First Encounter with the Italian Medical System

Mike D. relocated from Florida to Certaldo, Italy in 2022. He blogs about his experiences with the challenges of Italian bureaucracy and the joy that balances out all the challenges. You can read his other posts here.

I made it three months in Italy without the need for any medical assistance.  I had checked with my insurance company when I got here to confirm I was covered in case I did need something.  I knew I might have to pay some out-of-pocket costs and get reimbursed later.  I also made sure I knew who to call in case of an emergency: Italy’s equivalent to 911 in the United States is 118.

Well, my luck ran out and I had my first experience with the Italian medical system.  I was getting strong abdominal pains on my right side which didn’t go away despite the fact that I ignored them as much as possible.  I finally gave up and went to see a doctor.  When the doctor gave me a quick examination, he sent me directly to the hospital in the nearby town of Poggibonsi, with a note for bloodwork and a sonogram.  Not the outcome I was hoping for.

Walking into an Italian E.R. is the same experience you would expect to have just about anywhere in the U.S.  25 or so chairs, most of them filled with the sick and injured; nurses moving around from place to place trying to figure out what to do and how to get into the process and get started.  In Italy, the foreign language challenge adds a unique layer to the confusion for me personally, but I was fortunate to have been accompanied my guardian angel, Maria, who has watched over me since I arrived and was invaluable in this experience.
Evenutally they took my name, address and phone number, and that got me a ticket in the line.  After a half hour or so, I made it into the next step in the process.  Triage.  I didn’t know it at the time but this was the most important step in the process.  This nurse got to decide where you went on the list.  Fortunately (?) for me, I was getting waves of pain when she started taking my info. Scanning my passport, filling out forms.  Next, I got a gurney in the hallway with a dozen new friends and their gurneys.  After a few minutes, I was seen by a doctor and two nurses.  Considering the number of people in the E.R., I was impressed with where I was by this point.
The doctor knew less English than I knew Italian and I had lost my friend in the waiting room.  He poked and prodded.  Apparently wincing in pain is universal and he quickly determined where it hurt so, like any good doctor, he obviously poked and prodded there some more.   He ordered the sonogram and bloodwork and gave me a shot for the pain.  I don’t know what it was, but it was wonderful.  It completely masked the pain but I didn’t feel loopy and out of it.   They drew blood and wheeled me to another room to be scanned.  The doctor who had seen me in the E.R. and one of the two nurses came in while the technician did the sonogram, something that wouldn’t be common back home.  After ten minutes and several conversations in Italian between them, I got diagnosed with “calccoli renali”.  One of the nurses typed it into her phone and said “kidney stones”.
I’ve had them before. If you’ve never had them, people who have been shot and have had kidney stones will tell you passing kidney stones is the more painful of the two.  I knew the agony was going to get worse before it got better, but my fear had been that it might be my appendix, so kidney stones was actually a relief. They prescribed a round of antibiotics, a type of steroid to reduce the size of the stones to help pass them, and vials of pain medication that you inject yourself, something that apparently is very common here.
I went to the pharmacy to pick up the meds: a week of antibiotics, a week of steroids, 15 vials of pain meds and syringes.  I have no idea what that would cost in the U.S. but I knew they weren’t going to take my CVS prescription card and I expected a long battle with CVS later.   He rang it up and said 30 euros.  ($32).  I was prepared for 20 or 30 times that number and probably will never bother to attempt to recover the money from my insurance.
I previously mentioned having contacted my insurance company (Blue Cross / Blue Shield) before coming to Italy.  To say a little more about this: They assured me I was covered. They did indicate that most likely for doctors visits, they will want to be paid up front and I would have to turn in the bills to them to be reimbursed. For hospital visits (what were the chances that was going to happen?), the hospital would bill them directly. As it turned out, the doctor I started at didn’t charge me anything and the hospital never asked me for my insurance info so I don’t know what will happen. In the U.S. that is the first question they ask, before they even check if you are breathing: “What insurance do you have?” With socialized medicine, it’s not even part of the process. I don’t know if I will actually ever see a bill.

If the two experiences I had with the doctor and the hospital visits are a fair indication of what is common here, I expect I will be happy with any issues in the future.  It was an efficient, professional, and affordable process. As an American living in Tuscany, the Italian medical system get an A+ so far with me.


  1. Carol

    So happy to hear that Maria went with you to the hospital. She truly is your guardian angel. Also glad to hear how well the experience went and that you got all that medication for $32. Now please pass the kidney stones!!!

    • Michael D'Ambra

      The Italian medical system has their act together

  2. Kathy Baird

    Glad to hear it was kidney stones and not something worse. I was in the ER in Northern Ireland and had a similar experience. I have not as yet received a bill and that was four years ago.

    (Yankees are in first place in case you hadn’t heard.)

    Take care Mikey. Enjoy every minute!!


    • Michael D'Ambra

      Thank you. As I said, I was very impressed with the the entire medical system

  3. Jennifer D'Ambra

    I am very happy you’re okay. And I’m also very glad to hear that the hospitals there took good care of you. Please be careful.

    • Michael D'Ambra

      Yes they take good care of me and yes, I try to be careful

  4. Jim DeCaria

    Ciao Michele! Jim DeCaria here. Sharon shows me your account of the experience with the Italian Medical System and I found it most interesting. My Brother Bruno lives in Rome and we have visited him multiple times. I have not had any contact with a doctor or the medical system while visiting him, but am very glad that you were treated well and relatively quickly.


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