Healthcare and health cards for foreign citizens

Foreign citizens do not all follow the same route. Someone visiting with overseas insurance, a worker moving to Italy, a student and a child may have different documents and conditions. Citizenship and length of stay alone do not determine coverage.

Healthcare coordination rules with Italy also apply to Iceland, Liechtenstein, Norway and Switzerland. Check the route with the ASL and the insurer before following the ordinary non-EU guidance. Rules on residence documents need to be assessed separately.

The EHIC does not cover private treatment outside the public system, medical repatriation or a trip organised to receive planned treatment. Planned treatment may require different authorisations and procedures, including an S2 document where applicable.

Coverage does not automatically end on day 90: what matters is that the stay remains temporary and that you retain the relevant insurance. If your EHIC is missing or expired, contact your insurer to check entitlement and obtain a Provisional Replacement Certificate where available. Have your position reassessed if you start work or move your residence permanently.

If you live in Italy but another country remains responsible for your healthcare, ask the overseas institution whether you qualify for an S1 document and how to register it with the ASL. S1 applies to specific situations: it is not automatically the document needed for every move or period of study.

Prepare an identity document, tax code and evidence of the relevant circumstances, such as employment, family relationship or S1. The ASL will specify the documents needed in your case.

Do not assume that every permit creates the same entitlement or that every non-EU citizen must pay a voluntary contribution. Your previous circumstances may remain relevant when a permit changes: ask for a mandatory registration assessment before paying a contribution.

For a non-EU student, a study-related stay does not rule out other grounds for mandatory registration, such as employment that meets the relevant requirements. Without mandatory entitlement, check the conditions for the required insurance or for voluntary registration. The reduced student contribution does not apply to everyone attending a course.

Your university's international office can help you find the right office and prepare the application; the ASL must confirm your healthcare position and any payment required.

For the non-EU voluntary registration route, the annual reference amounts are:

The reduced student and au pair contributions do not extend coverage to dependent family members; including them requires assessment under the ordinary scheme. This table does not automatically determine what an EU citizen must pay.

Voluntary registration runs by calendar year, ends on 31 December and is neither prorated nor retroactive. Registering late in the year does not, in itself, produce a proportionately reduced payment. Before paying, ask the ASL to confirm the category, amount, start date and F24 payment instructions. Payment alone does not replace completion of registration.

The registration contribution is separate from any patient contributions for treatment and applicable exemptions.

This is not an identical mandatory list for everyone. Children, protection cases and STP have specific arrangements. If a document is missing, ask the office how to access the relevant route rather than waiting until you have every item on the list.

When the application is completed, check your personal details and address. Ask what certificate you can use while waiting for the card and whether any steps remain outstanding. This guide does not give a guaranteed processing time applicable to every ASL.

For mandatory registration, the permit renewal process should not, by itself, interrupt healthcare coverage while the conditions for entitlement remain satisfied. Submit evidence of the renewal application and have your record updated. Voluntary registration also requires attention to annual renewal and the contribution due. The permit renewal receipt alone does not replace these requirements.

Mandatory registration also includes EU children present in Italy who have no healthcare coverage in Italy or their country of origin, whose parents fall within the ENI category and who have no EHIC. This differs from a child on a temporary stay with valid overseas coverage. Ask the ASL to register the appropriate position and arrange a paediatrician where applicable.

While registration is pending, care protected by Article 35 of Italy's Consolidated Immigration Act remains available. Have applicable patient contributions and exemptions checked: this guide does not assume that applying for asylum alone creates a blanket exemption for every service.

Ask the ASL or healthcare facility where the code is issued. It lasts six months, is renewable and is recognised across Italy. The applicant's declared personal details are recorded for issue: lack of an identity document must not be presented as a general prohibition on accessing STP.

Accessing healthcare facilities does not result in reporting to the authorities solely because of irregular immigration status, except where mandatory medical reporting applies under the same conditions as for Italian citizens. This does not mean that every service is anonymous or always free. Protected care is provided without charge to people with insufficient resources, subject to any patient contributions applicable under the same conditions as for Italian citizens. If you lack sufficient resources, ask how to declare financial hardship and which patient contributions or exemptions apply.

There is no single ENI duration or procedure in this guide that applies throughout Italy. Ask the ASL whether the arrangement is available, where to apply, what declarations are needed and how renewal, patient contributions and exemptions work. For a child, first ask for an assessment under the specific protections described above.

If you are registered but the card has not arrived, ask the ASL which certificate to use. Before travelling, check EHIC entitlement separately: some healthcare or registration categories do not include an Italian EHIC.