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Health care access in Italy explained

Here is an excellent resource which explains the Italian health care system - in plainly written English. There are sections for different types of visitors - including tourists. Expat/Traveler page: https://www.doctorsinitaly.com/healthcare-in-italy/ There is also has a section to get specialist referrals over the internet by area.

If you know of other informational sources, I hope you'll share them.

Posted by
3986 posts

Following up on the link, or verifying: A few years ago while traveling I came down with what I thought was a cold but turned out to be what the doctor called "A really ugly case of bronchitis." I stated having symptoms in London, but didn't see a doctor until we were in Palermo. I saw a private doctor there, who charged me €100 for a visit to my hotel room, including diagnosis, some medication (steroid shot, I think,) and a prescription for the equipment and medication (more steroids) for breathing treatments. He also recommended I go to the hospital, but I resisted. We made arrangements to talk the next day.

I slipped up here by not asking for a receipt, so I couldn't claim this expense on my travel medical insurance.

The next day it was decided I should go to the emergency room for more intensive treatment. (His concern was my allergy to some common antibiotics.) I'll skip the details of the 6 to 8 hour emergency room visit, but I paid nothing for the trip to the emergency room. I was later told that if I had been admitted to the hospital there would have been a charge. One of the doctors at the hospital wanted me to be admitted, but his diagnosis was so far off the mark that I left.

Long story short (well, shorter than it could have been,) the charge for a house call with medication and prescription, followed by a visit to the emergency room where I saw at least three other doctors cost me a total of €100. There was a slight charge for the medication the first doctor prescribed, as well as the equipment for the breathing treatments, but on the whole it was definitely affordable. And I lived to tell the tale!

Posted by
1510 posts

As a resident in Italy not citizen), public health insurance mentioned is not free. Cost is based on % of income, with annual premium paid at once for the calendar year, regardless of when you pay. It only took us 8 trips to the ASL to get signed up with Primary Care physician. Everything else in the article us very accurate.

Posted by
1720 posts

Cost is based on % of income, with annual premium paid at once for the calendar year

Not for me, I've never heard of such a system. Is it for foreign residents with retirement incomes? Because working immigrants do not pay an annual premium.

It only took us 8 trips to the ASL to get signed up with Primary Care physician.

Citizens who can use a PC do it online. It's one of those things that could make a governor loose an election and Piedmont can switch sides if citizens of the big city get angry.

If I'm not wrong, The linked article does not mention the 20% tax deductibility of all medical expenses (including the so-called "ticket" and many over the counter medicines)

Posted by
11968 posts

Yes Dario.
Karen is probably in Italy on a long term elective residency visa.
Foreigners from countries not part of the EU or the European Zone, if they prefer to do so instead of having a private plan, can buy into the National Health Service (SSN) by paying a flat annual premium which covers from Jan1 to Dec31 (it cannot be prorated for partial year).
Details are in this link.
The premium is based on income.
Basically 7.5% of income up to €20658 plus 4% of income from this figure to the max €51646.
Basically, the max premium possible is €2789 for the whole year.
In California that will buy you insurance only for 2 or 3 months at most (and with significant deductibles)

http://www.salute.gov.it/portale/temi/p2_6.jsp?lingua=italiano&id=2522&area=Assistenza%20sanitaria&menu=vuoto

Posted by
9411 posts

We used Doctors in Italy as our primary care facility after we left the loving arms of the US Embassy. Dr. Serino is a gem and they have excellent service, very low prices by American standards, and our health insurer (BlueCross/BlueShield) never quibbled with a nickel. Drs. in Italy will set you up with a specialist when needed.

Posted by
11968 posts

Healthcare is now free for Americans. But not in America.

The Governor of Tuscany, Enrico Rossi, has announced earlier today 3/3/2020, that in view of the COVID19 crisis which caused over 90% of cancellations in Florence alone, any foreigner, whether student, tourist, visitor, etc. will have full universal healthcare guaranteed on the same term as Italian residents. Therefore in case of contagion by the Coronavirus, you will have nothing to worry, even if you end up in an ICU bed for a month.

https://corrierefiorentino.corriere.it/firenze/notizie/cronaca/20_marzo_03/lacrime-l-addio-studenti-usa-rossi-cure-gratis-tutti-stranieri-74b97a6c-5d33-11ea-a96f-d1ee77c33c6c.shtml

Posted by
16769 posts

Classy move, even if--I assume--done for selfish (economic) reasons. I hope it pays off in some way.

Posted by
255 posts

No premium for foreigners who work in Italy, everything is through taxes, but any hospitalization, surgery etc is free. Only accesses to the ER that weren't an actual emergency require a ticket payment, of €25.

The doctor can be chosen online, as Dario said.

Posted by
3928 posts

Thankfully my insurance company paid for the emergency appendoctomy I had in California, I believe it was around the $30,000 mark!!!!

Posted by
613 posts

The web site OP recommended has little to say about medial care for tourists. The only time I had to go to an MD in EU was in Germany. I knew from previous experience not to ask tour hotel to get a MD. Asked the pharmacy across the street from our hotel where the closet MD was. 10 minuts wait to been seen. No charge. He explained all was covered by Germany's universal socialized heath insurance system.

A neighbor had a heart attack in USA-- $30,000 bill. A few years later, he had the same thing in France. Same treatment, $3,000. The WHO regularly rates the quality of national health care systems. France regularly is # 1 or #2. France alternates with Italy for #1, and the citizens of those nations pay less than half as much for their superior hearth care as do Armenians (# 72, essentially tied with Cuba)

Another big difference between USA & EU hearth care is the role of pharmacists. In EU, pharmacists can do a lot of diagnosis and treatment that require a MD's prescription in USA.

Then there is the cost of drugs. www.pharmacychecker.com › Apr 9, 2019 - In the United States, the current average retail price of a three-month supply of Xarelto 20 mg is around $1,600. In Italy, I paid $333. In USA, it requires a prescription. In Italy, its OTC. With Medicare Part D, Diclofenac is $87-150 with a prescription. In EU, less that $10 OTC.

If you must get sick, do it in Italy.

Posted by
3928 posts

If you must get sick, do it in Italy.

Or anywhere else in Europe with nationalised health care.

Posted by
40 posts

In Italy pharmacists cannot make any diagnosis or treatments, it’s against the law.
What happens is, if someone goes to a pharmacy and says I have a cold, I have my usual bout of migraine, I have my usual heartburn, I have itchy mosquito bites, they will give you advice and over-the-counter medicines.
There’s no way that in an Italian pharmacy you will be able to get any diagnosis other than for the most common and minor ailments, or that you’ll be able to buy other than over-the-counter medicines without a prescription.

Posted by
1105 posts

Actually, Italian pharmacists are allowed to dispense modest amounts of some prescription medicines w/o one. I and friends have purchased several different types of meds in Italy w/o a prescription on several occasions. Well worth trying as the price on mine was 15% of the US price.

Posted by
11968 posts

Where does it say that Italian pharmacists are allowed to dispense prescription meds without the doctor’s prescription?

The law allows such circumstance only in case of “extreme necessity and emergency” (Ministry of Health Decree of 31 March 2008) and in any case it is never allowed for controlled substances (narcotics).

If some pharmacists do dispense some prescription drugs without prescription, in the absence of any emergent situation, it doesn’t mean they are allowed to.

Posted by
8889 posts

Roberto, I think it comes down to the definition of "prescription meds".

There are some drugs that can be sold "over the counter", for example at a supermarket, and in every country an Europe I am familiar with, an intermediate category of stronger drugs which you can only buy at a pharmacist and must be sold to you by the pharmacist, not by the untrained sales person. I think the poster is referring to these.

Maybe this intermediate category does not exist where Mike lives.

Posted by
3928 posts

Actually, Italian pharmacists are allowed to dispense modest amounts of some prescription medicines w/o one. I and friends have purchased several different types of meds in Italy w/o a prescription on several occasions. Well worth trying as the price on mine was 15% of the US price.

Mike, what might be prescribed medicine in the US may often be OTC in much of Europe.

I'll take Melatonin as an example. It's prescription only in the UK but I managed to buy some in Walmart. Not all medicines are treated equally.

Suffice to say, if a medicine requires a prescription in the country where the pharmacy is located then the pharmacist is unable to provide such medicine without a prescription. However, such rules are a bit more lax in places like Thailand etc.

Posted by
40 posts

Prescription medicines may be different from a country to another, but in Italy’s case a lot of medicines are prescription medicines, and I’m inclined to think that you will be able to buy more over the counter medicines in the USA than in Italy.
They, maybe, will give you the medicines you need if you are an elderly person they know, and you forgot to go to the doctor and you’ve run out of a medicine you really need and take every day, and you assure them you will be back with the prescription. If you don’t they will contact you and make sure you bring them the prescription.
For example, you will not be able to get any antibiotic in an Italian pharmacy without a prescription. Maybe you could get an antibiotic + cortisone ointment, even if that too would need a prescription. But you will not be able to buy anything more serious than that.
Health care in Italy is a very serious matter, I don’t know in which cities these very ”generous” pharmacists work. If law officers find out, they could be in tons of troubles.
I’m Italian and live in a “normal” Italian city in the North.

Posted by
1105 posts

Sorry I can't give you chapter and verse, but my experience was not an outlier. I had not packed enough metoprolol tartrate, a beta blocker, and I showed the empty US bottle to the pharmacist and she gave me a good supply w/o batting an eye. This was in a large, busy pharmacy in Sarzana. I was prepared to ask for a doctor's name as I had confirmed that the med required a prescription at this excellent resource https://www.federfarma.it/Farmaci-e-farmacie/Cerca-un-farmaco.aspx I have good friends from the US with a place in Lunigiana who have done the same multiple times. Another time I asked for the sleeping pill ambien at the same pharmacy, but they said I needed a prescription.

Posted by
1036 posts

Getting any health care in Italy might be a big challenge.

Italy saw a dramatic increase in the number of confirmed coronavirus cases today 3-7-20 with a rise of 1,247 in a single day, the Civil Protection Department said in a statement.
The country now has a total of 5,883 cases.
The death toll also continues to climb with 36 fatalities reported on Saturday. The country has reported the most deaths outside of China, a total of 233.