Below, you’ll find a clear guide to how the Italian system works, what it costs and how it differs from the NHS – plus answers to common questions we hear from buyers.
Contents
- How healthcare in Italy works for expats
- Will you still have access to the NHS?
- Do you need health insurance to visit Italy?
- Getting your Tessera Sanitaria
- Public versus private healthcare
- Is dental care free in Italy?
- Children’s vaccinations
- Accessing healthcare day to day
- What this means for you as a buyer
- Frequently asked questions
How healthcare in Italy works for expats
Italy’s public healthcare system is called the Servizio Sanitario Nazionale – SSN. It is funded primarily through taxation and is organised regionally under national guidelines set by the Ministry of Health.
If you are employed or self-employed in Italy and officially resident, you register with the SSN and access healthcare either free or at a heavily subsidised rate because you are contributing through the social security system. Your dependent family members can also register.
If you are not working, you may still be able to access public healthcare by enrolling voluntarily in the SSN (iscrizione volontaria). From 1 January 2024, the rules were updated under Law 213/2023 and the minimum annual contribution for voluntary enrolment (for the categories covered by this change) is now €2,000 per year, calculated on a calendar-year basis. The contribution is still income-based, using your total worldwide income from the previous year, and can rise with income up to a cap of about €2,789. In practice, the exact amount and how the rules are applied can vary by local health authority (ASL) so it’s worth checking the guidance for your region before you budget.
Once registered, you receive your Tessera Sanitaria – a personal health card that gives you access to public healthcare in Italy on the same basis as Italian citizens.
If you choose not to register, you must arrange private health insurance. In practice, many new residents take out private cover for their first year while residency paperwork is processed.
Using an S1 form in Italy
If you receive a UK State Pension, you may be entitled to an S1 form. This allows you to register with the Italian SSN without paying the voluntary annual contribution.
Once resident, you submit your S1 to your local ASL and you’ll be issued with a Tessera Sanitaria, giving you access to public healthcare on the same basis as an Italian resident. The UK reimburses Italy for the cost of your care.
If you move to Italy before reaching State Pension age and are not receiving a qualifying UK benefit, the S1 will not apply and you will usually need private cover or voluntary SSN enrolment.
Will you still have access to the NHS?
The NHS is residency based. According to the UK government, you must be “ordinarily resident” in the UK to access NHS services free of charge.
If you move to Italy permanently, you do not automatically retain full NHS entitlement. Should you return temporarily, you can still receive necessary treatment in an emergency, but you may be charged for certain services if you are no longer classed as ordinarily resident.
If you are legally resident in Italy, you can apply for an Italian-issued European Health Insurance Card – now part of the TEAM system – which allows access to necessary state healthcare during temporary stays in EU countries, Iceland, Liechtenstein, Norway and Switzerland.
If you move back to the UK permanently and re-establish residency, full NHS rights are restored.
Do you need health insurance to visit Italy?
If you are travelling to Italy to view property and hold a valid UK GHIC or EU EHIC, you can access medically necessary state healthcare during your stay.
However, these cards are not a substitute for travel insurance. They do not cover private healthcare, mountain rescue, repatriation flights or lost property.
If you require a visa to stay in Italy longer than 90 days, private health insurance is typically mandatory as part of your visa application.
Getting your Tessera Sanitaria
After securing residency – usually evidenced by your carta d’identità or permesso di soggiorno – you register at your local Azienda Sanitaria Locale – ASL.
You will normally need:
- Your passport
- Codice fiscale
- Proof of residence
- Residency documentation
You will be assigned a GP – medico di famiglia – or given a list to choose from. Children are assigned a paediatrician.
Your Tessera Sanitaria is posted to your address. In the meantime, request a paper certificate to confirm coverage. The card also functions as a European Health Insurance Card within the EU.
If your registration is mandatory – for example because you are working or have been legally resident long term – it is free. If voluntary, you pay the annual contribution.
If you are self-employed, you must register with INPS – the National Institute of Social Security – before accessing the SSN.
Public versus private healthcare
Italy combines public provision with a significant private sector. According to the latest data, Italy has 4.25 practising doctors per 1,000 inhabitants [2], above the OECD average.
Public hospitals provide comprehensive care, though waiting times for non-urgent procedures can vary by region. Northern regions often report shorter waiting lists compared with parts of the south, reflecting regional funding differences.
Private hospitals and clinics are widely available, particularly in cities such as Milan, Bologna and Rome. Costs are regulated by the Ministry of Health, and many expats choose low-cost private policies simply to meet visa requirements. Basic policies can start from around €150 per year for minimum coverage.
Is dental care free in Italy?
Routine dental care is generally private. Emergency dental treatment may be available through the SSN, but most residents pay privately for check-ups and procedures. The standard is high and fees vary by region.
Children’s vaccinations
Under the 2017 Lorenzin decree, 10 vaccinations are mandatory for children aged 0–16 [3]. Proof of vaccination is required for nursery and school attendance, and fines can apply where requirements are not met. Always check the latest regional guidance as enforcement may vary.
Accessing healthcare day to day
Pharmacies
Look for the illuminated green cross. Pharmacies are often open extended hours and operate a rota system for overnight cover. Pharmacists are highly trained and can supply some medications over the counter that would require a prescription in the UK. Once you have your Tessera Sanitaria, prescriptions are subsidised.
GPs
Many surgeries are small and locally run. You often wait your turn rather than checking in with a receptionist. Referrals to specialists are made via a printed form which you take to the hospital booking office.
English-speaking doctors are more common in larger cities, though translation apps are widely used in consultations.
Hospitals
Emergency departments – pronto soccorso – operate on a triage system. For an ambulance, call 112 or 118. Italy’s emergency care standards are strong, with universal emergency access guaranteed under national law.
Certain diagnostic tests require a small co-payment known as a ticket. Fees vary regionally.
What this means for you as a buyer
Healthcare should not be a barrier to buying in Italy – but you do need to factor it into your financial planning. Understand your residency pathway, budget for voluntary contributions if needed and consider whether private cover suits your circumstances.
Most buyers find that once registered, access is straightforward and local providers are practical and patient focused. As with many aspects of Italian life, relationships and local knowledge help.
If you are viewing property soon, carry your GHIC, arrange travel insurance and make sure your paperwork is in order.
Frequently asked questions
If you are legally resident and contributing to the social security system, public healthcare through the SSN is free or low cost at the point of use. Some services require small co-payments. If you are not working, you can join voluntarily by paying an annual fee.
Both systems are tax funded and offer universal coverage. The main differences are that Italy’s system is regionally administered, co-payments are more common and patients often handle more paperwork directly. The NHS is centrally managed and generally free at the point of use without routine co-payments for services in England beyond prescriptions and dental charges.
Italy’s lower obesity rate reflects dietary habits, portion sizes, walkable communities and strong social food culture. Italy’s obesity rate is among the lowest in Europe [4].
Sources:
[1]: https://georank.org/life-expectancy/italy
[2]: https://tradingeconomics.com/italy/medical-doctors
