The healthcare ticket: when and how to pay

Those who use some of the services provided by the Servizio Sanitario Nazionale – SSN (Italian national health system) are required to contribute a sum of money towards the health care costs of the State. This contribution is called a healthcare ticket. Learn how it works, how to pay and who does not have to pay it.

What is the healthcare ticket?

The healthcare ticket is a sum of money that you must pay after seeing a specialist, after an exam or to purchase medicines. You do not pay the whole cost of the service, but only a contribution. The rest is covered by the State.

You pay the cost of a ticket in these cases:

  • Diagnostic exams and appointments with specialists (doctors with specialties in different medical or pathological fields who are not your medico di base).
  • If, when you go to the emergency room, your case is not considered an emergency (white code) and you are not admitted to the hospital.

Medicines with a written prescription, that is called ricetta, by a doctor who belongs to the Servizio Sanitaria Nazionale – SSN, including the medico di base (red or pink ricetta). These medications are called di fascia A (category A medicines).

You pay a ticket following the appointment with a specialist or the exam, or at the pharmacy when buying medicines. 

Every region has its own procedure to pay for tickets, but generally you can find a place to pay directly at the hospital or healthcare setting where you have had the appointment with the specialist or the exam. You can also pay online through the PagoPA service and at those locations that are part of the PagoPa network, such as the tobacconist, the post office, some supermarkets, banks or at ATM points.

A ticket has a maximum cost of € 36,15In some regions it may be as high as € 46,15. The sum to be paid is the same for everyone.

However, there are some cases in which individuals are NOT required to pay. In these cases those individuals are “exempt” from paying. In other words they have been granted an exemption.

Exemption from paying for a ticket is possible in the following situations:

  • Serious/chronic/debilitating or rare illnesses: if you have a serious or chronic illness that can not be resolved in a short time, you do not have to pay any ticket for appointments with a specialist or diagnostic exams that are related to your illness. 
  • Disability: if you have a disability of 100% or less you are not required to pay for any ticket. Here is a list of the types of disabilities for which you can receive an exemption. 
  • Pregnancy: pregnant women are granted exemption for some appointments with specialists and diagnostic exams. The doctor will indicate on the prescription (ricetta) that the woman does not have to pay.
  • Income Status: if your income is less than an amount as established by the State, you do not have to pay any ticket. Those who do not have to pay because of income status: 
    • Children who are under 6 years of age and adults who are older than 65 with a sum total of family income (meaning the total amount of income of all members of the family)  that is less than € 36.165,98.
    • Unemployed individuals who are registered at the Centro per l’Impiego (employment office) with a family income that is less than or equal to € 8.263,31. If living with husband/wife the amount increases to € 11.362,65. For every dependent child the amount increases again by € 516,46. 
    • Those who receive an Assegno Sociale (or social allowance) and the family members who depend on them (dependents).
    • Those who receive the minimum pension (€ 515,58 is the lowest possible pension that one can receive), people older than 60  and whose family income is less than or equal to € 8.263,31. If living with a husband/wife the amount increases to € 11.362,65. For every dependent child the amount increases again by € 516,46.

To obtain the exemption for illness, disability or unemployment you will need to present specific documents that confirm your status to the local ASL (local health office in your region)

Instead, in the case of pregnancy or income status your doctor will include that you are exempt directly on the ricetta (prescription).  In the case of exemption for income status, your doctor will have access to a list of people who are exempt because of income status and so will find you on that list.  If you have the right to obtain the exemption but your doctor does not find you on the list, you should go to the local ASL to ask for information concerning your situation.


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