Italy's public health service helps deliver some of the longest lives in Europe — 85.7 years for women. Workers join it free. Retirees on the elective residence visa buy in at a minimum €2,000 a year. Here's how it works in 2026.
Figures verified 8 July 2026The Servizio Sanitario Nazionale is a universal public system run region by region — Lombardy's service and Calabria's are funded and managed differently, and quality varies with geography. Once registered at your local health authority (ASL), you're assigned a family doctor (medico di base), whose visits are free. Specialists, diagnostics, and prescriptions carry regional copays called "ticket" — typically tens of euros, not hundreds. Emergency care treats everyone.
The math for a retired couple: worst case, about €5,578 a year buys both of you into the SSN. Compare that with US private coverage before Medicare kicks in, and it's still cheap — but budget for it, and remember Medicare doesn't cover you in Italy.
You need a private policy at the visa stage regardless (€30,000 minimum coverage, 12 months, Schengen-wide). After arrival, many expats keep a domestic private policy — roughly €800–2,000 per person per year in your 60s, indicative — for faster specialist access and private hospitals, especially in the south, where public waiting lists run longer. Check enrolment age limits before you rely on buying it later.
The voluntary-contribution calculation, the payment slip, and the enrolment paperwork — start to finish.
What the regional quality scores actually show, and how expats plan around them.
Real quotes, age caps at enrolment, and what Italian private policies do and don't cover.
Most visas require proof of cover before you apply. We'll match you with an expat health insurance specialist we've independently vetted for Italy. Free, no obligation.