How to move to Italy with the elective residence visa

If you’ve ever dreamed of living in Italy, perhaps spending your days among Tuscan vineyards, lakeside towns, or historic cities, the Elective Residence Visa (ERV) might be your path to making it happen.

This visa is designed for non-EU citizens who want to live in Italy long-term without working, and who can show a stable income or sufficient savings to support themselves. It’s a popular option for retirees, remote property owners, and anyone ready to enjoy a slower lifestyle in Italy.

But there’s one important part of the process that often causes confusion: healthcare access.

Let’s break it down.

What the elective residence visa is

The elective residence visa (ERV) allows you to live in Italy for more than 90 days without taking up employment.

To qualify, you must prove:

• A stable and regular income (for example, a pension or investments).
• Accommodation in Italy, such as a rented or owned home.
• Comprehensive health coverage, valid for your entire stay.

You’ll need to apply for the visa before arriving in Italy (usually through your local Italian consulate), and it’s typically issued for one year, renewable annually as long as you maintain the same conditions.

Because ERV holders are not permitted to work in Italy, you’ll need to demonstrate that you can support yourself financially through passive income or savings.

Healthcare requirements for the visa

When applying for an Elective Residence Visa, you must show proof of private health insurance that:

• Covers you throughout Italy and the Schengen area.
• Is comprehensive, meaning it includes hospital stays, emergency care, and medical repatriation.
• Is valid for at least one year or matches the duration of your visa.

This is where Feather comes in.

Our health insurance plans are fully compliant with Italian visa requirements, making them ideal for your ERV application.

With Feather, you can easily provide the documentation required for your visa appointment and stay covered from your first day in Italy (even before you register with the public system).

Joining the Italian healthcare system (SSN) after moving

Once you’ve arrived in Italy and received your permesso di soggiorno (residence permit), you’ll become eligible to apply for residency. After that, you can register with the Servizio Sanitario Nazionale (SSN), Italy’s public healthcare system.

For Elective Residence Visa holders, SSN registration is usually voluntary, meaning you’ll need to pay an annual contribution. The cost depends on your income and residency type, but here’s a general overview:

• €2,000 per year (with income up to €31,925).
• Up to €2,788.87 per year for higher income brackets.

Payments are made via the F24 form and renewed annually.

Once registered, you’ll have access to public healthcare, including general practitioners, hospital care, and specialist visits. Typically, with small co-payments (“ticket”) of up to €36 for specialist visits or prescriptions and €25 for hospital visits.

However, coverage through the SSN applies only within Italy, and the registration process may take time to complete.

How to decide whether to join the public system or stay on private insurance

Private health insurance can cost significantly less than registering with the public system.

For example, Feather’s Newcomer Plan starts at just €72 per month (about €864 per year), compared to an SSN contribution that ranges from €2,000 to €2,788 per year for elective residents.

With Feather, you also gain direct access to private doctors and clinics without long waits.

If you have serious pre-existing conditions, you might choose to combine the SSN with private insurance, since the SSN covers ongoing or existing health issues that private plans may not include.

Pensioners from countries with a bilateral treaty might be able to transfer healthcare rights to Italy

If you receive a pension from a country that has a reciprocal healthcare agreement with Italy (such as certain EU or EEA countries) you might qualify for SSN coverage automatically or with reduced contributions.

For example, pensioners from countries with a bilateral social security treaty (like the UK or Switzerland) can sometimes transfer healthcare rights through forms like S1 or similar, depending on agreements in force.

For retirees from non-EU countries like the United States, Canada, or Australia, voluntary SSN registration is still available, but private insurance remains necessary at least initially.

Why private health insurance still matters

Even after joining the SSN, many Elective Residence Visa holders choose to keep private insurance. Here’s why:

• Immediate access: You won’t need to wait for your residence or SSN registration to be complete.
• Faster care: Private insurance lets you skip long waiting lists for specialists or scans.
• Language comfort: Many private doctors and clinics offer services in English.
• Broader coverage: You’ll be protected across Europe, not just within Italy.

For example:

An American retiree has just moved to Tuscany.

They apply for the Elective Residence Visa with Feather’s visa-compliant plan, using it for their first months in Italy.

Once settled and registered as a resident, they join the SSN for long-term peace of mind. But they keep Feather for fast access to private specialists and English-speaking doctors.

It’s a balance that gives them the best of both systems: the reliability of public care and the flexibility of private healthcare.

Conclusion

If you’re planning to move to Italy on an Elective Residence Visa, you’ll need private health insurance to apply. And, you’ll likely want to keep it once you’re here.

Feather makes that easy. Our plans are:

• Compliant with Italian visa and residence requirements.
• Accepted by consulates and local immigration offices.
• Flexible, letting you stay covered during your transition to the SSN.

Start your Italian chapter with confidence, knowing you’re protected from day one, supported every step of the way, and ready to enjoy life under the Italian sun.