Healthcare in Italy 2025

Overview of Italy’s healthcare system

Servizio Sanitario Nazionale (SSN) is a tax-funded national health service that guarantees universal coverage to citizens, legal residents, and — through European reciprocal agreements — most EU visitors. Core services such as primary care, inpatient treatment, maternity care, and preventive programmes are delivered free of charge at the point of use – see Italian Ministry of Health – “Strengths of the Italian National Health Service”.

Although the SSN sets minimum “essential levels of care” (LEA) for the whole country, delivery is highly decentralised. Each of Italy’s 20 regions (plus the autonomous provinces of Trentino-Alto Adige/Südtirol) manages its own Local Health Authorities (ASL) and public hospital trusts (Aziende Ospedaliere), deciding on budgets, staffing, and waiting-list policies. This regional autonomy explains why waiting times, co-pays, and even vaccine schedules can differ between, say, Lombardy and Sicily.

Public spending covers roughly three-quarters of all health expenditure, with private out-of-pocket payments and voluntary insurance making up the rest. In 2023 the country spent about 9 % of GDP — €176 billion on health, a share still below the EU average but rising after the COVID-19 surge in funding. Per-capita outlays were €2 800 in 2021 (latest consolidated data), some 30 % lower than the EU mean.

Funding & regional structure

Revenue sources. The SSN is financed primarily through national and regional taxes (personal income, corporate, and value-added taxes). Rome allocates a global health fund to each region via a needs-based formula; regions can top this up with their own surtaxes or earmarked levies (source: OECD & EU – Italy: Country Health Profile 2023 (PDF)).
Co-payments (ticket sanitario). While GP visits and hospital stays are free, most outpatient specialist appointments, diagnostic imaging, and non-exempt prescriptions carry a ticket of €15–€45, capped annually. Exemptions apply for children under 6, adults over 65 on low incomes, pregnancy care, and 59 nationally defined chronic diseases (source: ItaliaHello – “The healthcare ticket: when and how to pay”).
Purchaser–provider split. ASLs act as purchasers, contracting public hospitals and accredited private clinics. Regions that overspend face recovery plans and temporary central oversight — a mechanism introduced after repeated deficits in Campania, Calabria, and Lazio (source: Bordignon M. et al., 2020).
Digital budgets. Since 2024 every region must allocate at least 2 % of its health budget to e-health infrastructure (electronic prescription, Fascicolo Sanitario Elettronico, tele-monitoring). Implementation speed still varies widely, with Emilia-Romagna and Veneto topping digital-readiness indices (source: Budget Law 2025: News for the healthcare sector).

In short, Italy combines a Beveridge-style universal system with strong regional autonomy and modest co-pays. Understanding who controls funding and how co-payments work will help you anticipate real-world costs — especially if you move between regions or rely on private providers when waiting lists grow.

Who can access care in Italy

Italy applies a layered access model: your route depends on legal status, country of origin and length of stay. (See the flow-chart at the end of the article to find your path.)

Citizens foreign residents

Anyone legally resident (Italian or foreign) can register with the Local Health Authority (ASL) that covers their address.

Registration is free for employees and the self-employed.
Voluntary registration for students, au-pairs and dependants requires an annual fee (from €700 in 2024) and gives you a Tessera Sanitaria that doubles as your EU health-insurance card. Sources: Italian Citizenship Assistance, 2024; Expats Living in Rome, 2025.

EU / EEA / Swiss visitors

If you are visiting Italy temporarily and hold a valid European Health Insurance Card (EHIC), you are entitled to all medically necessary public care on the same terms as an Italian resident (source: European Commission, EHIC Factsheet 2025). Remember the EHIC is not a replacement for travel insurance and never covers private clinics or repatriation (EC Summer Travel note, 2025).

UK visitors (post-Brexit)

UK residents should travel with the Global Health Insurance Card (GHIC), which grants the same “medically necessary” cover inside Italian public facilities as the old EHIC. The UK Government stresses that a GHIC “may not cover all health costs and is not a substitute for travel insurance.” (Source: UK Department of Health & Social Care, Jan 2025)

Non-EU tourists

Travellers from outside the EU/EEA/UK must pay out of pocket or claim on private travel insurance for both public and private services. Scheduled treatment (e.g. planned surgery) is possible only with a specific medical-treatment visa (permesso di soggiorno per cure mediche).

Undocumented migrants asylum seekers

People without a valid residence permit can still obtain urgent or otherwise essential care by requesting a temporary STP code (Straniero Temporaneamente Presente) from any ASL or emergency department. The code is valid nationwide for six months and attracts the same co-pay rules as for residents (source: Salute Lazio guidance, 2025).

Healthcare costs in Italy 2025: ticket sanitario co-pays

Italy’s tax-funded SSN keeps most care free, but three everyday items still trigger a ticket sanitario (co-payment):

Specialist visit or diagnostic test — €15 to €36.15 nationwide. Five regions apply a €10 surcharge, so the absolute ceiling is €46 — see the Nomenclatore tariffario by the Italian Ministry of Health, 2025.
Non-urgent emergency-room visit (white code) — €25. The fee applies only if triage confirms the case is non-urgent (AUSL Romagna, 2025).
Prescription medicines, class A — €0 to €4 per pack, rate set by each region; classes B & C (mostly OTC) are never reimbursed (ItaliaHello ticket guide, 2024).

Out-of-pocket tip: co-payments account for < 3 % of total SSN funding, yet Italians still spend about €550 per person per year privately, mainly on faster specialist care and class C drugs (WHO Health-Systems Monitor, 2025).

Prefer to skip queues? Private clinics charge roughly €50–€70 for a GP visit and €80–€150 for a specialist. Oladoctor online GP, from €39, lets you book in English and avoid regional surcharges.

How to pay less (or nothing)

Ask for a GP referral. With a valid referral your test is coded as appropriate and the ticket stays at the capped rate.
Check your exemption code (E01/E02 = low income, E11 = pregnancy, etc.). Codes are issued by the ASL and zero out co-pays on related services.
Keep the scontrino parlante. Pharmacy receipts showing your tax code let you deduct class B/C drug costs on your annual return.

## Digital healthcare & online care in Italy 2025

Italy is racing toward a digital-by-default health service, and that matters whether you are a resident, a frequent traveller or just searching for an online doctor in Italy while on holiday.

Electronic prescriptions are now the norm

Since 1 January 2025 every prescription — public or private — must be issued digitally. Doctors generate a QR code that pharmacies scan in seconds; the paper slip is only a courtesy copy.
This nationwide switch, set in the Budget Law 2025, means you can request an e-prescription repeat without leaving home.

Why it helps: fewer GP visits, instant insurer refunds, automatic upload to your health record.

Fascicolo Sanitario Elettronico 2.0 (national electronic health record)

All regions now use FSE 2.0, funded by the EU Recovery Plan. Lab results, vaccine passes and every new e-prescription land here automatically.

Log-in with SPID or your electronic ID card (CIE).
Emergency teams see your file when you dial 112.
Opt-out for historical data closed on 30 June 2024; new documents are added by default.

Remote care is part of the NHS

National guidelines (Decree 21 Sept 2022) fund video consultations and connected-device home monitoring for at least 200 000 chronic-care patients by end-2025.

Video visits count as official medical acts — doctors can issue e-prescriptions and sick notes.
Chronic-disease patients receive monitoring kits free of charge.
Sessions use end-to-end encryption on EU-based servers.

Need help fast? Oladoctor online GP for €39 lets you book an express consultation and get an e-prescription added straight to your FSE within minutes.

Why this matters for tourists and short-term visitors

The same QR code works nationwide, so you can fill a prescription in Milan even if it was issued in Rome.
EHIC/GHIC holders get “medically necessary” care coded directly into FSE, avoiding paperwork.
Digital files mean private insurers process claims quicker — handy on a two-week trip.

## Prescriptions & pharmacies in Italy — what to know in 2025

Italy’s ricetta dematerializzata (digital prescription) and a dense network of farmacie make getting medicine straightforward—once you know the rules.

How the e-prescription works

Your doctor creates a QR code plus a 15-digit electronic number (NRE). Show either at any pharmacy nationwide; the system auto-checks exemptions and price caps.
Validity: 30 days for most drugs; up to 12 months for chronic-disease repeats.
A copy lands in your FSE 2.0 record, so you can re-download it if you lose the print-out.

What a pack really costs

Class A medicines are reimbursed; you pay the regional co-pay (max €4) or €0 if exempt (AIFA class A list).
Class C (OTC, some Rx) is 100 % out-of-pocket.
If you want a branded drug that costs more than the reference price, you pay the difference yourself (Pricing Reimbursement Law 2024).

Generics (farmaci equivalenti) save money

The pharmacist will offer the lowest-price equivalent unless your doctor ticks “non-substitutable.” Generics pass the same quality checks as brands and appear on AIFA’s Transparency List, updated monthly (AIFA generics FAQ).

Finding a pharmacy

Look for the green cross sign; most neighbourhood stores open 08:30–12:30, 15:30–19:30.
After hours, follow the door notice to the nearest farmacia di turno (on-call pharmacy). They may charge an extra €4 day / €10 night fee on top of the ticket (Mama Loves Italy, 2022).
In emergencies dial 112 (or 118 for medical only); paramedics can upload urgent scripts straight into FSE—see the Emergency Services section.

Tourist checklist

Bring your QR code plus passport; some pharmacies ask for ID when dispensing antibiotics or codeine.
Keep the box and scontrino parlante receipt — needed for travel-insurance refunds and airport customs.
Most common painkillers are OTC, but larger bottles of ibuprofen or any antibiotic require the digital script.

Emergency numbers & ER costs in Italy 2025

If you ever need to call an ambulance in Italy, remember these numbers, waiting-time rules and fees.

1. Dial the right number

112 – single European emergency number, active country-wide; operators route calls to police, fire or medical (see EU Commission on 112 (2025)).
118 – direct medical dispatch; still works everywhere, but the Italian Ministry of Health recommends 112 for tourists (MoH 118 overview).

Tip: turn on AML (Advanced Mobile Location) on Android/iOS; 112 pinpoints you within 30 seconds.

2. How triage colours affect your wait

Italian ERs assign one of four colours: Red (life-threatening), Yellow (serious), Green (minor urgent) and White (non-urgent). Targets and colour rules appear in the National Triage Guidelines 2023.
White code fee: you may pay a flat €25 ticket and wait the longest.

3. Ambulance & ER prices in 2025

Public 118/112 ambulance – free for red/yellow cases; green or white can be billed €26–€55 (e.g. Lombardy tariff 2025).
ER visit, white code – nationwide ticket €25; details under co-pay rules.
Private ambulance – from €90 + €1/km, always out-of-pocket.

4. Guardia Medica (after-hours GP)

For night-time aches and mild illnesses, call the local Guardia Medica (Continuità Assistenziale). The visit is free for residents and EHIC/GHIC tourists; any medicines follow standard e-prescription rules. Need rapid online advice instead? Try an Oladoctor online GP.

Register each child with a pediatra di libera scelta; visits, vaccines and growth checks are free under the SSN. Minors keep a paediatrician until their 14th birthday, then switch to a family GP (source: Expatica).
The national immunisation schedule (hexavalent, MMRV, HPV) is zero-cost; bring your Tessera Sanitaria to every appointment.
Need after-hours advice? Call the local Guardia Medica pediatrica or book an Oladoctor pediatrician online; prescriptions arrive as a QR code ready for any pharmacy.

Mental-health services & the bonus psicologo

Ticket: first visit often free; follow-ups cost the standard outpatient fee unless you hold an exemption.
Bonus Psicologo 2025: up to €1 500 towards private sessions if your ISEE €50 000 (apply on the INPS portal each July) (source: Expatica).
For medication, remember: only psychiatrists — or any medical doctor — can issue an e-prescription, not psychologists. See our guide “Psychiatrist vs psychologist” for details.

Chronic diseases & pregnancy exemptions

If you have one of 59 chronic conditions (e.g. diabetes, asthma, Crohn’s) or you’re pregnant, the SSN waives most co-pays: blood tests, scans and essential drugs are €0. Apply for your E-code at the ASL with a specialist’s certificate; once it’s in your file, the pharmacy system auto-applies full exemption.
Pregnancy care includes ultrasounds at 12, 20 and 32 weeks and standard lab work. Extra tests follow normal ticket rules unless medically justified (source: Expatica).
Rare-disease patients get similar coverage under the R-code regime. Check the full LEA list on the Ministry of Health site.

## First-Week healthcare checklist for new residents in Italy

Save or print this healthcare checklist for Italy—six things to do in your first 7 days.

Register with your ASL and choose a medico di base (family doctor). Bring proof of residence and your tax code—details in the Overview section.
Apply for the Tessera Sanitaria. The blue card proves NHS cover and doubles as your European Health Insurance Card (EHIC).
Activate SPID or your CIE PIN so you can log in to FSE 2.0 and view lab results or e-prescriptions online—see Digital Healthcare.
Check for ticket exemptions. Ask whether you qualify for an E-code (low income, chronic disease, pregnancy) to reduce or zero-out co-pays; full rules in the co-pay section.
Save the emergency numbers 112 and 118 in your phone and enable AML location-sharing.
Bookmark an English-speaking online doctor. For after-hours issues, the Oladoctor GP online service offers same-day video visits and e-prescriptions from €39.

Quick Medical Checklist for Tourists in Italy

Follow this Italy tourist medical checklist to avoid surprises on a short trip.

Pack or download your EHIC/GHIC (EU/UK travellers) or carry proof of private travel insurance if you’re from outside Europe.
Add 112 to favourites—it’s the EU-wide emergency number; 118 still works for medical-only calls (fees in the Emergency section).
Request digital copies of regular prescriptions before you travel; Italian pharmacies accept QR codes in English.
Know your co-pay risk. A non-urgent ER visit (white code) costs €25; details in the co-pay section.
Locate a 24-hour farmacia near your accommodation; look for the green cross and check the after-hours surcharge (€4 day / €10 night).
Plan for quick medical advice. Need a doctor who speaks English? Book an Oladoctor GP online consultation—available nationwide, prescriptions go straight to the nearest pharmacy.

Healthcare in Italy 2025: complete guide