Quality at the Health Service

Depending on certain clinical, income or social conditions, some medical services are provided by the National Health Service free of charge (exemptions) or upon payment of a ticket.

The ticket is the contribution that the citizen provides to health spending by paying a specific fee for some services included in the essential levels of assistance , or the services and services that the National Health Service (Ssn) is required to provide to all citizens, free or on payment of a fee , the ticket in fact.

To date, the contribution concerns:

• Specialist performances
• First aid services
• Spa treatments
• drugs

When is the right to exemption?

To be eligible for the ticket exemption , certain requirements are required:

• Income : it concerns all citizens who find themselves in an income situation lower than the limits established by the State and the Region and which vary from year to year;
• Age , for citizens aged 0 to 6 and aged 65 and over for services provided by the Emergency Department;
• Social status ;
• Presence of certain diseases : it concerns citizens affected by chronic diseases, disabling and rare diseases . These citizens are entitled to exemption from the payment of the ticket also for outpatient services and instrumental diagnostics closely related to the pathology from which they are affected.
• Recognition of the state of invalidity ;
• Other special cases ( pregnancy , early diagnosis of some cancers , HIV detection, vaccines ).

The exemption can be:

• Total , when no payment is requested from the citizen;
• Partial , when the citizen may be required to pay a reduced fee compared to that in force for all other citizens.

Tariffs for Region

The tariffs are identified by the national tariff nomenclator , a document issued and periodically updated by the Ministry of Health which contains the list of prosthetic services and devices available for free by the SSN. Many regions , however, have adopted their own tariff nomenclators in which they set their own rates, introducing new services, modifying or eliminating existing services.

Cost for exams and specialist visits

For the specialist and outpatient services at national level, a ticket is to be paid as a citizen’s contribution to health care costs. The amount varies depending on the performance, up to the reaching of a maximum ceiling established by law equal to € 36.15 per prescription , which the Regions can lower or raise. To this figure is added the fixed price per recipe , which almost all the regions have introduced and which can be fixed or variable, modulated on some factors and depending on the Regions:

• Cost of the service (creating shares proportional to the economic value of the recipe),
• Type of service,
• Exemptions,
• Family income,
• Health conditions (pregnancy, for example),
• Social conditions.

Cost for drugs

The ticket is also paid on drugs . There is no single rule valid at national level: both the amount and the methods of application vary from region to region based on various factors.

Cost for first aid services

The law imposes on the clients, paying a ticket of 25 euro for services provided in the emergency room hospital and are not followed by hospitalization, those classified with “code white” (non-urgent treatments, the patient in a critical condition ) with the exception of acute traumas and poisonings. No ticket , and therefore no cost, for the redcodes (very critical patient), yellow (moderately critical) and green (not very critical).

Also in this case, the Regions have implemented the law with their own provisions which, in certain cases, differ from the national standard.