---

Population Insurance Coverage For A Core Set Of Healthcare Services (%) (2019):
Public Coverage: 100%; Primary Private Health Coverage: 0%; Total: 100%

*“Population coverage for health care is defined here as the share of the population eligible for a core set of health care services – whether through public programmes or primary private health insurance. The set of services is country-specific but usually includes consultations with doctors, tests and examinations, and hospital care. Public coverage includes both national health systems and social health insurance. On national health systems, most of the financing comes from general taxation, whereas in social health insurance systems, financing typically comes from a combination of payroll contributions and taxation. Financing is linked to ability-to-pay. Primary private health insurance refers to insurance coverage for a core set of services, and can be voluntary or mandatory by law (for some or all of the population.”

Source: OECD (2021), Health at a Glance 2021: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/ae3016b9-en.

---

“As noted in Section 4, the NHS [National Health Service] covers all citizens and legal foreign residents. Coverage is automatic and universal, and care is generally free for hospital and medical services. Irregular migrants are entitled to access urgent and essential services. The basic benefits package covers a wide range of services, and must be guaranteed uniformly across the country. A compliance monitoring system is organised at the national level to identify regions that do not guarantee the basic package to their populations (Ministry of Health, 2021). Regions can also choose to offer services beyond the benefits package list, but must finance these with funds collected from regional taxes.”

Source: OECD/European Observatory on Health Systems and Policies (2021), Italy: Country Health Profile 2021, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.

---

“Health services are mainly delivered by public providers, alongside private or public-private entities. GPs and paediatricians act as gatekeepers for access to secondary care. Under the NHS, patients can choose either public or private providers for hospital care and specialised ambulatory services, usually depending on perceived quality and waiting time.

“Recognising that new types of services are required to meet emerging care needs, a national initiative designed to improve the coordination of chronic care was launched in September 2016 (Piano Nazionale della Cronicità; Ministry of Health, 2016). A number of regions are piloting the implementation of different health service models, through multispecialty community-based centres and case management that combine health and social care, to better respond to the needs of patients with co-morbidities. However, in most cases these pilots have not been subject to formal evaluation.”

Source: OECD/European Observatory on Health Systems and Policies (2019), Italy: Country Health Profile 2019, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.

---

“The SSN covers all citizens and ordinarily resident foreign nationals. Population coverage is automatic and universal. Undocumented migrants are entitled to access only urgent and essential services. Health care for prisoners, which was previously delivered through the Ministry of Justice, was integrated into the SSN in 1999; moreover, prisoners are usually excluded from having to pay co-payments.

“In terms of the scope of coverage, the SSN guarantees the provision of health services included in the national benefits package (LEA) across the entire country. These are delivered through the activities of public providers (i.e. regional and local health care authorities, independent public hospitals (known as “hospital trusts”), university hospital trusts, the tertiary care and research centres (IRCCSs) and private-accredited providers (see Chapter 2). Regions can choose to offer non-LEA services but must finance these themselves. Health care services provided within the SSN (i.e. the LEA) are identified by positive and negative lists using criteria related to medical necessity, effectiveness, human dignity, appropriateness and efficiency in delivery (Lo Scalzo et al., 2009).”

---

“Positive lists exist for community care services (primary care, emergency care, pharmaceuticals, specialist outpatient care, integrated care, prosthesis care, ambulatory and home care, residential and semi-residential care, and thermal therapy), public health and occupational health services (Torbica & Fattore, 2005). For the latter, there is a list of general community and individual levels of preventive services that are covered, including hygiene and public health, immunization and early diagnosis tools. Hospital services are not specifically defined. Dental care – specifically orthodontics and dental prostheses – is generally not covered and is paid for out of pocket or reimbursed through policies offered by private for-profit and not-for-profit insurance companies (see Box 3.1 and section 3.4).

“Negative lists include ineffective services; services that are covered only on a case-by-case basis, such as orthodontics and laser eye surgery; and inpatient services for which ordinary hospital admissions are likely to be potentially inappropriate (e.g. cataract surgery and carpal tunnel release). For the latter category, regions should provide substitute treatment at other levels of the health care delivery system, such as day hospital and ambulatory care.

“In 2017, the national benefits package was thoroughly revised and updated; in particular new vaccines, services for outpatient care, diagnostic services, neonatal care and health devices were added. It also included a list of rare disease to be covered by the SSN [Italy’s national health service]. Of note, Italy is probably the only country in Europe to introduce a voucher system to subsidize food for patients with coeliac disease.”

---

Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and sixteen other nations.

---

Page last updated Feb. 1, 2023 by Doug McVay, Editor.