Private health insurance for the permesso di soggiorno: what Italy actually requires (2026)

Not every foreigner in Italy needs private health insurance. Whether you do depends on why you hold your permit. This guide covers non-EU citizens only. EU citizens follow different rules.

Who is covered for free, and who is not

Italian law (D.Lgs. 286/1998, art. 34) splits permit holders into two groups.

Registered with the national health service (SSN) by right. This includes people working in Italy and people holding a permit for family reasons, asylum, subsidiary or special protection, pending adoption or foster care, or a citizenship application, among others. If you are in this group, you do not need private insurance for your permit.

Must arrange their own cover. Everyone else, for example students and elective-residence holders, must either:

• buy an insurance policy against illness, accident and maternity, from an Italian or foreign insurer, valid in Italy; or
• pay to join the SSN voluntarily: at least €700 a year for students, at least €1,200 a year for au pairs and at least €2,000 a year (income-based) for most others. See our guide to voluntary SSN registration and the SSN cost calculator.

Note that the law lists maternity as well as illness and accident. Many cheap policies leave maternity out.

One special case: parents over 65 joining a family member through family reunification need insurance covering all risks in Italy, or SSN registration (art. 29).

Step 1: the study visa

For a type D study visa, a Ministry of the Interior directive of 1 March 2000 (art. 5) asks students to show either the money for SSN registration or a specific policy for medical care and hospital stays, valid for the whole length of the stay.

Consulates then add their own details, and they differ. Examples from recent checklists:

• The Italian embassy in Belgrade asks for at least €30,000 of cover for urgent medical costs, hospitalisation and repatriation, valid in the Schengen area from your travel date through your first 15 days in Italy. For the permesso you then need cover for the whole academic year, or voluntary SSN.
• The Italian embassy in Washington asks for a letter from the insurer stating your name, coverage dates and at least €30,000 for hospitalisation, emergencies, evacuation and repatriation for the entire stay. Its newer checklist drops the €30,000 and instead asks for a consular declaration if your policy is foreign, or a declaration from the insurer if it is Italian, confirming no limits on emergency hospital rates.

The €30,000 figure comes from consulate practice, not from the permit law. Always follow the checklist of the consulate where you apply.

Step 2: the permesso application and renewals

After arrival you apply for the permesso itself. A Questura document list for the postal kit on poliziadistato.it asks study-permit applicants, for both the first permit and renewals, for a copy of a health insurance policy covering the period of stay or proof of voluntary SSN payment. University international offices (for example Milan's Università Statale) say the same. Check the Questura's current list before you go, since it can change.

What to check in any policy before buying

• Valid in Italy, stated in writing
• Covers the full permit period, with no gap between visa entry and permit expiry
• Covers illness, accident and maternity
• Covers emergency care and hospitalisation (ricovero), with no caps on the official hospital rates
• Meets any minimum amount your consulate states (often €30,000)
• Repatriation, if your consulate asks for it
• Policy document or certificate you can show in Italian or English; ask the Questura or consulate whether a translation is needed
• Your name and exact dates printed on the certificate
• Insurer listed in the IVASS register (ivass.it) if it is Italian or an EU insurer selling in Italy. Insurers from outside the EU will not appear there, so a missing entry is not a red flag in itself
• If the insurer is foreign, check whether your consulate must certify the policy's validity in Italy (dichiarazione consolare)

Insurance or SSN?

For students, voluntary SSN registration at €700 gives you a family doctor and the same services as an Italian resident, but it does not cover family members. It also always runs from 1 January to 31 December and cannot be split. A private policy can match your exact dates. Compare both with the SSN cost calculator.

Sources: D.Lgs. 286/1998 arts. 29, 34 and 39 on normattiva.it; Ministry of the Interior Directive of 1 March 2000, arts. 4 and 5 (vistoperitalia.esteri.it); Italian embassies in Belgrade and Washington, study visa checklists (esteri.it); a Questura postal-kit document list (poliziadistato.it); IVASS register of insurers (ivass.it); Università degli Studi di Milano, residence permit documents. Checked October 2026.