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Americans in Italy: Italian healthcare and planned changes to EU driving licence rules

Clare Speak
Clare Speak - [email protected]
Americans in Italy: Italian healthcare and planned changes to EU driving licence rules
Whether you're a resident or a regular visitor, if you have a US-issued driver's license there are some requirements to be aware of when driving in Italy. Photo by Daniel Hansen on Unsplash

From driving on Italy's roads to accessing health insurance, our new monthly newsletter Americans in Italy offers advice and support to US nationals who live on the Italian peninsula, have family or property ties here, or are considering making the move to Italy.


Welcome to our regular look at everything you need to know about life in Italy for The Local’s readers from the US. This newsletter is published monthly and you can receive it directly to your inbox by going to newsletter preferences in ‘My Account’ or following the instructions in the newsletter box below.

One potentially major hurdle US nationals face after moving to Italy is the requirement to obtain an Italian driver’s license, which you’ll need to do after a year of being legally resident. 

A short list of non-EU countries have agreements in place allowing their citizens to exchange their licenses for an Italian equivalent, but unfortunately the USA is not among them. So US nationals moving to Italy - with the exception of diplomatic staff and their family members - face the requirement to retake both their theory and practical exams in order to get an Italian license.


As well as the financial cost and the time this takes, there’s also the fact that both exams have to be taken in Italian, and many of those who have taken it say the test presents a significant challenge even if your Italian language skills are pretty good.

So it’s not surprising that many American readers were pleased to hear the news recently about a new proposal from the European Council which will, hopefully, make it easier for residents in EU countries who have a driving licence from a non-EU country to swap their licence for a local one.

Not a lot of details have been given yet, and it’s likely to be a while before anything actually changes, but the article below explains what we know about the plan so far:

Americans in Italy: What to know about planned changes to EU driving license rules

And if you don’t live in Italy, there are other requirements to be aware of if you have a US-issued driver's license and plan to drive here while visiting. This week we answered a question from a reader who was unsure about whether or not they would need to get an international driving permit for an upcoming trip. And no wonder, as the rules around this are not always made clear.

Italian law essentially says that you’ll need either an international driving permit or a legal translation of your US license. In the below article, we looked at the options plus the situations in which you may need these documents and how strictly these rules are really enforced.

Several regular visitors have told us they find Italian police are asking to see international driving permits more frequently in recent years. Please leave a comment below the article if you’d like to share your own experience.

Citizenship based taxation

Citizenship based taxation for American nationals is a subject many US citizens living abroad feel strongly about. This is essentially the system that sees US citizens can be subject to income tax on their worldwide income regardless of where they live.

The president of the Association for Accidental Americans, Fabien Lehagre, is leading a campaign to challenge this controversial method of taxation.

"The time has come to show the United States that we are not their property," he says. If you are interested in knowing more about his campaign you can find more information at this LINK.

Health insurance


Do US citizens need an international permit to drive in Italy?

When moving to Italy you'll also need to weigh up your options when it comes to health insurance.

While many foreign nationals are entitled to register with the Italian national health service, the rules around doing so are complex and your eligiblity, as well as the fees you'll pay, will depend on your personal circumstances. In many cases, foreign nationals find that they have to obtain private healthcare for at least their first year in Italy while getting other paperwork processed.

So who is entitled to free registration with Italy's national service health service, and what are the options for people who aren't? Here's a guide to the basics to help you get started.

Who can register for national healthcare in Italy?


Tips for Americans moving to Italy

We want to hear from you, so we're asking Americans in Italy to share their tips for living in the country so if you have advice you can share it in our survey HERE.

One thing a lot of readers who have made the move to Italy from the US stress is the importance of learning the language as soon as you can.

“Learning at least conversational Italian is important,” says Martha Browne, 70, in Frosinone.

Frances in the Veneto region recommends finding a good language school and taking private lessons if possible - preferably before you move to Italy.

“You will be glad you invested the time and money,” she says, not just because your new skills will be invaluable when dealing with bureaucracy, as Italian officials rarely speak English, but “because you’ll immediately get the most out of the enjoyable parts of life in Italy… the reasons you moved here in the first place.”

If you’re brushing up on your Italian skills, whatever your level, take a look at our Italian language section for some inspiration.

Thanks for reading. If you have any questions about moving to Italy, or life once you're here, feel free to email me and we’ll do our best to answer them in future articles.


Join the conversation in our comments section below. Share your own views and experience and if you have a question or suggestion for our journalists then email us at [email protected].
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