Italy is undoubtedly one of the most iconic destinations in Europe – from its rich culture and history, and of course, the food; the Mediterranean country boasts impressive sights, sounds, and experiences for both locals and visitors alike.
The country consists of a peninsula bordered by the majestic Alps and several islands surround it. Rome is the capital city, and other major cities include Milan, Naples, Genoa, and Venice – with the Vatican City being an independent state. Each with its own unique cultures and traditions. While there are approximately 34 native living languages, Italian is the official language.
Italy offers an excellent standard of living and quality of life for its vibrant population. In fact, it has a high average life expectancy, reaching 85.1 years for women and 79.6 years for men—achievements resulting from successful welfare practices and well-established healthcare policies.
If you are planning a trip to Italy, then this healthcare guide will give you everything you need to know to stay safe and informed during your stay.
- Healthcare Basics
- Cost of Healthcare in Italy
- Available Payment Methods
- Seeing a Specialist
- Drugstores and Pharmacies
- Hospitals and Clinics in Italy
- Emergency and After-Hours Healthcare
- Tips for Tourists
Healthcare In Italy – The Basics
Healthcare facilities in Italy vary in terms of quality from region to region, with the wealthier north of the country offering a more comprehensive range of medical centers and clinics than the south.
Healthcare in Italy has a mixed Public and Private system. Italian law recognizes health as a fundamental right, and healthcare is provided to everyone under a concept known as Universal Healthcare.
Italy’s average level of medical care is high in comparison to internal standards. According to the World Health Organization, the Italian healthcare system has ranked 2nd best in terms of worldwide performance, and Italian doctors are typically highly qualified.
Italy’s healthcare system is a regionally based national service known as Servizio Sanitario Nazionale (SSN), which provides universal coverage to citizens and residents. SSN provides public healthcare mainly free of charge.
Treatments covered by the public health system and a small co-payment include:
- Surgeries during hospitalization
- Family doctor visits (GP)
- Medial assistance provided by pediatricians and other specialists
- Out-patient treatments and dental treatments are also available
It’s essential to keep in mind that public healthcare facilities across the country vary in terms of quality depending on the region. Even though the standard of state hospitals and clinics in Italy are generally sufficient, some public hospitals fall below the standard that some expats are accustomed to.
Expats employed in Italy qualify for the local government healthcare network. To qualify, you should visit the nearest local health authority, the Aziende Sanitaria Locale (ASL), and register with a doctor. After which, a health card and number will be issued and serve as a ticket for free visits to the doctor.
European Union citizens moving to Italy can leverage the mutual healthcare agreements with their native countries. This requires expats to apply for form E111 (certificate of entitlement to treatment) at least three weeks before traveling to Italy.
Non-European citizens moving to Italy are required to have private insurance coverage. Upon their arrival, there is an eight-day period to visit a local police station and present a health policy that is valid throughout the duration of their stay.
Limits of public healthcare in Italy to keep in mind:
- Most primary care physicians (employed under NHS) are only available for consults during pre-set office hours, varying from doctor to doctor. In addition, house calls are rare and only occur under exceptional circumstances. As a general rule of thumb, the typical hours for GPs are weekdays: from 8.00 am – 8.00 pm; pre-holiday days (for example, Saturdays or on the eve of Christmas): from 8.00 am – 2.00 pm.
- Doctor’s offices may be crowded, and appointments are typically not available (first-come-first-serve basis). So, you may need to go back another day if the doctor’s rooms are too full.
- Most GPs (working under the Italian National Healthcare Service) do not speak English, so communication may be tricky if you cannot speak Italian.
- Hospitals are large and can be very confusing, so even if you have an appointment, you might be wandering around looking for the right place or waiting for a while.
- If you need to do a diagnostic procedure or see a specialist for a non-urgent condition through the SSN, you might end up waiting weeks or months for an available date.
- When you are being referred to a specialist, you cannot choose your doctor. You will be attended to by whoever is available at the time of your appointment.
Wealthier Italians and expats might prefer to take private health insurance cover as opposed to basic state cover. People who opt for private insurance can freely choose doctors and specialists and receive treatment at private hospitals, and therefore avoid the long queues and waiting lists.
Private medical facilities in Italy are in excellent condition. While the comfort and quality of service at private hospitals are typically superior to state facilities, the quality of care is likely to be similar. It is also important to note that some treatments at private medical facilities in the country can be costly without the support of private health insurance.
Cost of Health Care In Italy
Italy has universal healthcare coverage, but only some services are completely free. With most services demanding cost-sharing, and many provided at the total expense of the patient. Co-pay fees are called “Tickets”, and they are applicable to some specialist consultations, diagnostic procedures, lab analyses, and emergency room (Pronto Soccorso) visits.
The amount of co-pay fees varies from region to region and depends on the type of treatment required, as well as the patient’s status – since there are forms for exemption (esenzione in Italian) for low income and serious illnesses.
The typical hourly rate negotiated between the GP trade unions and the government is approximately EUR 25. Private medical care costs are EUR 50-124 for general practitioners, EUR 80-200 for specialists, and approximately EUR 100 for dentists.
Public and private providers under contract with the SSN are not allowed to charge above scheduled fees.
Available Payment Methods
In Italy, card payments are the most common payment method. However, PayPal is also as popular throughout the country.
Doctors And Specialists In Italy
In Italy, primary care is provided by contracted self-employed and independent GPs and pediatricians. These physicians are paid a capitation fee based on the number of patients on their list. Local health clinics can also pay additional allowances for providing care to specific patients, like home care for chronically ill patients, or for reaching targets related to quality or spending levels. In addition, GPs and pediatricians who are willing to work in remote areas receive additional payments of approximately EUR 5 (USD 6) per patient.
In recent years, group practices have become increasingly popular, especially in the northern part of the country. And GPs and pediatricians who operate in group practices receive additional payments per patient. In addition, they also receive additional payments for employing nurses or secretaries.
Seeing A Specialist
Many Italians rely on private medical centers for specialist consultations for increased comfort, more flexibility in scheduling appointments, faster access to medical assistance, and closer doctor-patient relationships.
However, referral consultations with a specialist can be arranged by a primary care physician of the National Healthcare in Italy at public healthcare centers or at ones that are private with an NHS agreement (called Privato Convenzionato). These services are subject to Ticket co-payments.
If you opt to see a specialist (i.e. an ob-gyn, dermatologist, a cardiologist) through the Italian NHS, your referral will be in the form of a red prescription (ricetta rossa). Urgent appointments (within 10 to 30 days) can be requested, which will give you access to available slots saved for urgent needs.
Once you have the red prescription, you can book your appointment online or by calling the regional CUP (Centro Unico di Prenotazione Regionale – regional central booking office). You can also contact a hospital directly on their CUP phone number. You will need to be able to speak Italian to book the appointment or get the help of an Italian-speaking friend, as there is no translation or English-speaking operation. Keep in mind that you will not be able to choose your doctor, and the earliest publicly available appointment will be assigned to you by the operator.
If you are looking for a less expensive option, you can visit an emergency room (if it is something urgent), or you can book an appointment with a specialist at a state hospital if it is not urgent. If you visit an emergency room for a non-urgent need, be prepared to wait for a long time and pay the Ticket.
Drugstores And Pharmacies
Most pharmacies across Italy are small, family-run establishments that only deal with medical items. But generally, they can fill most prescriptions. Pharmacists in Italy tend to be efficient and knowledgeable, and often pharmacists can recommend medication without a doctor’s prescription.
Identifiable by a green cross outside the window, pharmacies generally tend to have the same operating hours as shops: 9 am – 12:30 pm and 3:30 pm – 7:30 pm.
Expats and tourists living in larger cities will easily find 24-hour pharmacies, while those living in rural areas may have more difficulty sourcing medication after hours.
Patients covered by state health services qualify for subsidized rates that reduce the cost of most medication. It is always advisable to enquire about generic medication brands for long-term prescriptions since brand names vary from country to country.
Prescription drugs are divided into three tiers according to clinical effectiveness and partly cost-effectiveness:
- Tier 1 (Classe A): includes lifesaving drugs and treatments for chronic conditions and is typically covered in all cases.
- Tier 2 (Classe C): includes drugs for all other conditions and is not covered by the SSN.
- Tier 3 (Classe H): comprises drugs that can be delivered only in a hospital setting.
Hospitals In Italy
In Italy, there is a coexistence between public, private nonprofit, and private for-profit hospitals. While generally, most private hospitals are under contract with each region, public hospitals may also engage in private activities, since for the most part, they are independent hospitals. Any public physicians who consult with private patients in public hospitals are due to pay a portion of their extra income to the hospital.
Private hospitals also operate in agreement with the Italian National Healthcare Service. This is known as Privato Convenzionato (Private with agreement), and it means they can also be accessed through the Italian Health Insurance Card (Tessera Sanitaria) under certain conditions. If they have an emergency room, it will be accessible through public healthcare, although private hospitals do not always have emergency rooms.
List of International Hospitals
- Rome American Hospital: Via Emilio Longoni, 69; +39 06 22551
- Concordia Hospital: Via delle Sette Chiese, 90; +39 06 5160 0248
- Salvator Mundi International Hospital: Viale delle Mura Gianicolensi, 67; +39 06 588961
- Ospedale Santa Maria Nuova: Piazza Santa Maria Nuova, 1; +39 055 69381
- Ospedale Pediatrico Meyer: Viale Gaetano Pieraccini, 24; +39 055 56621
- Hospital of Innocents – Piazza della Santissima Annunziata, 12; +39 055 20371
- Milan Medical Center S.R.L.: Via Angelo Mauri, 3; +39 02 4399 0401
- San Raffaele Hospital: Via Olgettina, 60; +39 02 26431
- Ospedale Niguarda Ca’ Granda- Piazza dell’Ospedale Maggiore, 3; +39 02 64441
- Ospedale Antonio Cardarelli: Via Antonio Cardarelli, 9; +39 081 747 1111
- Ospedale Evangelico Villa Betania: Via Argine, 604; +39 081 591 2111
- Note that ambulance services are not usually available for public hospitals in this area.
Health Centers & Clinics In Italy
Out-patient specialist care is generally provided by local health units or state and private accredited hospitals under contract with them. Out-patient specialist consults are typically provided by self-employed specialists contracted by the SSN. These specialists are paid an hourly fee negotiated between trade unions and the government. Payment rates for out-patient care are determined by each region, with national averages serving as a reference.
Out-patient specialists consulting public patients are not allowed to bill above the fee schedule but can consult with private patients without any limitations.
Pharmacies in Italy also operate as walk-in clinics for minor ailments and are usually the first point of medical advice for most Italians since pharmacists have a particular level of medical training.
Emergency And After-Hours Healthcare
In the event of a medical emergency in Italy, call the number: 118. However, keep in mind that those with a limited understanding of Italian may struggle to find an English-speaking operator. English speakers and those who speak other foreign languages can dial the general EU emergency number: 112.
Generally, emergency services in Italy tend to be reliable and responsive. But expats should be aware that waiting times for ambulances may be longer in rural areas. It is also a good idea that visitors and expats keep the number of their home country’s consulate or embassy on hand for emergencies.
Telehealth In Italy
Telehealth is permitted in Italy, and Italian authorities refer to it as telemedicine (telemedicina). The Italian Ministry of Health (MoH) has issued specific guidelines, which are not binding but do provide helpful guidelines on how telemedicine services should be performed in Italy – these are known as MoH Guidelines. These reflect the definition of telemedicine by the WHO, i.e. the delivery of medical services using ICT for the exchange of information in situations where patients and providers are separated by distance.
There are no specific national laws regulating telehealth services in Italy. But general Italian laws and regulations specific to healthcare services apply to telemedicine. Due to this non-specific regulation, telehealth services are more commonly used in private practice.
Tips For Tourists In Italy
Italian culture is the epitome of an effective way of life. In these cultures, people want to express their emotions openly and even spontaneously. It is welcomed and accepted to show emotion: express them immediately, openly, and passionately. Typically, Italian people are warm and gregarious, using their hands to gesture and expressing their emotions both visibly and openly. Italians also communicate a lot with their facial expressions and body language and have difficulty connecting with people who do not. For instance, people will think you are rude if you don’t smile while greeting someone or introducing yourself.
It is best not to talk about money straight away since it is a delicate issue for Italians. For many centuries, the Church called money “the devil’s poo”, and even today, there’s still something dirty about it. It’s best to spend a few minutes discussing other matters before discussing financial aspects.
In hospitals, most nurses provide medical care, i.e. take blood, administer medication, check pulses, and bring bedpans. But this is all they do. They do not assist with regular care. The hospital generally expects family members to be available for primary care and needs – such as washing and cleaning. You will have to bring your own towels, soap, etc.
Some Useful Phrases:
As with many cultures, knowing even a few phrases in the local language will go a long way. Even if you only master a few essential words, chatting to locals will be more rewarding.
- Please: per favore
- Thank you: grazie
- You’re welcome: prego
If you are a tourist in Italy and would like to speak to a medical professional connected to an international network of doctors, you can make an appointment on the Air Doctor app right now and have an in-person or virtual consultation within minutes.