The Servizio Sanitario Nazionale (SSN) manages the Italian National Health Insurance system with funding through direct taxation (IRPED/IRAP) alongside indirect taxation (VAT/taxes on petrol etc.). The Azienda Sanitaria Locale (ASL) handles registration on a local level, using health cards (Tessera Sanitaria) and national insurance numbers. This allows the holder to low or no-cost health care treatment.
Hospital services are provided free with a 75% reduction given on the cost of outpatient treatment and some dental treatments. The address of the local ASL office is displayed outside nearby pharmacies. The larger ASL regional offices usually have their own website alongside online services with regional contact details.
 Eligibility for Italian National Health Insurance
EU and non-EU nationals who make National Insurance contributions can register with the SSN (Italian National Health Insurance) and claim entitlement to the same health care and the same treatment as Italian nationals/citizens.
EU citizens residing within Italy for longer than three months have to register with the Italian National Health Insurance, if they are classed as an employee or a self-employed individual, a family member (whether EU or non-EU) of an Italian national, a holder of an S1 form (having replaced the E106, E109, E120 and E121 forms) or:
- A family member of an employee or self-employed individual within Italian borders (being a spouse, dependant person under the age of 21 or a dependant parent).
- If you hold a permanent residence certificate obtained after a minimum of 5 years residence in Italy.
- If you are registered as unemployed.
- If you are unemployed and enrolled in a vocational program, especially if pertaining to your intended or continued profession.
Non-EU citizens with a residence permit are obliged to register with the SSN (Italian National Health Insurance), especially if you are an employee, self-employed or enrolled in the listings of unemployment.
Foreign nationals with a regular residence permit or foreign nationals renewing their permits for Self-Employment, Subordinate (employee) Work, Family Reasons, Seeking Asylum, Adoption, Foster Care, Religion or Citizenship also have to register with the Italian National Health Insurance system. Dependants of foreign family members who hold a valid residence permit are also obliged to register with the Italian National Health Service.
Certain foreign citizens, with their immediate family members, resident in Italy who aren’t entitled to automatic healthcare or required to register with the SSN can opt to voluntarily enrol. They can also opt to take out a sickness, accident and pregnancy insurance policy, valid throughout all of Italy with the cover extension covering dependant members of the family. A payment is required and has to be paid at the nearest post office before going to the local ASL office.
For more information on Italian Social Security, Italian Payroll, Working in Italy or Contracting in Europe visit the Euro Accountancy & Finance Services website.
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