Those who are moving to Italyshould not only focus on housing, taxes, and language, as medical care is also a central concern. Even though Italy is part of the EU and German citizens are generally free to enter and remain, the healthcare system works differently than in Germany. Without proper preparation, accessing health insurance can become complicated.
How the healthcare system in Italy is organized
Italy operates the Servizio Sanitario Nazionale (SSN), a tax-funded healthcare system that provides basic medical care to all permanent residents. The structure is state-run, but implementation falls to the individual regions. As a result, services, waiting times, and administrative procedures can vary considerably. Those who live in Italy permanently are generally entitled to medical care within this system.
What the "ticket" system means for insured individuals
Although many services are covered by the public system, healthcare is not entirely free of charge. Specialist appointments, diagnostics, and prescription medications are subject to co-payments in the form of so-called "tickets". The amount depends on income, region, and type of service. In certain cases, such as chronic illnesses or low income, exemptions are available.
Access to the SSN: Who is covered and how?
Employees are automatically enrolled in the system as soon as they begin socially insured work in Italy. The requirements typically include a valid tax code (codice fiscale), proof of registered residence, and proof of employment. A Tessera Sanitaria is then issued, which grants access to medical services.
German retirees can gain access to the Italian systemthrough the S1 form provided by their German health insurer. The Italian healthcare costs are then covered by the German health insurance provider.
Those who are not receiving a pension and are not employed can voluntarily register with the SSN. In this case, an annual Flat rate to be paid, which is based on income and can vary depending on the region. How the voluntary enrollment process works is described in this practical overview.
Important: Residence registration instead of a residence permit
As EU citizens, Germans do not need a residence permit but simply need to register their residence with the local municipality if they stay in Italy for more than 90 days. In many regions, this registration is a prerequisite for enrolling in the SSN. In practice, however, it can happen that local authorities set contradictory requirements such as requiring proof of residence before health insurance enrollment, or vice versa. Regional differences in administrative practice occasionally cause confusion here.
Private health insurance plays a supplementary role in Italy. It does not replace public coverage, but can offer advantages such as shorter waiting times, better facilities, or language support . Many expats therefore use a combination of public coverage and private supplemental protection, especially when they do not want to go without a certain standard of care. Recommended combinations and policies help with orientation.
Solid basic medical care in Italy
The Italian healthcare system offers solid basic medical care, but differs structurally from the German model in significant ways. Those moving to Italy should clarify early on whether they are automatically covered or need to enroll voluntarily, and whether the S1 form is an option. With good preparation , healthcare in the new home country can be secured without unexpected bureaucratic hurdles.
Tip for expats: Private international health insurance providers such as
👉 Ottonovaoffer special rates for Germans living in Italy
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