Healthcare in Italy

Healthcare in Italy follows the Beveridge model of universal coverage — funded through taxation and free at the point of use for citizens and legal residents. The Servizio Sanitario Nazionale (SSN) was created in 1978 on the constitutional principle that health is a fundamental human right (Article 32 of the 1948 Constitution). The World Health Organization (WHO) consistently ranks the Italian health system among the most efficient in the world in terms of cost versus outcomes.

This article analyses healthcare in Italy in terms of the structure of the SSN, the private healthcare system, life expectancy and health indicators, the hospital network, costs and access for foreign nationals, and points to note for Vietnamese people living there long-term.

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Overview of the Italian healthcare system

The Italian healthcare system combines public and private provision, with the public sector playing the leading role. The SSN provides almost free healthcare to Italian citizens and legally resident foreign nationals, funded mainly through income tax and value-added tax. About 80% of regional budgets were devoted to healthcare as of 2023. Total health spending accounted for about 8.7% of Italy’s GDP in 2024.

The system operates on three levels. At national level, the Ministry of Health (Ministero della Salute) sets standards and the “Essential Levels of Care” (Livelli Essenziali di Assistenza — LEA) — the national package of health benefits that every region must guarantee. At regional level, the 19 regions and the 2 autonomous provinces of Trento and Bolzano are responsible for organising, planning and delivering health services. At local level, about 100 Local Health Units (Aziende Sanitarie Locali — ASL) deliver services directly.

The LEA include primary care (through family doctors), inpatient treatment in public hospitals, prescription medicines, outpatient specialist services, rehabilitation, home care, end-of-life care (hospice), preventive medicine and health screening. Some services are not covered by the LEA — notably dental care for adults and most psychological services — and must be paid for privately.

According to the World Health Organization, Italy ranks near the top in international assessments of health system efficiency. However, the system also faces significant challenges: large quality gaps between the North (Lombardy, Veneto and Emilia-Romagna have the best systems) and the South (Calabria, Campania and Basilicata often rank below the national average), long waiting times for specialist appointments, and shortages of health workers.

Servizio Sanitario Nazionale (SSN): universal public healthcare

The SSN was established by Law 833 of 23/12/1978, based on three core principles: universality (universalità — covering the whole population regardless of income), equality (uguaglianza) and solidarity (solidarietà). The SSN automatically covers all Italian citizens and legally resident foreign nationals as soon as they register with their local ASL.

SSN users need a Health Insurance Card (Tessera Sanitaria) — proof of registration with the national health system. The card is issued to all legal residents and must be shown when seeing a public doctor, buying medicines at a pharmacy, having tests or being admitted to hospital. The Tessera Sanitaria also serves as a European Health Insurance Card (TEAM/EHIC) when travelling in EU/EEA countries.

The family doctor (medico di famiglia or medico di base) is the main gateway to the SSN. Each resident is assigned a family doctor from a local list of doctors accepting new patients. Family doctors provide general check-ups, basic prescriptions, specialist referrals and long-term management of medical records. For children under 6, families choose a paediatrician (pediatra di libera scelta) instead.

Many services involve co-payments (ticket sanitario) — fees for specialist visits, diagnostic tests and some prescription medicines. The ticket is usually no more than 50 euros per service, and many groups are exempt (pregnant women, people with HIV, people with chronic conditions, and low-income children and older people). Emergency care and family doctor visits are free. Undocumented people can still access emergency and essential care.

Private healthcare and supplementary insurance

Private healthcare in Italy complements rather than replaces the SSN. About 25–30% of Italians have private health insurance, mostly through employee benefits or mutual health funds (società di mutuo soccorso). Private insurance is usually chosen to shorten waiting times for specialists, access services outside the LEA (especially dental and psychological care) or choose hospitals and doctors.

Private clinics and hospitals are common in major cities such as Milan, Rome, Florence and Naples. Well-known private medical centres include Humanitas (Milan), San Raffaele Hospital (Milan, affiliated with Vita-Salute University) and Gemelli Hospital (Rome, affiliated with Cattolica University). These centres usually have modern equipment, short waiting times and leading specialists.

Private specialist consultations in Italy cost 80–250 euros per visit depending on the specialty and city. Private surgery can cost from a few thousand to tens of thousands of euros. Compared with the United States, Germany or the United Kingdom, private healthcare costs in Italy are significantly lower for comparable quality — which is why many foreigners choose Italy as a medical tourism destination.

Unlike in many EU countries, private health insurance premiums in Italy are not fully tax-deductible, so most Italians rely mainly on the public SSN. International health insurance is a popular option for foreign nationals without long-term residence or those who want flexibility between countries.

Life expectancy and health indicators in Italy

Italy has one of the highest life expectancies in the world. According to ISTAT data for 2025, average life expectancy in Italy is 81.7 years for men and 85.7 years for women — the gender gap has narrowed to 4 years. Italy ranks 4th in the OECD and 8th in the world for life expectancy. Trentino-Alto Adige and Marche usually have the highest life expectancy in the country.

Italy also stands out for healthy life expectancy — the number of years lived free of disease. Factors explaining this include the Mediterranean diet (recognised by UNESCO in 2013), a mild climate, a universal public health system, a traditionally active lifestyle and strong family and community networks. Sardinia is one of the world’s five “Blue Zones” — places with unusually high numbers of people living beyond 100.

Italy’s infant mortality rate was 2.7‰ in 2024 — among the lowest in the world. Cancer survival is about 65% (5 years after diagnosis), above the EU average. Italy offers free screening for breast, cervical and colorectal cancer for specified age groups, contributing to high rates of early detection.

However, the system faces serious challenges due to the fastest-ageing population in the EU. People over 65 made up 25.1% of Italy’s population in 2026, and the over-85s numbered 2.5 million (4.3% of the population). Pressure on the health system is growing with chronic diseases, dementia and the need for long-term care. Italy also has one of the lowest nurse-to-patient ratios in the EU — it is recruiting nurses from Argentina, Paraguay, Albania and Indonesia and plans to recruit from India.

The hospital network and leading specialist centres

Italy has a network of more than 1,000 hospitals, including SSN public hospitals, university general hospitals, specialist hospitals, scientific research hospitals (IRCCS) and private hospitals. Italy has 51 IRCCS — leading research medical centres working in cutting-edge fields such as oncology, cardiology, neurology, organ transplantation and rare diseases.

Italy’s leading hospitals include San Raffaele Hospital (Milan, affiliated with Vita-Salute University, specialising in oncology and cardiology), Humanitas Hospital (Milan, IRCCS, multi-specialty), Gemelli Hospital (Rome, IRCCS, the largest multi-specialty hospital in Rome), Niguarda (Milan, the largest emergency hospital in northern Italy), San Matteo Hospital (Pavia, IRCCS) and Careggi Hospital (Florence). Bambino Gesù Hospital (Rome, owned by the Vatican) is one of Europe’s leading children’s hospitals.

Italy has international strengths in specific specialties. Oncology (oncologia), with the National Cancer Institute in Milan and the European Institute of Oncology (IEO) in Milan. Cardiology, with Niguarda Hospital and Centro Cardiologico Monzino. Organ transplant surgery — Italy is one of Europe’s leaders in liver, heart and multi-organ transplants.

The Italian health system is going digital through the Electronic Health Record system (Fascicolo Sanitario Elettronico — FSE), allowing medical histories to be accessed across providers and regions. The COVID-19 pandemic accelerated telemedicine, enabling remote consultations, post-treatment monitoring and chronic disease management.

Costs and access to healthcare for foreign nationals

Foreign nationals in Italy have three ways to access healthcare depending on their residence status. EU/EEA/Swiss citizens visiting Italy short-term use the European Health Insurance Card (EHIC) from their home country and can access emergency and essential care. EU/EEA citizens living in Italy long-term (more than 90 days) must register with their local ASL like Italian residents.

Non-EU nationals have two types of SSN registration. Compulsory registration (iscrizione obbligatoria) is free and applies to holders of residence permits for work, family, international protection, pending adoption or maternity. Voluntary registration (iscrizione volontaria) applies to others such as international students, financially independent people and those awaiting citizenship — requiring an annual fee of about 700–2,300 euros depending on income.

Non-EU international students can choose voluntary SSN registration (about 700 euros a year for the basic level) or buy private health insurance (usually cheaper, about 100–300 euros a year for a basic plan). Voluntary SSN registration provides full entitlements equivalent to Italian residents and is a good choice for students with regular healthcare needs or accompanying family members.

Short-term non-EU visitors must pay all medical costs themselves or use their own travel insurance. Emergency departments (pronto soccorso) in Italian public hospitals do not refuse treatment to anyone in an emergency, but uninsured patients will be billed.

For Vietnamese readers: healthcare entitlements when living in Italy long-term

For Vietnamese students in Italy, there are two health insurance options. Option 1 is voluntary SSN registration for about 700 euros a year — full entitlements like Italian residents, suitable for long stays (3+ years). Option 2 is private insurance costing 100–500 euros a year — suitable for young, healthy students staying less than 1–2 years.

For Vietnamese people coming to Italy for contract work or family reunification, SSN registration is compulsory and free. Entitlements include free family doctor visits, free emergency care, free public hospital admission, free cancer screening, free vaccinations under the national schedule, and significantly discounted prescription medicines. Spouses and children joining them are also automatically covered.

For Vietnamese investors on the Italy Investor Visa or financially independent people on the Elective Residency Visa, voluntary SSN registration is the official option. The fee ranges from 700 to 2,300 euros a year depending on income; even the highest level is far cheaper than comparable private insurance in the United States. Some high-income Vietnamese choose to combine the SSN with private insurance to benefit from both free entitlements and fast access to private specialist services.

For Vietnamese people considering Italian citizenship after 10 years of residence, healthcare entitlements are guaranteed throughout the process. After naturalisation, Italian citizens have free access to healthcare in all 27 EU countries through the European Health Insurance Card (TEAM). This is an important long-term benefit — especially for older people, those with chronic conditions and anyone who wants to secure healthcare for the next generation.