AIRE health card: Italy’s National Health Service is back for Italians abroad
For millions of Italians living abroad, a long-awaited change is on the way. Parliament has approved a reform that will allow people registered with AIRE who live in non-EU countries to enroll voluntarily in Italy’s National Health Service and obtain a health card again.
For those who live in countries such as Mexico, the United States, Canada, the United Kingdom, Brazil or Argentina, this is an important change that could make it easier to access healthcare during stays in Italy.
What changes for people registered with AIRE?
Until now, when you moved your residence abroad and registered with AIRE, you lost your ordinary enrollment in Italy’s National Health Service.
This meant giving up:
- a family doctor;
- an Italian health card;
- specialist appointments covered by the National Health Service;
- ordinary medical and pharmaceutical prescriptions.
Under the new reform, Italians living in countries outside the EU and EFTA will be able to choose to rejoin the Italian healthcare system voluntarily without having to move their residence back to Italy.
How much does it cost to enroll?
To obtain a health card, an annual contribution of the following amount will be required:
€2,000 per year
The payment:
- must be made in advance;
- cannot be prorated;
- provides healthcare coverage for 12 months from the date the card is issued.
According to the technical report attached to the law, the amount was calculated on the basis of the average annual cost borne by the Italian state for each person covered by the National Health Service.
Good news for families
One of the most interesting aspects of the reform concerns minor children.
The approved text provides that healthcare coverage will be extended to minors when at least one parent or legal guardian enrolls in the program.
In other words, a family consisting of:
- one enrolled parent;
- one, two or more minor children;
could benefit from the healthcare coverage provided by the reform by paying only the parent’s annual contribution.
The final procedures will, however, be clarified by the implementing decrees planned by the Ministry of Health.
Who can enroll?
The new rules apply to:
- Italian citizens;
- who are duly registered with AIRE;
- who live in countries that are not members of the European Union;
- who live in countries that are not part of EFTA.
The reform fully applies to Italians living in Mexico.
What do you get with the health card?
Once enrollment is complete, it will be possible to access services provided by Italy’s National Health Service while staying in Italy.
The main benefits include:
- registration with an Italian local health authority, or ASL;
- issuance of a health card;
- access to National Health Service healthcare;
- medical appointments;
- hospital stays;
- prescription medication;
- tests and specialist services provided by the public healthcare system.
The fee could change over the years
The law provides that the €2,000 contribution may be updated periodically.
Any change will depend on:
- inflation trends;
- the actual costs borne by the healthcare system;
- monitoring how AIRE members use the measure.
What remains to be clarified?
Although the reform has been approved, several practical aspects still need to be defined:
- how to enroll;
- the documents required;
- how the relevant ASL will be selected;
- payment procedures;
- annual renewal;
- how family members will be handled.
These details will be established by a subsequent implementing decree from the Ministry of Health, and I will try to keep you updated.
Is it really worth it?
The answer depends on your personal situation.
For those who return to Italy for only a few days a year, the cost could be high.
For those who:
- spend long periods in Italy;
- have minor children;
- need periodic specialist checkups;
- want public healthcare coverage during their stays in the country;
the new AIRE health card could be a very interesting option.
Conclusion
After years of requests from Italian communities abroad, Parliament has opened the way for people registered with AIRE and living outside the European Union to return voluntarily to Italy’s National Health Service.
For thousands of Italian families around the world, and for many Italians living in Mexico, this could be one of the most important developments of 2026.
