European Health Insurance Card

The European Health Insurance Card (EHIC) allows you to receive medically necessary (hence not only urgent) care previously covered by forms E 110, E 111, E 119 and E 128, when you are in Italy for a temporary stay.

How and where to use it

You can obtain healthcare services directly from a public or contracted provider by presenting the EHIC, which entitles you to receive treatment under the same conditions as people registered with the NHS of your residence country. You will be provided the service free of charge, except for any co-payment which is paid directly by patients and is not reimbursable.

Please note that you cannot use the EHIC in Italy for planned specialised treatment abroad, which must be authorised in advance by your local health competent structure.

For people registered with the Italian National Health Service only

The European Health Insurance Card (EHIC) entered into force in Italy on 1 November 2004. The card, which is the reverse side of the National Health Card (Tessera Sanitaria nazionale – TS) or the Regional Service Card, allows you to receive medically necessary (hence not only urgent) care previously covered by forms E 110, E 111, E 119 and E 128, when you are in an European Country, EAA and Switzerland for a temporary stay.

To whom is it issued?

As a rule, all Italian citizens registered with the Italian National Health Service (SSN) and living in Italy may receive the EHIC. Exceptions concern:

workers under Italian law registered in the Registry of Italians Resident Abroad (Anagrafe italiani residenti all’estero – AIRE) and posted abroad
students (E106 or S1 form holders) registered in the AIRE
pensioners (and their family members) having an E121 or S1 form (from 1 May 2010, when the new EU Regulations on the coordination of social security schemes entered into force)
members of a worker’s family who do not reside in the same country as the worker, having an E109 or S1 form.

Since the EHIC, issued by the Revenue Agency, currently is not delivered abroad, the local health authority (ASL) can issue you the replacement certificate.

The EHIC is also issued to EU and non-EU citizens registered with the Italian NHS who fulfil the requirements and conditions laid down in EU and national legislation respectively.

How and where to use the EHIC

You can obtain healthcare services directly from a public or contracted provider by presenting the EHIC, which entitles you to receive treatment under the same conditions as people insured in the country you are in. You will be provided the service free of charge, except for any co-payment (for example, in France, patients are charged 20 % on all treatments including hospitalisation) which is paid directly by patients and is not reimbursable.

Please note that in Switzerland and France (which have reimbursement-based systems), most often you will be required to pay for treatment upfront. You can then claim reimbursement (except for the co-payment share, which is non-reimbursable) directly from the national institution while still in the country (LAMal in Switzerland and the competent CPAM in France). Alternatively, you can ask for reimbursement from your local health authority (ASL) when you get back to Italy, presenting your medical bills and treatment reports.

Note that you cannot use the EHIC for planned specialised treatment abroad, which must be authorised in advance by your local health authority.

Validity

The EHIC is valid for six years, unless otherwise specified by your regional authority/local health authority (Decree of the Ministry of Economy and Finance of 25 February 2010, updating the Decree of 11 March 2004). Before it expires, the Italian Revenue Agency (Agenzia delle entrate) will automatically send you a new card.

Replacement certificate

You can only apply for an EHIC replacement certificate from your health authority in the following exceptional cases:

if your card was lost or stolen after you received it; in this case you have to submit a copy of your police report;
if you are going to travel before obtaining your card, if you have not yet received it.

In this case, the Revenue Agency allows the health authorities to request the EHIC online, on the patients’ request. The EHIC will be delivered about 30 days from the request. In this case, the health authority can also issue a provisional replacement certificate filled in by hand.

If your personal details shown in the EHIC are incorrect, you must ask the Revenue Agency to correct them. If your card is lost or stolen, you can request issue of a replacement card by accessing the Service to request a duplicate of the card on the site of the Revenue Agency.

Please note that the Ministry of Health plays no role in issuing and sending the EHIC.

Relevant legislation:

Decree of the Ministry of Economy and Finance of 25 February 2010
updating the Decree of 11 March 2004, as amended, implementing Article 50(1) of Law No 326/2003
Decree of 11 March 2004
applying the provisions of Article 50(1) of Decree-Law No 269 of 30 September 2003, converted with amendments into Law No 326 of 24 November 2003 establishing the technical characteristics of the National health card (Tessera sanitaria – TS)