Tessera Sanitaria: what is it and how can I get one?

In order to get your Tessera Sanitaria (Italian Health Insurance Card) you will have to have:

• Your passport
• A valid permit to stay or the receipt you get when you ask for it
• A valid Codice Fiscale (Italian Tax Code) issued by the Agenzia delle Entrate (Italian Revenue Agency)
• Self-declaration of residency or place of abode (the address written on your permit to stay)
• The receipt of payment for the registration to the SSN from the Post Office (if required –  see below)
• If you are a student or au pair, a document confirming you are enrolled at a school or your au pair contract
• A copy of all above documents. 
• A pen (it’s incredible how hard it is to borrow one when you need it)

How can I get a Tessera Sanitaria ?

1 – Get your Codice Fiscale first (Italian Tax Code). You will need to go to the tax authority for getting this done (Agenzia delle entrate).

2 – Pay a visit to the Local Health Authority office (ASL – find the closest ASL here). This will save you a lot of time later. You should go there first to check if there are any specific requirements, what is the exact fee to pay, and how to fill out the payment form at the Post Office. 

3 – Go to a Post Office (here you can find the closest) to pay the annual fee. Just complete a postal order (Bollettino Postale – a paper form you can find at the office to make payments at the post office). Pay and keep the receipt, you will need to show it when applying for  your Tessera Sanitaria (Italian Health Card). 

4 – Make a copy of the receipt you got at the Post Office and go to your ASL (Local Health Authority) office again and this time bring with you all the documents listed on the top of this page.

5 – Keep the receipt you receive after completing the registration, you will use it as a proof of registration until you receive your Tessera Sanitaria (Italian Health Insurance Card) – it will be delivered at your home address by mail.

6 – Bring your registration documents to the Primary Care Physician (Medico di Base or Medico di Famiglia) you picked, so that he/she can register you as an official patient. Expect that each Medico di Base will be part of a small practice with its own business hours and way of doing business. Make sure to take note of office hours and the doctor’s phone number, in case you need to ask for a house call (available if you are too sick to get to the office). 

Foreign non-European Union citizens staying for work, family, international protection, pregnant women, fostering or adoption are entitled to be registered without paying the Italian National Health Service (SSN – Servizio Sanitario Nazionale). This is called mandatory or by rights registration.

Others (e.g. students, au pairs, religious staff, etc) who are staying for more than 90 days may apply for voluntary (or “optional”) registration: they have to pay a yearly lump sum. Only students and au pairs can opt to register with the Italian National Health Service even if they stay for less than 3 months.

Tourists cannot register with the Italian National Health Service (SSN – Servizio Sanitario Nazionale).

If you are entitled to “Mandatory registration” (see above) you don’t have to pay to register with the Italian National Health Service (SSN – Servizio Sanitario Nazionale). If you are not entitled to “Mandatory registration” but you are allowed to register (i.e. “Voluntary registration”) to the Italian National Health Service (SSN – Servizio Sanitario Nazionale) (e.g. students and au pair) you will need to settle a yearly payment. This can be a lump sum for students and au pairs or a variable amount depending on your last year gross income.

Applicants for optional registration (except students and au pairs) must self-certify their gross income.  If the applicant does not have a personal income, the cost of the registration is calculated on that of the family he is dependent on.

Students and Au Pairs Privileges

If you are staying for study purposes or au pairs you are entitled to two major benefits. You can:

1. Apply for registration to the Italian National Health Service (SSN – Servizio Sanitario Nazionale) even if staying for less than 3 months
2. Pay a fixed yearly lump sum: € 149.77 for students and € 219.49 for au pairs (for the latter the sum is usually paid by the member of the family who has signed the au pair agreement)

In any case the payment for optional registration refers to the calendar year (January 1st – December 31st) and cannot be split up (this means that if you pay in November, you have to pay again in January).

For students and au pairs the registration to the Italian National Health Service (SSN – Servizio Sanitario Nazionale) is personal and therefore the dependent family members are excluded (the annual contribution is paid according to the annual income as explained above).

Source of information. https://www.doctorsinitaly.com/b/how-to-get-tessera-sanitaria/ and https://sistemats1.sanita.finanze.it/portale/tessera-sanitaria