Italian healthcare for British residents: SSN, S1, GHIC and the €2,000 fee

The routes into the Italian health service

To register you need an Italian tax code (codice fiscale): the Agenzia delle Entrate explains that it is required to register with the SSN and choose a family doctor. Foreign nationals can obtain one from an Italian consulate before moving, or in Italy from the Questura or an Agenzia delle Entrate office.

If you lived in Italy before 2021

gov.uk states that British nationals who entered and have been living in Italy since before 1 January 2021 and are beneficiaries of the Withdrawal Agreement can register for free (iscrizione obbligatoria) and are not required to make voluntary contributions. A 2022 note of the Italian Ministry of Health tells ASLs to treat them, for these rights, as if they were still EU citizens, and not to insist on the electronic residence card if residence is otherwise documented.

The S1 for UK State Pensioners

If you start drawing a UK State Pension you may have the right to a UK S1. gov.uk explains that, once you have it, you register it with your local health authority and are entitled to healthcare in Italy on the same basis as an Italian citizen. The UK pays for that cover. The NHS also explains that people living in the EEA with a registered S1 can apply for a UK-issued EHIC or GHIC for trips.

Voluntary registration and the €2,000 minimum

The Italian Immigration Act (Legislative Decree 286/1998, art. 34(3)) says that non-EU nationals who are not covered otherwise must insure against illness, accident and maternity, either with a policy valid in Italy or by registering with the SSN and paying a contribution. Since the 2024 Budget Law (Law 213/2023, art. 1(240)) the contribution is a percentage of the previous year's total income, in Italy and abroad, and cannot be less than €2,000 a year. The law allows the minimum to be updated for inflation by decree.

gov.uk also warns that you cannot get an Italian EHIC if you are registered voluntarily, which matters for trips abroad, including to the UK: see the travel insurance guide.

Can I use my GHIC if I live in Italy?

Generally not. The NHS says a UK GHIC is for people who are ordinarily and legally resident in the UK. The main exceptions are people living in the EEA with a registered S1 and some Withdrawal Agreement cases. Once you live in Italy, your healthcare comes from the Italian system, or from your private policy.

Where private health insurance fits

Even with full SSN access, many residents add a private policy for two reasons: waiting times for specialist visits and diagnostic tests, and the co-payments (ticket) that the Ministry of Health describes as the way patients contribute to the cost of services. A policy that pays for private specialist visits, refunds tickets and pays cash during a hospital stay works alongside the public system. See our private health insurance guide.

Frequently asked questions