At a Glance: Italian Healthcare
| System Name | Servizio Sanitario Nazionale (SSN) |
|---|---|
| Administered By | Local Health Authorities (ASL / USL) |
| Eligibility | Universal (Residence Based) |
| Primary Card | Tessera Sanitaria (Blue Card) |
| Cost | Mostly Free, small Co-pay ("Ticket") |
| Emergency Number | 118 (Ambulance), 112 (Universal) |
Italy's Servizio Sanitario Nazionale (SSN) is ranked among the top healthcare systems globally by the WHO. It is a regionally based National Health Service that provides universal coverage to citizens and residents, mostly free of charge at the point of delivery.
The system is funded through general taxation. While the Ministry of Health sets the standards, the actual management is done by local health authorities known as ASL (Azienda Sanitaria Locale). This means your experience might slightly vary depending on whether you are in Lombardy, Tuscany, or Sicily.
What is the Tessera Sanitaria?
The Tessera Sanitaria (TS) is your gateway to the system. It is a plastic blue card containing your:
- Codice Fiscale (Tax ID Code).
- Personal Details.
- TEAM (European Health Insurance Card) details on the back.
You need this card to visit a doctor, buy medicines at a pharmacy (to get the discount), book blood tests, or go to the hospital.
Mandatory vs. Voluntary Registration
As a foreigner/expat, this is the most critical part. Your registration with the SSN falls into one of two categories:
1. Iscrizione Obbligatoria (Mandatory/Free)
You have a right to register for free if you are:
- An EU citizen employed in Italy.
- A Non-EU citizen with a valid residence permit for work (lavoro subordinato/autonomo), family, asylum, or pending citizenship.
- A dependent family member of the above.
2. Iscrizione Volontaria (Voluntary/Paid)
If you don't qualify for mandatory registration, you can pay to join. Common for:
- Students: Fixed fee (approx €700/year - 2024 rates increased significantly).
- Au Pairs: Approx €1,200/year.
- Elective Residents: Often up to €2,000+ calculated on income.
Step-by-Step: How to Register with the ASL
You cannot do this purely online in most regions; you must visit the local ASL office.
- Get your Codice Fiscale: Go to the Agenzia delle Entrate (Tax Office) to get your Tax ID. This is step zero.
- Visit the Post Office (If Voluntary): Pick up a payment slip (Bollettino) and pay the annual fee if you fall under "Voluntary Registration". Keep the receipt.
- Go to your local ASL Office: Bring the following documents:
- Passport / ID Card.
- Permesso di Soggiorno (Residence Permit) or receipt of application.
- Codice Fiscale.
- Proof of Residence (Certificato di Residenza) or self-declaration.
- Payment receipt (if voluntary).
- Choose a GP (Medico di Base): At the ASL, you will be given a list of available doctors in your area to choose from.
The "Ticket" System (Costs)
While many services are free, Italy uses a co-payment system called the "Ticket" to share costs for diagnostic procedures and specialists.
- Free: GP Visits, Hospitalization (Inpatient), Pediatricians.
- Paid (Ticket): Blood tests, X-rays, MRI, Specialist visits (e.g., Dermatologist) unless referred for a chronic condition.
- Emergency (Pronto Soccorso): Free if admitted or if it's a "Red/Yellow" code. If it's a "White" code (non-urgent), you may pay a ticket fee (approx €25-€50).
Guardia Medica (Out-of-Hours Doctor)
What if you get sick at night or on Sunday when your GP is closed?
Do not go to the ER for a simple fever. Call the Guardia Medica (Continuity of Care). It is a free service usually available from 8 PM to 8 AM and on weekends. They can prescribe medicines and visit your home if necessary.
Find a Hospital or ASL
Finding your local ASL office is the first step to getting insured. Use the Ministry of Health's portal.
Search Ministry of Health Database
Find authorized hospitals, ASL offices, and pharmacies anywhere in Italy.
Official Facility Search →Or visit Sistema TS Portal