Growing older in Italy: from village apartments to RSA care homes

How Italy houses its older population

Italian culture traditionally keeps elders at home, often supported by relatives or by live-in carers known as badanti. Residential care exists in every region but is less widespread than in northern Europe, and waiting lists for publicly funded places can be long in many provinces.

For foreign retirees who are still independent, the usual choice is an ordinary apartment or village house. Purpose-built senior housing with services is emerging in larger cities, while co-housing and small community residences are being tested in several regions as alternatives to institutional care.

Main types of senior accommodation

Terminology varies between regions, because each regional government organises social and health services. The table below summarises the categories most often encountered when searching for accommodation for an older person, from independent living to round-the-clock medical care.

Public, private and religious operators

RSA places can be accredited by the regional health system, which then pays the medical share while residents or municipalities cover accommodation costs. Many facilities belong to Catholic institutions, cooperatives or foundations, alongside private groups operating fully paying residences in cities and resort areas.

Access to an accredited RSA place normally follows an assessment by a multidisciplinary team of the local health authority, the ASL. Foreigners who are registered residents follow the same path, but places in private facilities can be booked directly without waiting for that evaluation.

Visas and residence for foreign retirees

Citizens of the European Union may live in Italy and register their residence at the town hall once they show sufficient resources and health cover. Since Brexit, British retirees are treated like other non-EU nationals unless they were already resident before 2021.

Non-EU retirees usually apply for the elective residence visa at an Italian consulate, demonstrating stable passive income and suitable accommodation. After arrival, a residence permit must be requested from the local police headquarters, and paid employment is not allowed under this status.

Healthcare and insurance

Residents can register with the national health service and choose a family doctor. EU pensioners and holders of a UK S1 form are generally covered through their pension country, while other non-EU retirees often need private insurance or voluntary enrolment for a yearly fee.

Quality of hospital care is generally higher in the north than in parts of the south, which matters when choosing a region. Private insurance can shorten waiting times for specialists, and pharmacies play a strong advisory role for minor conditions in towns and villages.

Costs and popular regions

Housing in rural Abruzzo, Molise, Calabria or inland Sicily can be very affordable, whereas Florence, Milan, Lake Como and the Amalfi Coast are expensive. Some small southern towns offer a special flat-rate tax regime for foreign pensioners; check eligibility with a qualified tax adviser.

Tuscany and Umbria remain the classic choices for English-speaking retirees, while Puglia, Le Marche and Sardinia attract newcomers looking for sea, lower prices and fewer tourists. Winter in mountain villages can be cold and isolating, so access to services matters as you age.

Checking a contract before signing

Care-home contracts should specify the daily rate, what is included, how medical costs are shared and the notice period. For property purchases, a notary handles the deed, but an independent lawyer and a surveyor protect your interests far better than relying on an estate agent.

• Assuming a public RSA place is immediately available after arrival.
• Buying an isolated farmhouse that becomes impractical without a car.
• Hiring a badante informally instead of under a regular employment contract.
• Forgetting to register with the health service or keep private cover active.
• Underestimating paperwork delays at the town hall and police headquarters.

Moving to Italy step by step

The order of operations matters because the consulate expects proof of accommodation before issuing a visa. Renting first is usually wiser than buying immediately, as it allows you to compare towns, hospitals and transport while your residence status is being finalised.

1. Choose a region and visit it in different seasons.
2. Secure a rental contract and gather proof of pension income.
3. Apply for the elective residence visa if you are not an EU citizen.
4. Request your residence permit and register at the town hall.
5. Enrol with the health service or confirm private insurance cover.

Is there a specific retirement visa in Italy?

There is no visa labelled for retirees, but the elective residence visa serves this purpose. It targets people who can support themselves without working in Italy, using pensions, rental income or investments, and it must be renewed through the residence permit system.

Do foreigners pay full price in an RSA?

Registered residents assessed by the health authority can obtain accredited places in which the medical part is publicly funded. The accommodation share remains payable by the resident, with possible municipal help when income is low. Private places are paid entirely by residents.

Will my UK pension be uprated if I live in Italy?

The UK State Pension is currently uprated for people living in EU countries, including Italy. Rules can change, so confirm your own situation with the International Pension Centre before moving, and remember that Italian tax residence may apply to your income.

Are English-speaking care homes available?

Very few facilities operate in English, although some private residences in popular expatriate areas employ multilingual staff. Learning basic Italian early makes a real difference for daily life, medical appointments and, later, communication with carers and residence staff.