Foreigners in Italy: increased contribution to the National Health System for non-EU citizens

The 2024 budget maneuver has increased the cost of registering with the SSN (National Health Service) for non-EU citizens. In this article, we will see who is required to make this payment and which categories are exempt.

The 2024 budget law (Law 213 of 2023) has increased to €2,000.00 (from the previous €387.00) the annual contribution required for registration with the National Health Service for foreigners who are not entitled to public assistance. The maneuver has aroused much criticism and perplexity, especially from religious congregations with members from non-EU countries who have to stay in Italy for more or less long periods.

In response to the perplexities raised by the law, the Ministry of Health has clarified that “the provision contained in the 2024 financial maneuver refers to specific categories, not entitled to compulsory registration, which can voluntarily register with the National Health Service through the payment of an annual lump sum contribution as regulated by Legislative Decree 25 July 1998, n. 286 currently in force. The law simply updates the amount of the lump sum contribution provided for. All the information on health care for non-EU citizens in Italy is available on the website of the Ministry of Health”.

Who must pay the contribution?

Let’s see, therefore, which categories must pay the lump sum contribution for registration with the National Health Service in order to have the right to access health care:

1) Who must pay the contribution to the National Health Service.

  • Students and au pairs even for periods of less than three months (with a study permit the cost in 2024 increases from €149.00 to €700.00, for au pairs the contribution increases from €219.00 to €1,200.00);
  • Those who hold a residence permit for elective residence and do not carry out any work;
  • Religious personnel (not compulsorily registrable as they are not subjects with an employment relationship);
  • Diplomatic and consular personnel of foreign representations operating in Italy, with the exception of personnel hired on a contract in Italy for whom registration is compulsory;
  • Foreign employees of international organizations operating in Italy;
  • Foreigners participating in volunteer programs;
  • Parents over sixty-five years of age entering Italy for family reunification, after 5 November 2008;
  • All other categories identified by exclusion compared to those who are entitled to compulsory registration.

It should be remembered that as an alternative to registration with the National Health Service (paid or by right, therefore free of charge), it is always possible to proceed to the stipulation of private health insurance.

Who does not have to pay the contribution

They are not obliged to pay the contribution because they are already compulsorily and gratuitously registered with the National Health Service:

  • Holders of a residence permit (or awaiting renewal) for employment or self-employment, for waiting for employment or for family reasons, for asylum application, for asylum, for subsidiary protection, for temporary protection, for special protection, for medical care/pregnancy (article 19, paragraph 2, letter d-bis of T.U. 286/98) for waiting for adoption, for foster care, for acquisition of citizenship;
  • Those who are awaiting the first issue of a residence permit for employment or for family reasons or for international or temporary protection;
  • Unaccompanied minors, even while their residence permit is being issued, following the reports by law after their finding on the national territory and in any case all minors regardless of their regular stay status, with the consequent right to a general practitioner from 0 to 14 years of age and a general practitioner from 14 to 18 years of age.

Other information on healthcare for non-EU citizens in Italy is available on the website of the Ministry of Health (updated in January 2024) and, for students, also on the websites of the individual universities.

If you want to know more, do not hesitate to contact us at our email address: info@fiatlux.legal. We will be happy to make our knowledge available to you to clarify your doubts and solve your problems.

See you soon and a warm greeting,

Fiat Lux Legal

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