From 1 October 2026, the list of services that the National Health Service must guarantee to citizens throughout Italy will change. Approximately 800 services, performances and therapies enter the new essential levels of assistance (Lea), with numerous innovations regarding prevention, screening, pregnancy, rare and chronic diseases and oncology.
These are services guaranteed by the NHS, free when exemption is foreseen and, in other cases, accessible with the payment of the ticket. The last update of the LEAs was dated 2017, but full activation dates back to 2024. However, the issue of long waiting lists that can push the patient towards private healthcare remains.
The Regions
The Regions can also provide additional services compared to the LEAs, the so-called extra LEAs, financing them with their own resources. To give an example: Umbria has just removed the health copay for women who are victims of abuse and violence.
Newborn screening, what changes
One of the most important innovations concerns newborns: neonatal screening for SMA, spinal muscular atrophy, is extended to the entire national territory. The expanded newborn screening program is also being expanded to eight additional metabolic and rare conditions.
Pregnancy, new tests arrive
New tests are included in the new LEAs to monitor physiological pregnancy, with the aim of protecting the health of the mother and the unborn child. New services such as non-invasive prenatal tests are also introduced.
Breast cancer, there’s news
Among the services included in the new LEAs are those intended for hormone-responsive breast cancer in the early stage, with the aim of identifying the most effective therapy in the quickest time.
A screening and surveillance program is also launched at a national level to search for pathogenic variants of the Brca1 and Brca2 genes. The program particularly concerns women belonging to families in which breast or ovarian cancers have been diagnosed and the two variants have been identified. For healthy women who test positive for Brca1 or Brca2 variants, active surveillance courses are envisaged, aimed at early diagnosis of breast and ovarian cancer.
The tools indicated include, for example, breast examinations, ultrasounds and mammograms.
Updated radiotherapy
Radiotherapy services have been updated, with a single path for both radiotherapy services and those preparatory to treatment.
Rare and chronic diseases, new exemptions
New pathologies are inserted and new exemptions are introduced: as regards rare diseases, the conditions recognized for exemption purposes increase and the descriptions of diseases or groups of diseases already present in the Lea are updated.
Obsolete features deleted
Part of the intervention then concerns the cancellation or replacement of services considered obsolete, together with the revision of those already present. Here is the updated list of new health services (there are 800 in total).
This is the comment of the Minister of Health, Orazio Schillaci:
We are writing a decisive chapter to give citizens a more modern, fairer and closer National Health Service that is closer to their real health needs. This is a measure that I strongly wanted to guarantee all Italians, wherever they live, access to innovative benefits and services. So that there isn’t a series A and a series B healthcare system, but there is a fairer NHS for everyone. This has been a government objective since we took office.
