Health insurance when moving to Italy: the checkpoints

The Servizio Sanitario Nazionale (SSN, Italy’s national health service) serves the whole population regardless of circumstances; the state, the regions and local bodies implement it, and the services are provided by the local health authorities (ASL), hospitals and private providers under contract.

Within the organisation of the services, SSN users have the right to choose their doctor and place of treatment freely and are entered on the lists of the ASL (local health authority) for their place of residence. An own share (ticket) can be charged for SSN services and varies by service; people in certain income groups or with certain conditions are exempt.

You find out how to get the health card and choose a family doctor (Hausarzt) at the ASL for your future place of residence.

In principle, the country responsible for health insurance is the country where you work, otherwise the country where you live; nationality does not count.

EU citizens who stay longer than three months are compulsorily enrolled in the regional health service, for example as employees or self-employed people in Italy, after five years of permanent residence, or with certain certificates from the home country (for example S1).

Anyone who is not compulsorily registered chooses between a policy and voluntary registration. Both are covered in the section “Options”.

Anyone who stays longer than three months registers in the municipal population register (anagrafe); registration is required after three months from entry, and people not in employment show sufficient means and health insurance or another suitable arrangement when doing so.

The Ministry of the Interior follows the European Commission: in principle, any private or public health insurance taken out in Italy or elsewhere is sufficient if it offers full protection and creates no burden on public finances. How the municipality and the ASL check the proof today, you clarify with them before the move.

Voluntary registration requires registration as a resident in the population register (for students, the residence note is enough), applies for the calendar year, cannot be split, does not take effect retroactively, gives no entitlement to the TEAM and requires an annual contribution for which the law sets a minimum amount.

Whether voluntary registration is open to you, you clarify with the ASL for your future place of residence before the move. More on the policy under international health insurance.

Before you deregister (Abmeldung) in Germany, you clarify in writing what happens to your current insurance. The questions below apply to any destination country. They are questions, not legal advice: the answers are in your contract documents or come from the body you ask.

You clarify three Italy topics in advance with your Krankenkasse (German statutory health insurer): the EHIC, a possible S1 (the form for entitlement in the new country of residence) and the day your cover in Germany ends. The European Health Insurance Card (EHIC) applies only to temporary stays in another EU country and only for public providers; when the habitual place of residence moves, the European Commission names the S1 form instead.

If you have statutory insurance: questions for your Krankenkasse

• What happens to my membership when I deregister in Germany, and on what date does it end?
• Can I suspend the membership or take it up again later, and under what conditions?
• What confirmation of my previous insurance periods do I receive, and how quickly?
• What applies to co-insured family members: who stays insured and who does not?
• Is an S1 an option for me, and who issues it?
• Until which day does my cover apply, so that there is no gap between Germany and Italy?

If you have private insurance: questions for your insurer

• Does my contract end with the move, is it suspended or does it continue?
• Is there an Anwartschaft (a German option to keep certain rights in private insurance while abroad), and what is preserved under it? Ask about the difference between the small and the large Anwartschaft, and whether a new health assessment would be needed on a return.
• Does my contract apply in the destination country, and for how long at a stretch?
• Which documents do I receive in writing before I cancel?
• Does the policy apply in Italy for the entire length of stay?
• Does the insurer confirm in writing the scope of cover, territory, term and an Italian translation?

Do not cancel any contract before it is clarified in writing what applies afterwards. We explain the connections on the pages Health insurance when emigrating and PKV and Anwartschaft. For families, there is more at Health insurance for the family abroad.

1. EHIC as a permanent solution

   The EHIC applies only to a temporary stay. Ask your health insurer (Krankenkasse) about the route for a change of residence.

2. Taking out a policy without checking it

   Have the features of the policy confirmed in writing and ask the municipality whether it accepts the policy. The sources are in the section “Options”.

3. Counting on voluntary registration as an immediate solution

   Voluntary registration applies for the calendar year, cannot be split and does not take effect retroactively. Clarify how you cover the time until this protection begins.

4. Putting off the entry in the population register

   Registration in the population register is required after three months from entry. Clarify cover and documents beforehand.