San Marino

The Secretariat of State for Health and Social Security (Segreteria di Stato per la Sanità e la Sicurezza Sociale) is an autonomous government body responsible for social welfare, social security, long-term care and occupational health care and safety and environmental protection in the workplace. It is equivalent to a ministry of health and welfare and is responsible for health care planning. Jointly with the Council of Health (Consiglio di Sanità) and the Health Officers’ Council (Consiglio dei Sanitari), the Secretariat of State for Health and Social Security is responsible for financing and providing health care and social security for the entire population.  

 Public healthcare expenditure is covered mainly through general taxation and the national budget. Out-of-pocket payments mainly refer to payments for inpatient and outpatient care that are not generally covered by the state, and to medicines that are either not on the reimbursable list or sold to foreigners (including tourists), mainly Italians, or cross-border workers. 

 Primary health care in San Marino is delivered through healthcare centres that are publicly funded and managed. Each covers an average of 8 000 people. Besides general practitioners, the health care centres employ some specialists, professional nurses, and administrative staff. General medicine corresponds to primary healthcare and covers general practice, community care, home care and immunization. Secondary and tertiary care is mainly provided within the hospital, although the Serravalle Health Centre provides some specialized ambulatory services.