Healthcare in Italy for Italians living abroad: what the new €2,000 annual fee could mean

Healthcare in Italy for Italians registered abroad: what is changing?

Italian citizens who move abroad and register with AIRE, the Registry of Italians Resident Abroad, generally lose their standard entitlement to the Italian National Health Service. This can mean no longer having access to a family doctor in Italy, free hospital care or medicines covered through the usual co-payment system.

The new measure aims to give Italians living outside Europe the possibility of accessing healthcare services in Italy again, in exchange for an annual contribution of €2,000. This would allow eligible citizens to receive care in Italy during temporary stays, including access to doctors, hospital treatment and prescriptions.

This change is particularly relevant for Italian expatriates living outside the European Union, such as retirees spending part of the year in Italy, professionals based abroad, students, researchers or families who return to Italy regularly.

Why this matters for Italian expats outside Europe

For Italians living in another European country, access to healthcare may be partly supported by European coordination rules, depending on their situation. But for those living outside Europe, the situation is often more complex.

Healthcare access can vary significantly depending on the country of residence. Some destinations have high-quality private healthcare but limited public access for foreign residents. Others may require international residents to pay out of pocket, subscribe to local insurance or rely on private hospitals for faster treatment.

The €2,000 annual fee may therefore be useful for Italians who regularly return to Italy and want to keep a formal route into the Italian healthcare system. However, it should not be seen as a full replacement for expats health cover in the country where they actually live. Medical needs can arise at any time, and emergency treatment, specialist consultations, hospitalisation or long-term care may be needed abroad before any return to Italy is possible.

International health insurance: an important layer of protection

For Italians living outside Europe, international health insurance can help bridge the gap between local healthcare systems, private medical costs and occasional returns to Italy.

Unlike travel insurance, which is usually designed for short trips and emergencies, international health insurance is intended for people living abroad for a longer period. Depending on the plan selected, it can cover hospitalisation, outpatient care, consultations with specialists, diagnostic tests, medical imaging, prescribed medicines and other healthcare needs.

It can also be particularly valuable in countries where private healthcare costs are high, where access to public healthcare is restricted for expatriates, or where treatment in international hospitals is often preferred.

How APRIL International can support Italians living abroad

APRIL International offers international health insurance solutions designed for expatriates, families, students, retirees and internationally mobile professionals. For Italians living outside Europe, this type of cover can provide support in the country of residence and, depending on the selected plan and area of cover, during stays in other countries.

With APRIL International, insured members can benefit from flexible levels of cover, access to a large international medical network, digital services to manage claims more easily and multilingual assistance. This can help expatriates feel more secure when navigating healthcare systems abroad, especially in destinations where medical costs can be unpredictable.

For Italian citizens considering whether to pay the annual contribution to access healthcare in Italy, an international health insurance plan can act as a complementary solution: the Italian option may help during stays in Italy, while international cover helps protect day-to-day healthcare needs abroad.

What should Italians living abroad check?

Before making a decision, Italian expatriates should carefully review their situation. Important questions include: where they are officially residents, whether they are registered with AIRE, what healthcare rights they have in their country of residence, whether they return to Italy regularly, and whether they need cover for planned treatment, emergencies or ongoing medical conditions.

They should also compare the cost and scope of the €2,000 Italian healthcare contribution with the benefits of international health insurance. The right solution may depend on their age, destination, family situation, medical needs and how often they travel back to Italy.