Health For Members

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

Clare Speak
Clare Speak - [email protected]
Who would be affected by Italy's plan to charge €2,000 a year for healthcare?
(Photo by Alberto PIZZOLI / AFP)

Italy's government has said it wants to charge a €2,000 annual fee for some foreign nationals to register with the Italian national health service - but it's not yet entirely clear who this would apply to.


We now know that the plan to introduce a €2,000-euro charge for healthcare mentioned in a budget statement by Italy’s economy and finance ministry on Monday will not in fact apply to all non-EU nationals, as it appeared to state.

According to a clarification from the health ministry on Tuesday, the charge will only apply to non-EU nationals who already have to pay an annual fee to use the public health service (servizio sanitario nazionale, or SSN).

The rule contained in the 2024 budget draft is "limited to updating the stipulated lump-sum contribution," the health ministry said, suggesting that the new charge would replace existing annual registration fees, rather than being an additional fee.

So it doesn't appear to be a blanket charge applied to all non-EU nationals as many initially feared - and it doesn't look like this will apply to people who are currently exempt from paying annual registration fees for Italy’s health service (those who are entitled to free healthcare under ‘mandatory’ registration, or iscrizione obbligatoria.)

But for many others, it seems that - if this proposal becomes law - they could face higher charges.

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

Many of Italy’s international residents are required to pay an annual fee (the "lump-sum contribution" the health ministry referred to) if they choose to register with the SSN under what’s called ‘voluntary’ registration, or iscrizione volontaria.

(You can read more about the two different types of registration in a separate article here.)

Under the government’s proposal, it seems people in the ‘voluntary' registration category are the ones who could face a steep increase in fees from next year.

The SSN registration fee starts at €387.34 and goes up to a maximum of €2,788.86, based on your income and other factors. The average payment is around €1,200, meaning that for the majority of people a €2,000 fee would be a sharp increase.

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


With very little information about the plans announced so far, a lot of questions remain about exactly who the charge would apply to.

Many of The Local’s readers have expressed concern and frustration about the lack of detail given so far, with some saying that, as they did not factor a €2,000 healthcare charge per family member into their budget when they moved to Italy, they would struggle to afford this extra cost.

Based on the information available so far, the main - and perhaps only - factor determining whether or not someone will face the €2,000 charge so far appears to be whether or not they are signed up to the SSN via voluntary or mandatory registration.

Announcements so far have not dealt with the issue of whether British nationals who were resident in Italy before the end of December 2020, and who are therefore covered by the post-Brexit Withdrawal Agreement (WA) would be treated like EU or non-EU nationals in the application of this rule.

The WA provides that British nationals who were legally registered as resident in Italy before the Brexit date should be treated the same as EU citizens in Italy.

There has also been widespread confusion among Italy’s international residents about what it means to pay a registration fee for the SSN.


This fee is charged annually upon registration with and subsequent renewal of registration with your local health authority, which entitles you, among other things, to register with a medico di base (family doctor, or general practitioner).

It’s important to note that this fee is not the same thing as the INPS (health, social security and pension) payments due if you’re obliged to pay your own contributions in Italy, such as in the case of those who are self-employed under a partita IVA.

In this case, you would be entitled to ‘mandatory’ registration with the SSN, with no fee - but as INPS contributions in this case are charged at around 23-26 percent of your income, the total of these payments usually comes to much more than 2,000 euros a year.

Anyone who is signed up to the ‘voluntary’ system can effectively opt out of the public system and choose to pay for private healthcare instead. However, whether or not this would prove better value than a 2,000-euro fee will depend on the type of healthcare coverage you need.


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