How to register with the Italian national health service (SSN)

What it is

The Servizio Sanitario Nazionale (SSN) is Italy's public health service. Registering gives you:

• a family doctor (medico di base), and a paediatrician for children;
• referrals for specialists and tests at public prices;
• the tessera sanitaria, your health card. It doubles as your codice fiscale card.

Who can register

• Mandatory, and free: you're registered if you live in Italy legally and work (employed or self-employed), are registered as unemployed, or have a permit for family reasons, international protection and some other reasons.
• Voluntary, for a yearly fee: some residents who don't qualify automatically, for example students or people with an elective residence permit, can join by paying a yearly contribution.
• EU citizens: if you're registered as resident and working, you join like Italians. If you're covered by your home country, you can use your European Health Insurance Card or an S1 form instead.

Before you start

You'll usually need:

• Your passport or ID.
• Your codice fiscale.
• Your residence permit (or postal receipt) if you're from outside the EU.
• A residence certificate, or a declaration of where you live (domicilio).
• Proof of your situation: for example an employment contract, or for EU citizens an S1 form.

Steps

1. Find your ASL (Azienda Sanitaria Locale): the local health authority for your address. Some regions use another name, such as ATS or AUSL.
2. Go to the registration office (ufficio scelta e revoca or anagrafe sanitaria). Many need an appointment or a queue ticket; some regions let you apply online.
3. Show your documents and confirm your address.
4. Choose your family doctor from a list of doctors near you who are taking patients.
5. Get your health card. The tessera sanitaria is posted to you; the ASL gives you a paper document to use until it arrives.

Cost

Free for mandatory registration. Voluntary registration costs a yearly amount, which varies with your situation.

Common pitfalls

• Registration ends with your permit. If you're from outside the EU, your registration usually ends when your permit expires. Renew both on time.
• Wrong ASL. You must register at the ASL that covers your address.
• No family doctor near you. Popular doctors fill up. Ask the office for doctors who still have space.
• Assuming students are covered. Many student permits need private insurance or voluntary registration.

When to ask a helper

If your region asks for documents not listed here, or you're not sure whether you qualify for free registration, ask someone who registered in the same region.