Eligibility for National Health Insurance

Information on who is eligible to register with the Italian National Health Service...

EU and non-EU nationals making National Insurance contributions can register with the National Health Service (SSN) or through the local health authority (Azienda Sanitaria Locale – ASL) They are entitled to the same health care and equal treatment as Italian citizens.

EU citizens

EU citizens staying in Italy for more than three months must register with the SSN if they are:

  • An employee or self-employed
  • A family member (EU or non-EU) of an employee or self-employed person in Italy. (A family member is a spouse, dependant child under 21-years and dependant parent)
  • A family member (EU or non-EU) of an Italian citizen
  • Has a permanent residence certificate obtained after at least 5 years' residence in Italy
  • Registered as unemployed, or unemployed and enrolled in a vocational program pertaining to their profession
  • Holder of an S1 form for pensioners

Non-EU citizens

Foreign nationals required to register with the National Health Service (SSN) are those with a residence permit who are:

  • Employees
  • Self-employed
  • Enrolled in the unemployment listings

Also required to register are foreign nationals with a regular residence permit, or those renewing their permits for the following reasons:

  • Subordinate work (employee)
  • Self-employment
  • Family
  • Asylum
  • Asylum application
  • Adoption
  • Foster care
  • Citizenship
  • Religion

Dependants of foreign family members with a valid residence permit must also register.

Some foreign citizens (and their family members) resident in Italy who are not required or entitled to automatic registration with the SSN may opt to enrol voluntarily or take out a sickness, accident, and pregnancy insurance policy, valid throughout Italy, and extended to their dependent family members. A fee is required and must be paid at a local post office before visiting the ASL office.

Duration of eligibility for the employed and self-employed

Those employed or self-employed in Italy are required to enrol in the National Health Service (SSN), with the cost of coverage paid through tax contributions.

  • Those employed on a long-term basis, remain enrolled in the National Health Service for the duration of their employment
  • Those employed on a fixed-duration contract of less than one year will be eligible for coverage for the duration of the contract. For longer-term contracts, annual renewal is necessary
  • Any employed or self-employed EU national with a seasonal work contract of three months or less is eligible, though not required to register with the ASL and contribute to the National Health Service. Workers who choose to enrol will be covered for the duration of their work contract

Eligibility for retirees

Retirees who are EU citizens and are legal residents in Italy are entitled to register for state health insurance at no cost provided they have a Form S1. Form A1 should be obtained from the national health service of the former country of residence. It proves that appropriate social security taxes have been paid in the former country of residence, the person has reached the official retirement age, and that they are receiving a state pension. Retirees not in possession of a Form S1 will be required to obtain private health insurance.

From July 1 2014, UK early retirees can no longer apply for a residual S1 form entitling them to up to 30 months of UK-funded healthcare if living in another EEA country. More information and advice can be found on nhs.uk.

Eligibility for students

Foreign students who attend a course of studies in Italy can be registered with the ASL for the duration of their course. The costs of registration are borne by their home country.