Key points
- Italy runs the Beveridge model: a national health service (SSN), funded from general taxation.
- Public coverage is 100%, for all citizens and resident foreign nationals (Commonwealth Fund).
- Care is delivered by 20 regions through local health authorities, with GPs as the entry point and a referral needed for specialists.
- Most services are free or carry low co-payments, with exemptions by income, age, chronic illness and disability; adult dental care is mostly not covered.
- Life expectancy at birth was 83.5 years in 2023, and health spending was 8.4% of GDP in 2024 (OECD Health at a Glance 2025).
Direct answer: Italy runs the Beveridge model: a national health service (Servizio Sanitario Nazionale, SSN), funded from general taxation. Public coverage is 100%, for all citizens and resident foreign nationals, and the system guarantees a comprehensive package of essential services: primary, hospital, mental health and preventive care. Care is delivered by 20 regions through local health authorities, with GPs as the entry point and a referral needed for specialists. Most services are free or carry low co-payments, with exemptions by income, age, chronic illness and disability; adult dental care is mostly not covered. Life expectancy at birth was 83.5 years in 2023, and health spending was 8.4% of GDP in 2024 (OECD Health at a Glance 2025).
At a glance
| Item | Detail |
|---|---|
| Model | Beveridge — national health service (SSN) |
| Who pays | General taxation plus regional taxes and co-payments; government expenditure was 74% of total health spending in 2022 |
| Who delivers | 20 regions plan, finance and deliver care; local health authorities (ASL) deliver primary, preventive and hospital care |
| What is free at the point of use | Most essential services free or low co-payment; exemptions by income, age, chronic illness and disability; adult dental care mostly not covered |
| Life expectancy at birth | 83.5 years (2023, OECD Health at a Glance 2025) |
| Health spending | 8.4% of GDP (2024, OECD Health at a Glance 2025) |
| Source for the model and coverage | Commonwealth Fund — Italy country profile |
Figures are a snapshot checked 7 November 2026, not a live feed. No country is ranked as best.
How the system works
Italy’s national health system (Servizio Sanitario Nazionale, SSN) was established in 1978, replacing a fragmented social insurance system with a universal, tax-funded public service modelled on the United Kingdom’s National Health Service. Reforms in the 1990s decentralised control to autonomous local authorities and more independent hospital trusts, and a 2001 constitutional reform shifted financing and service delivery to the individual regions, while the state kept stewardship over the Essential Levels of Care (Livelli Essenziali di Assistenza, LEA), the national benefits package that defines guaranteed services (Commonwealth Fund).
The national Ministry of Health oversees planning and performance, defines the LEA and the funding criteria, and the National Health Fund allocates the budget to the regions. Within each region, local health authorities (aziende sanitarie locali, ASL) deliver primary care, preventive services and hospital care, and manage community services. The first point of contact is primary care: all residents register with a GP — or a paediatrician for children under 6 — through their ASL, and a GP referral is needed to access specialist care, after which patients can choose any accredited provider in the national system. A 2022 ministerial decree added community health centres (Case della Comunità), home-care coordination hubs and telemedicine to strengthen local, integrated care.
Who pays, and what people pay
General taxation pays for most of it, with additional revenues from regional taxes and co-payments: government expenditure was 74% of total health spending in 2022. Out-of-pocket spending was 22.7% of total health spending, driven by cost-sharing for outpatient services, diagnostics and branded pharmaceuticals (Commonwealth Fund). About 25% of Italians held some type of private insurance in 2023, supplementing the public system.
What patients pay is mostly a low co-payment on outpatient services and prescriptions, with wide exemptions: children under 6 and adults over 65 in households with an income below EUR 36,152 are fully exempt from outpatient co-payments, as are people with severe disabilities, war-related injuries, blindness or deafness, and anyone with a chronic or rare condition for services related to diagnosis and ongoing management. Regional authorities can offer additional services beyond the LEA if they fund them independently.
What is free, and what is not
Most essential services are provided with a low co-payment or none at all: preventive care, inpatient hospital care, outpatient care, maternity care, primary care, medicines, mental health care, palliative care and rehabilitation. What is not free is the margin: dental care, which is not generally covered except for some services for children under 14; eye care, which is not in the public benefits package; and long-term care, which is not covered through the health service, though a separate national allowance exists for people with severe functional limitations. Private insurance covers some of that margin for the quarter of the population that holds it.
How it compares
Italy spends 8.4% of GDP on health — below the OECD average of 9.3% — and $5,164 per person, below the OECD average of $5,967 (USD PPP, 2024). Its life expectancy of 83.5 years is 2.4 years above the OECD average of 81.1 years (OECD Health at a Glance 2025). Its distinguishing feature is the combination of strong outcomes at below-average spending with deep decentralisation: 20 regions run the system under one national guarantee, the LEA, so the same package is promised everywhere while delivery, waiting times and quality vary — with the poorer south having worse access to care and lower quality of services (Commonwealth Fund). Italy also has one of the highest doctor densities in the OECD table, 5.4 per 1,000 people, and one of the oldest medical workforces: in 2023 about 55% of doctors were over 55. Compare countries side by side in the Health System Comparison tool, or read the other profiles in the country index.
Frequently asked questions
Is Italian healthcare free?
Most essential services are free or carry only a low co-payment. Exemptions cover children under 6 and people over 65 in low-income households, and anyone with a chronic or rare condition for related care (Commonwealth Fund).
Who runs Italian healthcare — Rome or the regions?
Both. The national government sets the Essential Levels of Care (LEA), the guaranteed national package, and the regions plan, finance and deliver care through local health authorities (Commonwealth Fund).
What is the LEA?
The Livelli Essenziali di Assistenza: the national list of essential services every resident is guaranteed, defined by the state while the regions organise delivery (Commonwealth Fund).