San Marino (SM)
A compact, high-income microstate entirely surrounded by Italy, known for low taxes, strong public administration, hilltop heritage, cross-border dependence on Italy and a small but rules-heavy residence system.
Healthcare in San Marino
San Marino healthcare is centred on the Istituto per la Sicurezza Sociale (ISS), combining health and social-security functions. Residents and insured workers use the public system, while visitors and elective/atypical residents need private insurance.
Small-country care is strong for primary and routine hospital services, with specialist referral to Italy for complex cases.
Public healthcare: ISS - Istituto per la Sicurezza Sociale
Social Security Institute
- primary care
- specialist referrals
- hospital care
- emergency care
- prescriptions
- maternity and child care
- digital health record services
- some private clinics
- cosmetic care
- medical evacuation
- non-authorised out-of-territory care
- private rooms/upgrades
Private healthcare: Private and international health insurance
Accessing care
Eligible residents use ISS general-practitioner pathways; private doctors in San Marino or Italy are an alternative for non-covered residents.
ISS referrals are important for public coverage and out-of-territory treatment in Italy. Private specialists can often be booked directly.
Call 112 for emergencies. San Marino hospital handles urgent care, with transfer/referral to Italian hospitals for higher-level specialities.
Use emergency numbers, hospital emergency services and on-call pharmacy information. Cross-border urgent care in Rimini may be relevant.
From 12 January 2026, the electronic health record added local and out-of-territory prescription tracking. Private prescriptions may be handled through San Marino or Italian pharmacies.
Dental care is often private or partially reimbursed depending status. Many residents compare providers in San Marino and Rimini.
ISS provides public mental-health pathways; private therapists in San Marino/Italy or teletherapy may be easier for English-speaking care.
ISS maternity pathways cover eligible residents, while private/international insurance is needed for visitors or special-residence categories without full public entitlement.
Expat-specific advice
- Confirm health entitlement tied to your permit route
- Buy private insurance before arrival if required
- Register with ISS if eligible
- Save 112 and hospital contacts
- Translate medication and diagnosis records into Italian
Pharmacies (Farmacia)
- paracetamol
- ibuprofen
- cold remedies
- antihistamines
- digestive remedies
- sunscreen
- first aid supplies
Typical costs
| GP visit (with insurance) | Covered/reimbursed if eligible or insured |
| GP visit (private pay) | EUR 60-120 private |
| Specialist visit | EUR 100-250+ private |
| Emergency visit | Coverage/status dependent |
| MRI scan | EUR 250-700+ private/cross-border |
| Prescription average | EUR 5-60+ depending medicine |
| Dental check-up | EUR 70-150 |
| Baby delivery | ISS/private insurance dependent |
Healthcare
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