• Italy has a public health service

• The right to equal health care for all is enshrined in the Italian constitution

Those are the facts, but for those without papers it can be a different story. The government has been working towards a unified approach in all its regions, but reports suggest that there are still disparities. Even an official report from the government suggests that different doctors and clinics have a lot of leeway to interpret the laws as they see fit, which can obstruct the equal access principle enshrined in the constitution.

Italy’s Ministry of Health website quotes the president, Sergio Mattarella: “The way a society tackles the problems of those most vulnerable is a measure of its civility and its true strength.”

But the Organization Open Migration has called the right to health care for migrants an “obstacle race.” Since a decree in 2015 (number 142) regarding asylum and reception, some regions of Italy have offered registration to asylum seekers only for the first two months. After that they are expected to pay more of the health costs, which can put many off trying to access health care.

For children over six whose parents are undocumented migrants, access to health care also ceases to be free, which means that many parents take their children to the emergency room instead of paying for normal pediatric care.

The Prefecture, local and regional administration, an organ of the Ministry of the Interior lays out guidelines for foreigners accessing health care here. 

SSN – Italian National Health Service

If you DO have papers, you should sign up for the National Health Service or Servizio sanitario nazionale (Ssn); for that you need to go to an ASL counter in your local town. The service is free if you have a permit to stay.

• You will need a residence permit or receipt of request of one and a tax code (codice fiscale).
• Foreigners outside the EU cannot sign up until they have been resident in Italy for more than three months.
• All unaccompanied minors and pregnant women have a right to health care, in the case of the latter, until the child is six months old.

The Stp (Stranieri temporaneamente presenti) Temporary Foreigners Code

• Those without papers still have access to emergency health care, if refusal would put their life in danger.
• Italian hospital emergency departments are meant to accept those without documents. They will register you and give you a Temporary Foreigners Code (Stp – Stranieri temporaneamente presenti) which is valid for six months and offers free care.  
• Registering for this code should not mean that you are reported to the authorities.
• SIMM in Lazio (the region around the capital Rome) has created a map which shows all the clinics in the region where you can register for an Stp and access free health care. Most of the costs for medicines and care should also be covered by this card.
• To obtain an Stp you need to prove that you don’t have the means to pay for your own medical care.

**You can also ask that the card is issued without your name or surname. Once you have this card you will have access to basic medical care and to any urgent hospitalization as a day patient. Although doctors are not obliged to inform the authorities when you apply for this card, the authorities might be informed if you create a public disturbance, as would be the case with any Italian citizen.

Other useful organizations that provide help

CARITAS (a Catholic Charity) https://www.caritas.it/

SIMM (Società Italiana di Medicina della Migrazioni) – Italian Society for Migration Medicine https://www.simmweb.it/

Centro Astalli https://centroastalli.it/ which offers cost free access to doctors, lawyers and many basic medicines which are not covered by the Italian medical card. https://centroastalli.it/servizi/ambulatorio/ As well as offering health care they offer help with accessing the full public services in Italy.

The Italian Refugee Council (Cir) might also be helpful: http://www.cir-onlus.org/ They offer treatment and rehabilitation services in Rome for instance for victims of torture. In this project they try and offer psychiatric rehabilitation via music and theater.

There are also small and large non-governmental organizations which often run out-reach clinics and mobile facilities in regions where access to medical health care can be difficult.

Emergency https://www.emergency.it/

MSF (Doctors without Borders) Italy - https://www.medicisenzafrontiere.it/

In Milan the organization NAGA https://naga.it/ can help with migrants’ rights including in the area of medical care. They have a clinic and outreach doctors as well as a special service for foreign prostitutes called Cabiria.

In Rome the INMP https://www.inmp.it/index.php/ita (Instituto Nazionale per la promozione della salute delle popolazioni Migranti) – National Institute for the promotion of the health of migrant populations. They have a clinic which offers care to all citizens both Italian and foreign.

The clinics are in Via delle Fratte di Trastevere 52, Rome and are open Monday - Friday between 07:30 and 12:30. They offer blood tests until 10 am each day.

Monday - Thursday they are also open from 14:00-17:00.

On Saturday and Sunday they are open 08:00-12:00: **Clinic appointments are given out from 8 am and you don’t need an appointment but it is best to arrive early as they fill up quickly. https://www.inmp.it/ita/Assistenza-sanitaria

There are also useful links on their page explaining the services they offer and how to access different parts of the health service in Italy.

If you are already ill and want treatment in Italy

**You can also access a visa in Italy specifically to receive medical care. In this case you need to:

• Request a visa from the Italian embassy or consulate in your country.
• Once you enter Italy, you need to request a "medical care" permit to stay from the Questura (Police HQ) in the town or city where you intend to be hospitalized. **If you don’t do this within eight days of entering the country you will be considered an undocumented migrant.
• You need a medical certificate explaining the condition you have.
• You need a certificate of acceptance from the Italian hospital where you intend to be treated which will indicate the types of treatments needed, the date you need to start your treatment and the presumed duration of treatment.
• You need to pay a deposit of at least 30% of the total costs of care at the hospital where you intend to be treated.
• You need a document to prove that you have enough money in Italy to pay the entire medical costs of your care, as well as food and board, at the end of treatment.
• You need a document to prove that you have enough money to pay for the return journey for you and the person who accompanies you to your country of origin.
• Any certificates from abroad need to be translated in Italian.

Attitudes to migrant health

There have been numerous studies over the years into migrant health commissioned by the government and various non-government organizations.

Guidelines have focused particularly on diagnosing and treating particularly common conditions prevalent among those arriving on Italian soil, such as Tuberculosis, Malaria, Hepatitis B and C, HIV, parasitic infections, Sexually Transmitted Diseases (STDs).

The document also highlights chronic-degenerative diseases like Diabetes, Anemia, High Blood Pressure, Cervical and Uterine Cancer which should be screened and, if found, treated because the cost of not doing so would be higher for the Italian public health services. Many doctors who work in the field of migration point out that migrants are no more unhealthy than the rest of the population and often arrive in very good health. Many of their medical needs arise through living in insanitary conditions in the host country.