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Urgent and necessary treatment in Italy

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Medici che assistono un pazient

For necessary treatment when you are temporarily in Italy, the key legislation is mainly Regulation (EC) No 883/2004 of 29 April 2004 and Regulation (EC) No 987/2009 of 16 September 2009.

The Regulations apply both to emergency or urgent situations and to medically necessary but non-urgent treatment which must be delivered during the period of stay in Italy, so that the insured person is not forced to return to their home country to receive it. The need for treatment must be established by the treating physician and must be certified.

In these cases, the services offered by public health facilities or by facilities and professionals accredited with the Italian National Health Service - NHS are delivered under the same conditions as for persons covered by the Italian NHS and shall be paid for directly by your Health System to the Italian NHS.

To obtain direct healthcare, you must present the European Health Insurance Card - EHIC or its replacement certificate, together with an identity document, to the healthcare provider.

Restrictions on use of the EHIC

  • The EHIC does not cover the healthcare costs of planned treatment.
  • The card does not cover private healthcare

If the necessary treatment has been provided by private facilities or professionals not affiliated to the Italian NHS, you will not be able to use the EHIC and the rules of Directive 2011/24/EU of 9 March 2011 on patients’ rights shall apply (See: Indirect healthcare in Italy). For more information please contact your country’s National Contact Point. Directive 2011/24/EU of 9 March 2011 guarantees to persons who are insured in EU Member States the right to receive treatment in another Member State and the right to reimbursement of the costs of such treatment under the same conditions as in the country where they are insured.

Special Cases

If you do not have the EHIC with you even though you are entitled to it, and if the necessary treatment is provided by public or NHS-affiliated private facilities or professionals, you will have to advance all expenses.

When you return to your country of origin, you can claim reimbursement for the costs of your treatment from your national health service/health insurance provider, which will be granted under the conditions applying in Italy, if the actual need for treatment is established and you met the requirements for holding an EHIC.

Alternatively, with the consent of the public or NHS-affiliated private health facilities and health professionals, you may contact your health insurance provider and have them certify, by fax or e-mail, that you are entitled to the EHIC; in this case, you will not have to pay for the treatment upfront, and you will receive treatment under the same conditions as people covered by the Italian NHS.

Whenever you pay for treatment upfront, you must keep and present to your national health service/health insurance provider the medical documents and the original receipts and/or invoices for the costs you paid.

Lastly, please note that, if you have the EHIC with you and you received publicly-funded treatment from public or NHS-affiliated private health facilities or professionals, you will only have to pay any applicable co-payment (ticket). This does not apply to tourist medical services (guardie mediche turistiche)  which charge fees to all patients, whether or not covered by the Italian National Health Service.

How to get treatment

If you are insured in an EU Member State or in one of the other EEA countries (Iceland, Liechtenstein, Norway) or in Switzerland and, during a temporary stay in Italy, you need medically necessary healthcare, you are entitled, by showing the European Health Insurance Card - EHIC, or its replacement certificate, to obtain direct healthcare services  from public and NHS-affiliated private facilities.

Direct healthcare services are medically necessary treatments provided free of charge, except for the co-payment costs (ticket), which you will have to pay. The amount of the co-payment is fixed by each Region.

To obtain these health services, you can go directly to the healthcare provider (hospital, doctor, etc.) and show them your EHIC, together with an identity document. This is all you need to be entitled to treatment under the same rules as Italian patients.

Ambulance service

For medical emergencies, all the Regions have an Emergency Health Service in place, which you can contact by calling 118 (ambulance transport to the hospital and emergency air ambulance). This service is normally free of charge on presentation of the EHIC or its provisional replacement certificate.

Hospital treatment and emergency departments

You can be admitted to public (and accredited private) hospitals through the emergency room, by presenting the EHIC or its provisional replacement certificate directly.

Some emergency room services, which have a special code, are subject to co-payment (ticket). Hospital admissions are free of charge; however, if you wish for more comfort, you can, upon payment, request a private room.

Primary care out-of-hours service (Guardie mediche)

A free out-of-hours medical service (Guardia medica notturna) is available from 8 p.m. to 8 a.m. on weekdays and on a 24-hour basis at weekends and on holidays.

The phone number of this service can be obtained from the local Health Authority (ASL).

During the summer, in the Regions with high tourist numbers, a tourist medical service is available. For organisational reasons, this service charges fees, which are set by each Region. In this case, the cost of treatment paid upfront by the patient (and the cost of any other health services), is fully refundable by presenting the receipts of payment to your health insurance provider.

General practitioners and paediatricians affiliated with the National Health Service

General practitioners and paediatricians affiliated with the National Health Service - NHS, upon presentation of the EHIC, or the provisional replacement certificate, will perform ‘occasional’ consultations and can prescribe specialist services, laboratory tests, diagnostic tests, medicines or hospital admissions.

You will be charged upfront and must then claim reimbursement of the cost of the consultation from your health insurance provider in your home country, submitting the original proof of payment and the doctor’s certificate.

We suggest that you contact the Local Health Authority for a list of doctors affiliated with the Italian NHS and their surgery hours.

Medicines prescribed by Italian NHS physicians

Medicines are classified according to how essential they are for health:

  • Essential (or life-saving) medicines and medicines for chronic diseases, prescribed by GPs or paediatricians, are entirely free of charge for patients, unless the individual Regions charge a co-payment. These medicines are classified in Group A
  • Non-essential medicines for diseases considered to be minor are charged entirely to patients. These medicines are classified in group C and are divided into:
    • medicines subject to medical prescription
    • non-prescription drugs, which include over-the-counter products and drugs on the pharmacist’s advice.

If you need to continue your treatment when you return to your country, the doctor should prepare a prescription in accordance with EU rules.

Medicines prescribed in your country

If you need to take medicines during your stay in Italy ask your doctor (or other healthcare professional qualified to prescribe) to prepare a prescription that complies with EU standards. You can claim a refund when you return to your country, presenting the payment receipts together with the prescription. If you do not have the prescription with you, or if your prescription is not accepted by the pharmacist, you should go to a general practitioner or paediatrician, hospital emergency room or primary care out-of-hours service (guardia medica) to obtain a prescription.

Specialist visits and diagnostic tests

The visits of a specialist doctor and the various tests (diagnostic, laboratory) prescribed by NHS doctors can be performed at a public health facility or at a private NHS-affiliated facility. These services involve a co-payment that you will have to make upfront.

Pregnancy and childbirth

During your temporary stay in Italy, you can obtain pregnancy-related healthcare from public health facility or private NHS-affiliated facilities presenting your EHIC. If, on the other hand, you wish to plan the birth in Italy, you must follow the procedure for scheduled treatments in Italy (form S2).

Dialysis, oxygen therapy and chemotherapy

If you have already undergone these treatments in your country, before coming to Italy for a short period, you must make the necessary arrangements with the facility that provides the above treatments in Italy, in order to ensure continuity of treatment. These services will be provided free of charge (except for any co-payment charged to patients), usually on presentation of the EHIC.

Dental care

All patients (including Italian patients) normally pay for dental care.

However, a number of dental clinics run by the local Health Authorities (ASL) and other NHS-affiliated clinics offer a number of  dental treatments on the NHS. However, these treatments are subject to co-payment (ticket) and, usually, long waiting lists.

Last update 28 october 2019


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