Do I qualify for Italy's income-based health co-pay exemption?
Italy has four national income-based exemptions from the health co-pay (ticket): E01 for people under 6 or over 65 with household income up to €36,151.98, E02 for the unemployed, E03 for people receiving the social allowance, E04 for people over 60 on a minimum pension. Answer five questions to see which code applies and what to do next.
The result is a guide to the national rules: only the ASL grants the exemption. The check runs in your browser: age, income and family details are not sent to anyone.
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What the income exemption covers
It covers the co-pay on specialist visits and tests. Some regions also charge a co-pay on medicines and decide on their own who is exempt: for medicines, ask the ASL or check your region's website.
Regions can also add their own exemption conditions to the national ones. This tool only checks the four national codes.
How income is counted
What counts is the total income of the tax household in the previous year, as shown in the latest tax return: everyone's income added up, before deductible expenses.
The household is the tax household, which can differ from the one registered at the town hall. It includes:
- the person filing the tax return
- the spouse who is not legally separated, even if not a dependant
- children and other relatives who are tax dependants
How long it lasts
The Sistema Tessera Sanitaria updates the list of exempt people every year. If you self-certify at the ASL, you get a certificate valid for the current calendar year (Ministerial Decree of 11 December 2009). Ask your ASL which expiry date your region applies.
If you were not entitled
The ASL checks every self-certification. If you were not entitled, it asks you to pay the unpaid co-pays within 30 to 120 days. Until you pay, you cannot get further specialist visits and tests covered by the national health service. False statements are also a criminal offence.
Official sources (in Italian)
- Sistema Tessera Sanitaria: Esenzioni da reddito (codici e soglie)
- Sistema Tessera Sanitaria: come funziona l'autocertificazione
- Sistema Tessera Sanitaria: FAQ su reddito e nucleo familiare
- Sistema Tessera Sanitaria: servizio online per i cittadini
- Legge 24 dicembre 1993, n. 537, art. 8, comma 16 (Normattiva)
- D.M. 11 dicembre 2009, verifica delle esenzioni per reddito (PDF, Sistema TS)
- Ministero della Salute: Esenzioni per reddito
Last updated: 11 October 2026. Rules and thresholds checked against the sources above.
The tool applies the national rules and gives a guide. It does not replace the ASL's check, which alone grants the exemption, and it is not legal or tax advice.
Frequently asked questions
What are the income thresholds for the co-pay exemption?
For E01, household income must be at most €36,151.98. For E02 and E04 it must be below €8,263.31, rising to €11,362.05 with a spouse, plus €516.46 for each dependent child. E03 has no threshold. These are the figures of Law 537 of 1993 converted into euro, as published by the Sistema Tessera Sanitaria.
Does the E01 exemption renew automatically?
Every year the Sistema Tessera Sanitaria recalculates the list of exempt people using Revenue Agency and INPS data. If you are on it, you don't need to do anything. If you are not but qualify, you have to self-certify at the ASL.
Does the income exemption cover medicines too?
It covers the co-pay on specialist visits and tests. Some regions also charge a co-pay on medicines and decide on their own who is exempt: ask your ASL how it works where you live.
Who counts as unemployed for the E02 exemption?
Someone whose unemployment status is registered with the job centre. In the self-certification you state which job centre you are registered with and commit to reporting when you find work, because the exemption ends at that point. If you have never worked, check with the ASL before self-certifying.
Where can I see whether I'm already exempt?
Ask your GP, who sees the list in their software, or the ASL. In some regions there is also the Sistema Tessera Sanitaria online service, with SPID, CIE or an activated health card.
Do you store the data I enter?
No. The check runs in your browser: age, income and family details never reach us or anyone else.