Monday, 22 June 2026
Italy approves National Health Service access for Italians abroad: AIRE-registered citizens can now enrol for €2,000 per year
Italy’s Senate has definitively approved a law allowing Italian citizens registered with AIRE, the Registry of Italians Residing Abroad, to access the Italian National Health Service (SSN) by paying an annual contribution of €2,000. The measure, approved with 72 votes in favour, 3 against and 54 abstentions, applies to Italians residing in countries outside the European Union and outside the European Free Trade Association (EFTA). It represents a significant change in the relationship between Italy and its global diaspora, removing a long-standing barrier that many Italians abroad had experienced as a penalisation for choosing to live outside Italy.
What does the new law provide?
The law, DDL n. 1730, sponsored by MP Andrea Di Giuseppe (Fratelli d’Italia), provides that all Italian citizens regularly registered with AIRE and residing in non-EU, non-EFTA countries will be automatically enrolled in the SSN. However, automatic enrolment and actual access to healthcare services are two distinct steps: the health card, the tessera sanitaria, will only be released after the citizen has paid the annual €2,000 contribution and after verification of their tax and contributory position.
The reform is structured as a model of sustainable co-responsibility: the costs of healthcare for Italians abroad are covered entirely by their own contributions, with no additional burden on the Italian national public finances.
How will the contributions be managed?
Contributions paid by Italians abroad will be managed through traceable digital platforms and will flow directly into the budgets of the individual regional health systems and the competent local health authorities (ASL). The stated aim is to ensure that every euro collected covers the real cost of services provided, ring-fenced for the regional system where the citizen seeks care.
The law also introduces simplified enrolment procedures, including dedicated AIRE-ASL information desks, targeted agreements between the Ministry of Health and the Ministry of Foreign Affairs, and a real-time digital interoperability system linking civil registries with regional health systems.
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Who benefits, and who is excluded?
The law applies to AIRE-registered Italian citizens residing in non-EU, non-EFTA countries. In practice, this covers large Italian communities in the United States, Canada, Australia, Brazil, Argentina and other countries outside the European economic area. Italians residing within the EU or in EFTA countries are already covered by European healthcare coordination rules and are not included in this law.
A specific provision extends free healthcare to children of AIRE-registered Italians, a measure described by the law’s sponsor as a central element of social justice.
What this means for descendants considering Italian citizenship
This reform is directly relevant to the growing number of descendants of Italian emigrants who are considering or pursuing Italian citizenship by descent. Obtaining Italian citizenship, and registering with AIRE, would, under this new framework, entitle them to access Italy’s National Health Service during visits to or stays in Italy, for an annual contribution of €2,000.
For descendants who have not yet obtained formal recognition of their Italian citizenship, the new law adds a concrete, practical benefit to the list of reasons to pursue recognition. The path to citizenship, whether through a consulate or through a judicial proceeding, remains the necessary first step before AIRE registration and NHS access become available.
If you are unsure whether you are eligible for Italian citizenship by descent, or whether the 2025 reforms affect your situation, a case-specific assessment is the necessary starting point.
Frequently Asked Questions
Who can access Italy’s NHS under the new law?
Italian citizens registered with AIRE who reside in non-EU, non-EFTA countries (including the United States, Canada, Australia, Brazil and Argentina) can access the Italian NHS by paying an annual contribution of €2,000.
Is enrolment in the SSN automatic?
Yes, all eligible AIRE-registered Italians will be automatically enrolled. However, the tessera sanitaria giving access to healthcare services will only be released after payment of the annual €2,000 contribution and verification of the citizen’s tax and contributory position.
Do Italians living in the EU benefit from this law?
No. Italians residing in EU or EFTA countries are already covered by European healthcare coordination rules. This law applies specifically to those in non-EU, non-EFTA countries.
Does Italian citizenship need to be formally recognised first?
Yes. The law applies to Italian citizens registered with AIRE. Descendants of Italians who have not yet obtained formal recognition of their citizenship must complete the recognition process, consular or judicial, before they can register with AIRE and access the NHS under this law.
Where do the contributions go?
Contributions flow directly into the budgets of the relevant regional health systems and local health authorities, covering the real cost of services provided. They do not enter the general national budget.
Are children of AIRE-registered Italians covered?
Yes. The law provides free healthcare for children of AIRE-registered Italians, a provision described as a key element of social justice by the law’s sponsors.
Thinking about Italian citizenship?
If you are a descendant of an Italian-born ancestor and want to understand whether you are eligible for Italian citizenship by descent, and what benefits recognition would bring, including access to the Italian NHS, a case-specific review is the first step.