International Health Insurance in Italy for Expats

Americans can access the SSN, but only once their residency status is confirmed. To register with the SSN, you need a valid residence permit, a codice fiscale (Italian tax code) and registration with your local health authority (Azienda Sanitaria Locale or ASL). Once registered, you will receive a tessera sanitaria – an Italian health card – which is required to access public healthcare services. Before your residency is finalised, you are required to hold private health insurance. Even after joining the SSN, many Americans continue to hold private cover for faster access to specialists and English-speaking doctors.

Yes – for most visa categories, Americans are required to show proof of private health insurance as part of their visa or residency application. Your policy must be valid in Italy, provide full coverage for the duration of your stay and meet minimum coverage thresholds, which are typically between €30,000 and €60,000. This applies to the elective residency visa, the digital nomad visa, student visas and most other long-stay visa categories. ExpatInsure can help you find a plan that meets Italian visa requirements and provides comprehensive cover throughout your time in the country.

The SSN is funded through taxation and provides residents with access to GPs, specialist care, hospital treatment, prescriptions and preventive services. Most services are free or involve small co-payments known as ticket. To join the SSN, Americans must register with their local ASL office once their residency permit is confirmed. You will then choose a medico di base (family doctor) who acts as your first point of contact for most medical needs and provides referrals to specialists. Waiting times for non-urgent specialist appointments can be significant, which is one reason many Americans in Italy choose to supplement SSN access with private health insurance.

Not legally – once you are registered with the SSN you have access to public healthcare. However, many Americans in Italy choose to hold private health insurance alongside SSN registration for several reasons: to avoid waiting times for specialist appointments, to have access to English-speaking doctors, and to use private clinics and hospitals with a wider range of services. Private insurance also provides cover for services not included in the SSN such as most dental care. ExpatInsure can help you find a private plan that works alongside your SSN registration.

No. US Medicare does not provide coverage outside the United States in most circumstances. Some Medicare Advantage plans offer limited emergency cover abroad and certain Medigap policies include emergency foreign travel coverage, but these are designed for short trips rather than long-term living abroad. Americans planning to live in Italy should arrange international health insurance as a separate plan. ExpatInsure can help you find options suited to your age, health needs and length of stay in Italy.