‘Confused and concerned’: What Italy’s non-EU residents think of planned €2,000 healthcare fee

Jessica Lionnel
Jessica Lionnel - [email protected]
‘Confused and concerned’: What Italy’s non-EU residents think of planned €2,000 healthcare fee
Photo by Ina FASSBENDER / AFP.

After the Italian government announced plans to increase annual healthcare charges to €2,000 for some international residents, The Local’s readers told us what they thought of the idea.


It’s no overstatement to say there was widespread confusion amongst Italy’s international residents this week when the Italian economy and finance ministry (MEF) first mentioned a €2,000 healthcare charge for “foreign residents who are citizens of countries that are not members of the European Union” 

The MEF included the brief mention of the new charges in a statement on the draft budget bill for 2024, and the health ministry later clarified that the charge would not in fact apply to all non-EU nationals, but only to those who already pay an annual fee to use the SSN.

This however means the many foreign residents who do have to pay to register with the SSN under what’s called ‘voluntary’ registration, or iscrizione volontaria, could see a sharp increase in their registration fees from next year.

Still others say they’re unclear as to whether or not the charges would apply in their circumstances.

In particular, UK nationals who moved to Italy before Brexit say they are concerned that changing rules could impact their access to healthcare in future.

READ ALSO: What we know about Italy's plan to charge non-EU residents €2,000 for healthcare

“The imposition of a €4,000 charge for us as a couple would begin to make staying here untenable,” said one British reader who lives in Abruzzo.

As holders of an S1 form they do not currently have to pay a registration fee, but like many others they said they were concerned by the lack of detail about what the plan could mean.

“To change the rules to adversely affect us when we are already committed to being here is grossly unfair.”


The administrators of the Facebook group Beyond Brexit, which has 4500 members, explained in a statement to The Local: “The WA provides that those legally resident in Italy from before the end of December 2020 and their families are treated the same as EU citizens in their host country. 

“However, that has not prevented a multitude of errors and misunderstandings with resulting difficulties accessing healthcare.

“Quite understandably, when the proposed €2,000 fee for non-EU citizens hit the headlines, some people were confused and concerned that once again our status would be misunderstood. 

“In our view, it needs to be explicit, not just implicit that Withdrawal Agreement beneficiaries would not be affected if this goes ahead.”

READ ALSO: Who would be affected by Italy's plan to charge €2,000 a year for healthcare?

Jim Grant, a retiree who moved to Ostuni, Puglia, before the transition period ended, agrees that a lot of questions need to be answered.

“Whilst I have no objections towards paying my way for the health service here, I'm distinctly worried about the lack of information surrounding this.

“For example, will the new fee be in addition to the yearly charge currently paid? Will the new fee be applicable to the household or individual? Will this charge also be levied on those in receipt of a UK state pension and a form S1 (currently entitling the holder and dependents to healthcare funded by the UK)?

“Depending on the answers to some of these, we may have to reconsider our life in Italy.”


Janet Bird, in Scalea, Cosenza, has similar concerns to Grant, but says she is not worried “as long as the UK honours the S1”.

“If not, then it’s a different scenario. We don’t have €4K going spare,” she said. “That would be our groceries for the year, something else to worry about.

“Cost of living is through the roof, electricity and water bills have tripled this year. We have a decent pension but €4K extra would mean that we would never be able to afford a holiday.”

Some readers however say they feel higher charges would be reasonable given Italy’s ageing population and the cost to the Italian health service.

Emma Noteman, a farmer who owns an olive grove in central Italy, has been a resident for over five years, is covered by the WA and is self-employed so does not need to pay a yearly registration fee for the SSN. 

She says however that, if she had to pay it, the 2,000-euro charge would be "reasonable" and "proportionate" to her earnings.

“My INPS contributions are roughly the same amount based on an expected annual income from my farm of around 10k,” she says.


Nancy Hampton, an American living in Umbria, does pay for a ‘voluntary’ registration with the SSN and she also says a €2,000 charge would be fair.

Hampton, a former graphic artist and web designer, says: “Since so many here are retirees they can and will be a weight on the system, so better we pay our way.

"That said, I know many upon which this new tariff will place a real burden.” 

Reader Jill Holmden points out €2,000 a year is significantly cheaper than health insurance in her home country, the USA

However, she highlights the difference in quality and availability in healthcare between Italian regions.

“There are often long waiting lists to see specialists, resulting in people paying privately down here [in southern Italy],” she said. 

“Paying €2,000 a year would surely mean that we would expect better healthcare but this is not a given. It seems unfair to retrospectively impose this cost on people already living here.”

As few details of the plan have been made available, many people may find it hard to form a concrete opinion yet. But, should the proposal become law in the coming months, some may feel as though Italy has become too expensive for them.

Thanks to everyone who shared their views on this subject, including those not quoted in the article.

If you would like to share your thoughts on the planned charges, please leave a comment below or get in touch by email at [email protected].


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