Public vs Private Health Insurance in Italy – What Expats Should Know

 

Moving to Italy is exciting, but one of the first things expats need to understand is how healthcare works. Italy has a strong healthcare system, but should you rely on public healthcare (SSN) or get private insurance? 

 Public Healthcare in Italy (SSN)

Italy’s public health system is called the Servizio Sanitario Nazionale (SSN). Once registered, you receive a tessera sanitaria (health card), giving access to doctors, hospitals, and subsidized medicines.

Costs of SSN

• Employees: Public healthcare contributions are automatically deducted from your salary, usually around 10% of your gross income, partly paid by you and partly by your employer. For example, if you earn €1,500/month, roughly €150–€200 is deducted for healthcare and social security.

• Self-employed (Partita IVA): You pay INPS contributions yourself, typically 24–26% of income, which includes healthcare.

• Students, unemployed, or dependents: You can register with SSN by paying a flat annual fee of €387–€450, depending on the region.

Coverage

SSN covers general practitioner (GP) visits, emergency care, hospitalization, maternity services, pediatrics, diagnostic tests (sometimes with a small co-pay called a “ticket”), and subsidized medicines.

Limitations

• Waiting times for specialists can be long.

• Some advanced tests require co-payments.

• Limited English-speaking doctors outside major cities.

 Private Healthcare in Italy

Many expats choose private insurance to access faster services and English-speaking doctors. You can use it alone or together with SSN for comprehensive coverage.

Costs of Private Insurance

• Basic plans: €500 – €800/year, covering GP visits, emergency care, and limited hospital care.

• Standard plans: €1,000 – €1,500/year, covering specialists, diagnostics, some dental/vision care, and private hospitals.

• Comprehensive plans: €2,000 – €3,000+/year, covering hospitalization, maternity, chronic illness, and international coverage.

Costs depend on your age, pre-existing conditions, and whether you want international coverage.

Coverage

Private plans usually include specialist visits without long waiting times, emergency treatment in private hospitals, diagnostic tests (X-rays, MRI, blood tests), hospital stays in private rooms, surgery (planned or emergency), dental and vision care (depending on the plan), maternity services (in higher plans), and sometimes international travel coverage.

Limitations

• Pre-existing conditions may not be covered unless declared.

• Cosmetic procedures and alternative therapies are usually excluded.

Popular Providers

Common providers for expats include Allianz Care, Cigna Global, Generali, Axa, and UniSalute.

Public vs Private – Key Differences

For employees, SSN contributions are automatically included in your salary, so you don’t need to pay separately. Private insurance is extra, usually €1,000–€3,000 per year depending on coverage. For students or unemployed expats, SSN costs a flat €387–€450 per year, while private student plans start around €500/year.

Public healthcare covers essential services such as GP visits, hospitals, maternity, and emergencies, but waiting times can be long and most doctors speak only Italian. Private insurance allows faster access to specialists, private hospitals, and often English-speaking doctors, making it a good complement to SSN.

 Which Should Expats Choose?

• Short-term expats, au-pairs, or students: Private insurance or university-provided coverage is usually sufficient.

• Long-term workers: SSN is included in your salary. Adding private insurance ensures faster access and specialist care.

• Families: Register with SSN for basic coverage and consider private insurance for children or maternity needs.

• Tourists: Travel insurance is recommended since SSN is not available for short stays.

Final Tips

1. If you need a residence permit (permesso di soggiorno), proof of health insurance (public or private) is required.

2. Combining SSN + private insurance gives peace of mind and faster services.

3. Check if your employer or university already provides healthcare coverage.

 By understanding both public and private options, expats can make informed choices, save money, and get quality healthcare while living in Italy