Healthcare in Italy – registering with the SSN, your tessera sanitaria and a medico di base
Last updated 25 September 2026Rules checked every MondayOfficial sourcesSources & methodology →
Italy's national health service treats most newcomers exactly like Italians, but only once you register with your local health authority. Here is who gets a tessera sanitaria as of right, who pays at least €2,000 a year, what care costs and which number to call when something goes wrong.
Your key to healthcare in Italy is the tessera sanitaria (health card). It carries your codice fiscale (tax code) and your family doctor's name. The SSN (national health service) is national, but each region runs it through the ASL (local health authority) where you live, so rules and charges vary by region.
Two things to know first. Since the 2024 Budget Law (law 213/2023), most people who register voluntarily pay at least €2,000 a year. And 116117, the free number for non-urgent medical help, now answers in Italian and English across Lazio, Lombardy, Piedmont and Tuscany – so in Rome, Milan, Turin and Florence – according to the Ministry of Health.
Who registers with the SSN – and who has to pay?
Registration is compulsory if you live in Italy legally and work, or if you hold or are renewing a permesso di soggiorno (residence permit) for work, family, asylum, subsidiary or special protection, special cases, pending adoption, foster care or acquiring citizenship. You then have the same rights and duties as Italians, and cover extends to dependent family members legally in Italy.
| Your situation | Your health cover |
|---|---|
| Employed, self-employed or registered job seeker | Compulsory SSN registration |
| Permit for work, family, asylum or protection, or a renewal receipt | Compulsory SSN registration |
| EU citizen working in Italy, or holding an S1 form | Regional health service, according to ASST Milano |
| Ukrainian with, or applying for, temporary protection | Compulsory registration guaranteed until 31 December 2026 |
| Child under 18, whatever the residence status | Paediatrician from 0 to 14, family doctor from 14 to 18 |
| Student, au pair, elective residence, parent over 65 joining family | Private insurance or voluntary registration |
| Visitor staying up to 90 days | No registration; pay regional tariffs, or use an EHIC |
| No valid permit | STP card for urgent and essential care, from any ASL |
Source: the Ministry of Health, Normattiva, ASST Milano and the Prefettura di Roma, read 23 September 2026.
According to the Prefettura di Roma, the STP card is valid for six months, can be renewed, and using health services is not reported to the authorities. If you are an EU citizen who does not work here, your right of residence already requires health insurance covering all risks – see part 2.
How do you get a tessera sanitaria and a medico di base?
You register at the scelta e revoca (choice of doctor) office of the ASL for the comune (municipality) where you are registered as resident – or, if you are not resident yet, where the address on your permit is. There you choose a medico di base (family doctor), or a paediatrician for your children. The doctor's name goes on your card, visits are free, and you need this doctor's referral to book specialist care under your region's rules.
| Bring | Why it matters |
|---|---|
| Valid residence permit, or the post-office or Questura (police immigration office) receipt for its renewal | Registration does not lapse during a renewal |
| Self-certification of residence, or a declaration of your actual address on the permit | Residence registration is covered in part 3 |
| Codice fiscale, or a self-certification of it | A code issued in your first 90 days stays valid afterwards |
| Identity document | Listed by the Prefettura di Roma |
Source: the Ministry of Health, the Prefettura di Roma and the Agenzia delle Entrate, read 23 September 2026.
For foreign residents the card lasts as long as the permit; while a first work permit or a family permit is pending, registration is temporary. The card covers your family doctor, free stays in public and contracted hospitals, medicines, specialist and home visits, vaccinations, tests and scans. Registering and choosing a doctor earns 4 credits under the accordo di integrazione (integration agreement). Since 4 December 2024 you can add a free digital copy of the card to the IO app.
With compulsory registration, the back of the card is the TEAM, the Italian European Health Insurance Card, issued by the Agenzia delle Entrate and valid for six years. Voluntary registrants do not get it.
What does voluntary registration with the SSN cost?
Staying more than three months without a right to compulsory registration, you need private insurance valid in Italy for sickness, accident and maternity, or voluntary registration. It is open, among others, to students, au pairs, non-working elective-residence permit holders, religious staff, volunteers and parents over 65 who joined family after 5 November 2008. Holders of medical-treatment or tourist permits cannot register.
| Who | Annual contribution | Covers dependants |
|---|---|---|
| Most voluntary registrants, such as elective-residence retirees | A percentage of last year's worldwide income, at least €2,000 | Yes |
| Students with a study permit | At least €700 | No |
| Au pairs | At least €1,200 | No |
Source: Normattiva and the Ministry of Health, read 23 September 2026.
The amounts are national; the regions collect them. In Lombardy, according to ASST Milano, the €2,000 applies to income up to €31,925, with 4 per cent added on income between €31,925 and €51,646, to a maximum of €2,788.87. Registration covers the calendar year, 1 January to 31 December, is paid by form F24 and cannot be split or backdated, even if your permit expires mid-year.
What do you pay at the doctor, the pharmacy and the hospital?
Much of the SSN is free at the point of use. Elsewhere you pay a ticket (co-payment), and many regions set their own tariffs.
| Care | What you pay |
|---|---|
| Family doctor or paediatrician | Nothing |
| Hospital stay | Nothing |
| Vaccines in the national plan, organised screening, maternity care | Nothing |
| Specialist visits and tests | The tariff, up to €36.15 per prescription, which can cover up to 8 services of one specialty |
| Medicines | Class A free nationally, but most regions add a ticket; class C in full; a brand instead of a generic costs the difference |
| Pronto soccorso (emergency department), white code 5, not admitted | A ticket set by each region; under-14s exempt |
Source: the Ministry of Health, read 23 September 2026.
You may be exempt because of low income combined with age or social status, a chronic or rare disease, disability, pregnancy or an early cancer diagnosis. Income exemptions are self-certified and checked through the Sistema Tessera Sanitaria; your ASL issues the exemption card.
Which number do you call in an emergency in Italy?
112 is free from any phone, even without a SIM, with a locked phone or without credit. Where a region runs the NUE 112 model, one call centre takes calls to 112, 113, 115 and 118 and sends police, carabinieri, fire brigade or ambulance; elsewhere the Carabinieri answer 112.
| Number | What for | Where |
|---|---|---|
| 112 | Any emergency | Everywhere |
| 118 | Medical emergency, free, 24 hours | Everywhere |
| 113 / 115 | Police / fire brigade | Everywhere |
| 116117 | Non-urgent medical help, free, 24/7, in Italian and English | Fully active in Abruzzo, Basilicata, Calabria, Friuli Venezia Giulia, Lazio, Lombardy, Molise, Piedmont, Tuscany, Veneto and Trento; partly in Liguria, Marche, Sardinia, Umbria and Bolzano |
| Guardia medica | Free out-of-hours doctor for urgent needs: weekends and every night, 20:00–08:00 | Everywhere – your ASL gives the local number |
| 1522 | Anti-violence helpline for women | Everywhere |
Source: the Ministry of Health and the Ministry of the Interior, read 23 September 2026.
Do not call 118 to book a visit. When you call, say what happened, where – comune, street and house number – and how many people are involved, give your phone number and keep the line free. In summer, tourist areas run a guardia medica turistica whose fee varies by region, and EU visitors with an EHIC get necessary care on the same terms as SSN patients.
What to do now
| Step | What | When |
|---|---|---|
| 1 | Check your right to compulsory registration, or arrange insurance or voluntary registration | Before you arrive |
| 2 | Get your codice fiscale and register your residence (part 3) | In your first weeks |
| 3 | Register at the ASL and choose a medico di base or paediatrician | Once you have your permit or receipt |
| 4 | Voluntary registrants: pay the contribution by F24 | For each calendar year |
| 5 | Save 112, 118 and 116117 or your guardia medica number | Now |
| 6 | Renew your registration with your permit | At each renewal |
Source: the Ministry of Health, read 23 September 2026.
Official sources
The official pages this guide is based on, read 23 September 2026. Links open the authority’s own website.
- Ministero della Salute · salute.gov.it
- Normattiva (official law database) · normattiva.it
- Ministero della Salute · salute.gov.it
- Ministero della Salute · salute.gov.it
- Ministero della Salute · salute.gov.it
- Ministero della Salute · salute.gov.it
- Ministero della Salute · salute.gov.it
- Ministero della Salute · salute.gov.it
- Ministero della Salute · salute.gov.it
- Ministero della Salute · salute.gov.it
- Ministero della Salute · salute.gov.it
- Ministero della Salute · salute.gov.it
Relocate in Europe provides general information, not legal or financial advice for your individual situation. Check with the authority named above before you act – rules change, and your case may differ.