News for Italian citizens registered with AIRE: paid access to the Italian National Health Service (SSN)

A new regulation changes the procedures for accessing the National Health Service (SSN) for Italian citizens residing abroad and registered with AIRE (Registry of Italians Residing Abroad). The reform introduces a system that allows Italians living outside Italy to obtain healthcare coverage in Italy again through the payment of an annual contribution.

The change mainly concerns AIRE-registered citizens residing in non-European countries that are not part of EFTA, meaning those citizens who, after moving abroad, are no longer automatically included in the Italian healthcare system.

An annual contribution to access healthcare services

The new regulation provides the possibility of enrolling in the SSN by paying an annual fee initially set at €2,000. The payment will allow eligible AIRE members to benefit from the main healthcare services during periods spent in Italy.

Available services include access to a general practitioner, hospital care, medical visits, and necessary prescriptions according to the rules established by the public healthcare system.

The amount of the contribution will not necessarily remain fixed over time: it may be updated through specific ministerial measures, taking into account changes in healthcare expenditure and national economic indicators.

Who will benefit from the new rules

The measure is mainly aimed at Italian citizens who, despite living permanently abroad, maintain a significant connection with the national healthcare system. These include, for example, students enrolled in educational programs outside Italy and pensioners who have chosen to move to another country but continue to spend periods of time in Italy.

The reform therefore represents an attempt to create a more stable connection between Italians living abroad and the SSN, overcoming a situation that often left many citizens without ordinary healthcare coverage during their stays in Italy.

Some exemptions confirmed

The regulation also provides for certain situations in which the contribution will not be required.

Minors residing abroad will be able to access Italian healthcare services free of charge if at least one parent or legal guardian has a health card.

An exemption is also provided for pensioners living outside Italy who continue to pay taxes in Italy through the withholding tax system.

What changes for AIRE members

Until now, registration with AIRE generally resulted in cancellation from the Italian National Health Service, with the possibility of receiving only limited healthcare services in Italy, mainly in cases of need or emergency.

Under the new system, however, residence abroad will no longer automatically result in the loss of the relationship with the SSN. Access will depend on the citizen’s decision to join the new system and on the regular payment of the required contribution.

This is an important change for millions of Italians living outside the country who, for family, work, or personal reasons, return to Italy periodically.

Funds will go to the regional healthcare system

According to the statements provided, the funds collected through these contributions will be allocated to the Regions and local healthcare facilities that provide services to enrolled citizens.

The new model also includes greater administrative simplification, with the goal of making access to information and the management of applications easier through digital procedures and dedicated tools for Italians registered with AIRE.

A reform affecting millions of Italians abroad

The group affected by the new regulation is large. Italians living abroad represent a community of more than six million people, with a particularly significant presence in non-European countries.

The operational details of the reform will be defined through subsequent implementing measures, which will establish the procedures, timelines, and methods for joining the new healthcare system for Italian citizens residing outside Italy.

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The content of this article is intended to provide general information on the topic. For doubts or specific cases, it is advisable to seek specialized legal advice tailored to your particular situation.

Article written by Alessia Ajelli, Managing Associate of LCA Studio Legale, Italian lawyer specialized on Italian immigration and citizenship law.