Detailed guide: Healthcare for UK nationals living in Italy

UK nationals living in Italy usually access the Italian health system in one of these ways:

• registering to use the Italian state health system
• using a European Health Insurance Card (EHIC) or UK Global Health Insurance Card (GHIC) for temporary stays
• registering a UK-issued S1 form with the Italian health system

You have to pay to use parts of the healthcare system, although some parts are free.

Healthcare if you live and work in Italy

You must register as a resident to access state healthcare in Italy.

If you’re employed or self-employed you can register with the national health system for free. This is called ‘iscrizione obbligatoria’.

You can register your dependants at the same time.

If you are not working or paying social security contributions, you may be able to register with the national health system voluntarily by paying a fee each year (‘iscrizione volontaria’).

If you do not register with the Italian health system using either of the above routes, you’ll need to take out private health insurance.

If you’re registered under ‘iscrizione obbligatoria’, you may be entitled to an Italian EHIC (‘TEAM’ in Italian) for travel, including visits to the UK.

You cannot get an Italian EHIC if you’re registered voluntarily.

You may also have the right to apply for a UK S1 if you start drawing a UK State Pension.

How to register for healthcare

First, apply for a permit of stay at the immigration office and register as a resident.

If you started living in Italy before 1 January 2021, you must register as a resident.

Then register for healthcare at your local health authority (Azienda Sanitaria Locale or ASL).

You’ll need your:

• residency certificate, permit of stay or application receipt
• passport
• tax code (codice fiscale)
• evidence of your dependants, such as a translated marriage certificate or birth certificate (if you’re registering your spouse or children)

If you’re registering your family members, check with your ASL if you need to provide evidence that they’re economically dependent on you.

If you’re employed or self-employed, you’ll also need to bring evidence of your employment status, such as a work contract, to prove you’re eligible to register for free.

If you’re registering voluntarily (if you are not working, not paying social security contributions and not registering for healthcare as someone’s dependant), you’ll need to pay a fee to register.

Your ASL will tell you how much to pay and how to pay it. Show your proof of payment at your local health authority when you complete your registration.

Once you’ve registered for healthcare:

• you can register with a GP
• you’ll receive a health card (which includes your Italian EHIC if you’re registered with the obligatory scheme)
• you may be able to apply for co-payments exemption if you have a chronic condition or low income

How much you’ll pay

Once you’ve registered for healthcare, the following are free:

• emergency care
• hospital admission
• GP appointments

You’ll need to pay a co-payment, called ‘Ticket’, for:

• specialist referrals
• diagnostic tests
• prescription medicines, unless you’re registered as exempt, for example because of a chronic medical condition

If your UK employer has sent you to Italy temporarily (‘posted workers’)

A posted worker, also known as a ‘detached worker’, is someone employed or self-employed in the UK, but temporarily sent to a European Economic Area (EEA) country.

UK posted workers can access healthcare in Italy using an EHIC, GHIC or S1 form.

HMRC has a helpline for National Insurance enquiries from non-UK residents. They can answer questions about posted worker status and explain which documents you will need to get healthcare while posted.

UK-funded healthcare: using an S1 form in Italy

There’s different guidance if you have an S1 as a posted worker.

You may be entitled to state healthcare paid for by the UK if you’re living in Italy and receive a UK State Pension.

You may also be entitled to an S1 form if you’re a frontier worker (someone who works in one state and lives in another). You must contact HMRC National Insurance enquiries to find out if you’re eligible.

If you started living in Italy before 1 January 2021, you may also be entitled to an S1 if you receive some other ‘exportable benefits’.

Once you have an S1 form, you must register it with your local health authority.

This will mean you and your dependants will be entitled to healthcare in Italy on the same basis as an Italian citizen.

You’ll also be able to get:

Dependants and family members may be classified differently in Italy than the UK.

Check with the local authorities when you register your S1 form.

How to get an S1 form

If you have a UK State Pension, you must request an application form by phone from NHS Overseas Healthcare Services.

How to use an S1 form in Italy

You must register your S1 form with your local health authority. You will need your:

• passport
• tax identification number (codice fiscale)
• residency certificate, permit of stay or application receipt

Once registered, you will receive a health card, valid throughout Italy. This will mean you’re entitled to healthcare on the same basis as an Italian citizen.

You can register with a GP and apply for co-payment exemption if you qualify.

Studying in Italy

You can use an EHIC or GHIC to get medically necessary healthcare until the end of your study period in Italy.

As part of the immigration process you may have to:

• pay for private health insurance
• register voluntarily with your local health authority and pay a reduced student fee of around 150 euros for the year

Speak to your university for advice.

Getting treatment in the UK

Some former UK residents do not have to pay for NHS treatment when visiting England. This includes UK nationals who started living in the EU before 1 January 2021.

Read more about healthcare when you no longer live in the UK.

If you return to live in the UK you’ll be able to use the NHS like any other UK resident.

Read more about using the NHS when you return to live in the UK.

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