The right to healthcare in Italy is guaranteed by Art. 32 of the Italian Constitution that states: “The Italian Republic in the interest of the common good safeguards the individual’s fundamental right to health, and guarantees free treatment to the destitute – those who live in absolute poverty, that is they have no means of support.”
This means that all persons living on Italian territory, regardless of their citizenship, judicial standing or economic capacity, have the right to receive basic medical care. This is a fundamental right applicable to all.
The National Health Service (Servizio Sanitario Nazionale, SSN) was created to guarantee this right. The SSN is a public system that delivers healthcare throughout Italy. The Local Health Departments (ASL,) together with independent hospitals, are the infrastructures that are responsible for the delivery of healthcare to the public at the local level. Their organization and structure can vary from region to region. For this reason it is essential that one register at the Local Health Department (ASL) in the city where one resides..
N.B. The term ASL, meaning Local Health Department, is the most commonly used. You will find it in Campania, Lazio and Sardinia. In other Italian regions a different terminology is employed.
For example:
- In Lombardy the term is ATS (Agency for the Promotion of Health)
- In Lombardy you will also find ASST (Local Department of Health and Social Services)
- In Sicily the term adopted is ASP, Provincial Health Department;
- In Veneto there are the ULSS, Local Units for Health and Social Services;
In Tuscany, Emilia-Romagna and Umbria the term used is Azienda USL, Local Health Department Units.
To receive the necessary healthcare, you must register with the National Health Service (SSN) and obtain a health insurance card (or STP card that provides foreign citizens in Italy, with or without a valid residence permit, with the code necessary to obtain medical treatment.) Each member of a family unit must have his/her health insurance or STP card.
The health insurance card will be issued as soon as you have registered with the National Health System; it will last as long as the residence permit, and will be automatically renewed after you have renewed the permit. What does it do?
- It guarantees free medical visits.
- It allows the purchase of medication with the proper prescription.
- It allows laboratory tests, visits at day hospital, specialized visits, at-home visits, vaccinations, blood tests, x-rays, ecographies.)
- It enables treatment in hospitals.
- And treatment in other European Union countries. In this case you must ask the local health department (ASL) to give you an International Health Insurance Card or EIHC card.
If you do not have a valid residence permit, you can request an STP (Foreigner Temporarily Present) card at the appropriate local health department information desk (Consult the link below to find the desk nearest you: https://www.jumamap.it/map/litemap.php?ser=san.) The STP card, with a temporary fiscal code, allows you to receive basic and urgent medical treatment. The card, issued by the local health department (ASL,) is free and lasts six months. It can be renewed after the six months have expired even though you have not yet regularized your status.
Registering with the National Health Service is mandatory for those who hold a residence permit for the following reasons:
- Employment,
- Self-employment (attesa lavoro),
- Family reasons.
- Asylum,
- Special Cases,
- Humanitarian protection,
- Medical treatment in case of an illness so severe that adequate treatment cannot be delivered in the country of origin,
- Request of asylum. Asylum seekers are exempt from paying for their medical treatment during the first six months after their arrival in Italy.
- Waiting to be adopted,
- Custody,
- Granting of citizenship.
Unaccompanied minors are considered vulnerable, and registering with the National Health Service is mandatory and free. Even if the minor is waiting for her/his residence permit, he/she can obtain medical treatment.
If your residence permit does not fall in any of these categories (for example: education or work as an au pair.) in case of illness, accidents or pregnancy you must be covered. Therefore you can:
- Take out a private insurance policy (Italian or if foreign it must be valid in Italy;)
- Voluntarily register with the National Health Service (SSN) and pay an annual fee. Check to see if there have been changes in this policy or if possible subsidies are available.
Beware! The residence permit for elective residence, often granted to foreigners with disability, does not give you the right to free registration with the SSN. The holders of this permit might not be able to get “basic or urgent” healthcare, guaranteed to those foreigners without a residence permit. If you find yourself in this situation, you need alternative coverage via insurance or voluntary registration where that is possible.
To get further information, please call the free number, 800 999 0977, NABILA Help Desk for foreign citizens with disability or vulnerability.
See the Juma Map page: https://www.jumamap.it/it/disabilita/)
If you are in Italy temporarily or without a residence permit:
- And are a foreign citizen without a residence permit and come for a country outside the EU (for example: USA, Gambia, Afghanistan.) you are still entitled to receive basic and urgent care. Public hospitals have the duty to treat you even if you are unable to pay..
To get the proper care, either ask for the STP card (Foreigner Temporarily Present,) another type of documentation (temporary fiscal code) that allows one to get free urgent medical care, the type that cannot be postponed without jeopardizing life or causing harm to a person’s health, and basic care, the kind of medical treatments, diagnostic and therapeutic, for non serious pathologies, which in the short run are not life threatening but overtime could cause major harm to a person’s existence.
Some examples of whom can get the STP card:
Any person who needs medical treatment but whose status in Italy is not defined. For example:
- Tourists who are in Italy for a brief spell and need urgent medical care.
- Asylum seekers waiting for their residence permit.
- In some regions unaccompanied foreign minors recently arrived in Italy and are awaiting their residence permit.
- Foreigners with irregular status are eligible to receive emergency medical care.
If an individual arrives from outside Europe and has a residence permit for less than six months, he/she will receive a temporary paper medical insurance card that makes it possible to get medical treatment, but only for the residence permit’s length of time
A general practitioner (GP,) or family doctor, is the person who delivers everyday medical care and, if necessary, refers you to the specialized treatment that you need.
What Does a General Practitioner Do?
- Treats common pathologies (flue, headache, fever, etc.)
- Prescribes the necessary drugs and, if necessary, refers to a specialist.
- Signs medical certificates.
If you have light symptoms, instead of going directly to a hospital you must consult a GP first. The services of a GP are completely free.
After having registered with the National Health Service (SSN,) you either can select a GP or one will be assigned to you. In Italy to select a general practitioner you have to go to the local health department (ASL) in the city where you reside. The Department will provide you with a list of the practitioners available in your area. YOU will have to select one (the Department CANNOT do so for you.)
You can call his/her office or go in person during visiting hours. Agree on a date and hour with the GP. Some doctors will receive patients without an appointment during the office’s established visiting hours.
N.B. If you don’t speak Italian well, you are entitled to bring an interpreter to the visit. Communicating clearly with a doctor is important: having an interpreter can help to understand one another better and, therefore, result in a more accurate treatment.
Registering with the National Health Service (SSN) can prove complicated for someone who arrives from another country, especially due to the problems tied to the documentation needed and bureaucratic procedures. One key area of concern are those people who are waiting for their residence permit. Specifically:
- Who has applied for asylum often has only a voucher (a receipt that proves they have petitioned for protection,) but they are not yet in possession of a residence permit.
- Without a residence permit it is difficult to get a permanent fiscal code necessary to register with the National Health Service.
- Some asylum seekers are given a numerical fiscal code that is not always accepted by the national health system.
Possible Solution: Immigration lawyers suggest that one consider the voucher an ID valid to ask for a fiscal code or demand that a temporary fiscal code be assigned to you (i.e. the STP card for Foreigners Temporarily Present.)
Consult a lawyer or legal assistance service:
https://www.jumamap.it/map/litemap.php?ser=leg
Initially unaccompanied foreign minors can also encounter problems due to the wait for an official ID. Nevertheless it is essential to know that they have the right to register. Registration with the National Health System is free and mandatory. They are entitled to receive medical care like every other minor in Italy.
- You go to a GP for minor health problems such as headaches, fever and other light symptoms.) The GP can prescribe lab tests or refer you to a specialist.
- If you have a problem when the GP is not available, you must consult the doctor on call who is responsible for medical care at night, during the weekend or on holidays.
- The Emergency Room (ER) is to be used only in case of serious problems such as breathing difficulties, severe trauma, intense pain in the chest, etc.
Pay attention to the Emergency Room’s tags:
When you arrive at the ER, a nurse will evaluate your case and assign a color tag.
- Red: It indicates a life threatening condition that requires immediate attention.
- Yellow: It indicates a serious problem and entails quick medical attention.
- Green: The problem is less serious, you will have to wait to get treated.
- White: This is not an emergency situation therefore there will be a long wait. In this case the individual can be redirected to their GP.
If it’s not an emergency situation, you might wait many hours. This is why it is important to first consult your GP or the doctor on call prior to going to the ER.
If the GP thinks that the medical problem needs a deeper look, he/she can refer a patient to a specialist, that is a doctor who is expert in a particular field of medicine (Oculist for the eyes, Physiatrist for the muscles, Cardiologist for the heart, etc.)
At times to arrive at a correct diagnosis, the specialist prescribes diagnostic tests such as XRays or MRI. You should know that the number of people who need these types of tests is very high, therefore the wait can be protracted.
How are priorities established?
The GP attaches a priority label to the request for a specialist visit:
- U (Urgent;) Must be seen within a few days.
- B (Short:) Must be seen within 10 days.
- D (Deferrable:) Visit must happen within 30 – 60 days.
- P (Programmable:) Not urgent, it can wait.
If the wait protracts for too long, one can:
- Verify the situation in other hospitals in nearby cities where the waiting lists could be shorter.
- Ask if appointments are available through the private health service with the payment of a fee (if available.)
- Go to a healthcare assistance center to signal the emergency and attempt to hasten the visit.
If you don’t understand Italian well, advise medical personnel of the situation before the visit. This way they will be able to request the presence of an interpreter during the appointment.
A pediatrician is a doctor who is responsible for the health of children and young adults.
He/she follows their development, treats their illnesses and ailments, prescribes the appropriate drugs, delivers precautionary vaccines and gives advice on an infant’s health needs (problems with nutrition, sleep, behavior…) In Italy each child has the right to be followed by a pediatrician.
In Italy to find a pediatrician, you can consult the list of those who are available in your area. The list is found at your local Health Department (ASL.) Or you can ask friends, relatives or neighbors who live in the same area..
- Call 112, the free national emergency number.
- Go to the pediatric emergency room at the nearest hospital.
- Explain in simple terms the symptoms or the emergency to hospital personnel.
- Keep your pediatrician’s number close at hand.
Patients have a right to:
- Be informed of their medical condition,
- Choose whether or not to accept a treatment (informed consent,)
- Keep one’s medical information private,
- Read one’s medical chart.
For additional information, ask your local health department or patient advocacy group.
Examine the list of health services available:
https://www.jumamap.it/map/litemap.php?ser=san
This FAQ was developed by ARCI starting from the text of Infomigranti.
NABILA is a Help Desk for migrant citizens with disabilities and vulnerabilities that provides socio-legal assistance, language mediation and orientation to services on the national territory.
Through the toll-free helpline 800 999 977, NABILA provides:
Remote listening and support
Guidance to local services through JUMA MAP
The possibility to request in-person appointments (at the Immigration Office of ARCI National)
This project is funded by the Presidency of the Council of Ministers with the eight per thousand IRPEF contribution.
