Doctors who assists the patient

With regard to the care which could  become necessary when you are temporarily in Italy, the relevant legislation is represented mainly by the Social Security Regulations (EC). This system applies to situation of emergency or urgent need of care, as well as to treatments  necessary but not urgent, that should be continued  during the period of stay in Italy, so that the insured should not be obliged to return to their country to get the necessary treatments.

In these cases, the  services provided by care centres and professionals, both public or private contracted with the Italian National Health Service (SSN), are provided under the same conditions as for people registered to the Italian National Health Service, and will be paid directly by the  Health system of affiliation to the Italian National Health Service.

To get the assistance in this way (direct assistance) it is necessary that the patient shows  the European Health Insurance Card (EHIC) or its provisional replacement certificate to the health care providers, along with an identity document.

The European Health Insurance Card (EHIC) in Italy is called Tessera Europea di Assicurazione Malattia (TEAM)

 

Restrictions on the use of EHIC

  • The card does not cover health care costs of planned treatments
  • The card does not cover private health care

If you are insured in a European Union Member State or in one of the other States of the European Economic Area (Iceland, Liechtenstein, Norway) or in Switzerland, and, during a temporary stay in Italy you need  medically necessary health treatments, you are entitled to obtain the assistance in a direct way, at public and private contracted with the Italian National Health Service (SSN) health care providers, exhibiting the European Health Insurance Card - EHIC (or its provisional replacement certificate).

Direct assistance means that the health treatments are generally provided free of charge, subject to payment of a co-payment fee (ticket) that remains at your expense. The amount of the co-payment is set by each Region.

To get these benefits, you can go directly to the health care provider (hospital, doctor, etc. ..) and exhibit your EHIC (or its provisional replacement certificate), together with an identity document, as the only condition for getting the right to obtain healthcare services under the same rules applicable to the Italian insured citizens.

The services available for emergency care

Ambulance service

For accidents and emergencies, the Emergency Medical Service is available. This service is obtainable by calling the telephone number 118 (transport by ambulance to the hospital, transport by helicopter for  primary surgery).
This service is normally free of charge upon presentation of the European Health Insurance Card (EHIC) or its provisional replacement certificate, subject eventually to the co-payment of the ticket.

Hospital treatment and emergency care

Hospitalization in public hospitals (also private if contracted with SSN) may occur, either through the Emergency Room, exhibiting directly the European Health Insurance Card (EHIC) or its provisional replacement certificate, or through the prescription  by doctors of SSN.

For some emergency care, identified by a special code (triage),  a co-payment is requested (ticket).
The hospital stay is exempt from ticket; however,  if you want more hotel-like comfort, you can request a room reserved, subject to payment.

The Doctor on Duty – Continuous Assistance Service

On Saturdays, Sundays, and during the night (from 20 to 8 am) every day, for emergencies, it is in operation all  over the Italian territory the Service (free of charge) of Doctor on Duty for night service.

It is possible to ask for the telephone number of this service to the Local Health Authority (usually called ASL, but also USL, AUSL or USSL).  It can be useful also to ask for help.

During the summer, in the regions with high tourist flow, it is activated the service of Doctors on Duty for tourists.  For organizational reasons, this service requires the payment of the visit by all tourists. The fee can be different in every Region. In this case, the amount anticipated by the insured (and the cost of any other health service or treatment),  is fully refundable by presenting receipts of payment to the health institution of affiliation.

General practitioners and paediatricians contracted with the Italian National Health Service

The general practitioners and paediatricians, agreed upon the Italian National Health Service (SSN) will make the medical examination according to the direct assistance  procedures and may prescribe specialist examinations and treatments , laboratory tests, diagnostic tests, medicines or hospitalization, upon presentation of the European Health Insurance Card (EHIC) or its provisional replacement certificate.

We recommend contacting the Local Health Authority (ASL or USL , AUSL , USSL) for getting the list of general practitioners and paediatricians agreed upon the SSN.
From Monday to Friday visits by these general practitioners and paediatricians do not require any payment by the patient (i.e. they are exempt from the ticket).
The opening hours of the ambulatory  is fixed by each physician.


Medicines prescribed by doctors of the SSN
For drugs there is a classification based on their essentiality for health:

  • The essential medicines (or life savers) and those for chronic diseases prescribed by a General Practitioner  (or Paediatrician)  are entirely free of charge to the patient by presenting a SSN prescription, unless the specific region does not charge a  co-payment (ticket). These drugs are classified in group A
  • Medicines not essential, i.e.  for diseases considered minor, have to be entirely paid by the patient. These drugs are classified in group C and are divided into:
    1. drugs requiring  a prescription;
    2. drugs not requiring prescription, which include the over the counter products and medicines on the advice of the pharmacist.

If you need to continue treatment when you return  to your country, it is appropriate that the doctor provides a prescription according to EU rules.

Drugs Prescribed in your country
If you need to take medicines during of your stay in Italy ask your doctor (or other health professional authorized to prescribe) to prepare a prescription according  to EU rules. You can still request a refund upon returning to your country, by presenting the payment receipts (or invoices) together with the prescription.  If you do not have the prescription with you, or if your prescription is not accepted by the pharmacist, you will need to go to a General Practitioner or a Paediatrician, or to the Emergency Room or to the Doctor on Duty to get the prescription needed.

Specialist visits and diagnostic
The visits of a medical specialist and the examinations (diagnostic, laboratory tests) prescribed by doctors of the SSN, can be made at health care centres, both public or private contracted with the NHS. These services are subject to  co-payment (ticket), which is not refundable.

Pregnancy and birth
During periods of temporary stay in Italy the healthcare assistance  that should  become necessary during pregnancy can be obtained from the public or private contracted with the SSN structures, by presenting the European Health Insurance Card. If  you want to program delivery in Italy, the procedures laid down for planned care must be followed.

Dialysis, oxygen therapy and chemotherapy

If you have already had such therapies in your country, before coming to Italy for a short period you must take the necessary agreements with the structure that provides the above services in Italy, in order to ensure the continuity of care. These services will be provided free of charge by presenting the European Health Insurance Card (possibly subject to the co-payment of a ticket, which is not refundable).

Dental treatments
All patients (including Italian insured) normally go privately and pay for dental care.
However, you can go to health care centres managed by ASL or to other public structures where a dentistry service, agreed upon SSN, is provided.  In both cases, the treatments are subject to payment of the ticket and long waiting times.


If you do not have the EHIC (or its provisional replacement certificate) with you, you will need to anticipate all the costs, even if you have the right to obtain it, and if emergency care is provided by health care providers, both public or private contracted with SSN. Upon your return you can ask the reimbursement of costs to your health care institutions , which will be granted under the same rules applicable to the Italian insured, if it is confirmed the actual need of care and that you were entitled to the EHIC (or its provisional replacement certificate). However, you may contact your health insurer to certify your entitlement to EHIC , by fax or e-mail, in which case you will not anticipate the costs, and you will  access  to health care under the same conditions applied to people registered to the SSN.

If you are entitled to EHIC,  but emergency treatment was provided by health care providers not contracted with the SSN, the refund will be granted under conditions provided for the same treatment in the country where you are insured.
In these cases, the rules laid down by the recent Directive on patients' rights will be applied, for more information please contact the National Contact Points for Directive in your country.

In any case you will need to submit, to your health care institutions, health records and receipts and / or invoices related to health care costs that you have anticipated.

Finally, please be aware that if you are carrying the EHIC (or its provisional replacement certificate), and the healthcare services are provided by structures or health professionals, both public and private contracted with SSN, the only payment that may be requested in these situations is the ticket. With the exception of services provided by the Doctors on Duty for tourists,  for which the payment is required to any patient, even to an Italian insured.


Data di pubblicazione: 4 aprile 2014, ultimo aggiornamento 4 aprile 2014

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