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Health & Insurance

SSN: Register with the Italian health care system

The SSN is Italy's national health service—generally affordable and comprehensive. Here's how to register with the ASL, get your Tessera Sanitaria, and choose your primary care physician.

News Editorial Team News Editorial Team
June 22, 2026
| Health & Insurance
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Symbolic image: Hospital @ shutterstock.com

Symbolic image: Hospital @ shutterstock.com

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Table of contents

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  • What is the SSN?
  • Mandatory or voluntary?
  • Requirements and Documents
  • How to Sign Up for the SSN – Step by Step
  • The Tessera Sanitaria
  • Choosing a primary care physician
  • EU Citizens: S1, EHIC, and Special Cases
  • What You Need to Do Next

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The National Health Service (SSN) is Italy's national health service—and for most expats, the key to affordable, comprehensive medical care. The general requirement is that you have your Residenza. Here you can find out who needs to register (and who pays), what documents you need, and how to apply to the ASL for your Tessera Sanitaria and your family doctor.

What is the SSN?

The National Health Service is Italy's public, largely free healthcare system. It is organized regionally through local health authorities, which ASL (Local Health Authority). With your SSN, you have access to primary care physicians, specialists, hospitals, and prescription medications—usually for a small copay (ticket).

Mandatory or voluntary?

Whether your registration is free (mandatory membership) or requires a fee (voluntary) depends on your status.

➤ Required registration (free) – e.g., for:

  • Employees and Self-Employed Individuals in Italy
  • registered unemployed
  • Family members of an insured person
  • Non-EU citizens with a permesso for work, family, or asylum

➤ Voluntary Registration (Annual Fee) – for anyone not subject to the requirement (e.g., holders of an elective residence visa, certain students). The fee is Students at around 700 €, for others starting at about 2,000 € per year (income-based). Check the current amounts with your ASL.

Requirements and Documents

To register with the SSN, you'll usually need:

  • valid Identification card or passport
  • your Tax ID number
  • your Residenza (Proof of Residence)
  • for Non-EU citizens: valid Residence Permit
  • Proof of status, if applicable (employment contract, proof of premium payments for voluntary enrollment, etc.)

If your Residenza is still being processed, you can often use the information listed on your Permesso domicilio Sign in.

How to Sign Up for the SSN – Step by Step

  1. Make sure you have your Codice Fiscale and Residenza.
  2. Go to the ASL your place of residence (it's often a good idea to make an appointment).
  3. Submit your documents; if you register voluntarily, you'll pay the annual fee.
  4. Choose your primary care physician (Family doctor) from the ASL list—one for children pediatrician.
  5. You will receive your Tessera Sanitaria (usually arrives by mail).
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The Tessera Sanitaria

The Tessera Sanitaria is your health insurance card. With it, you can access doctor's visits, hospital care, medical exams, and prescriptions. Handy: The The back serves as a European Health Insurance Card (EHIC/TEAM) and ensures you receive medical treatment in the EU, Norway, Iceland, Liechtenstein, and Switzerland. Your Codice Fiscale is also listed on the card.

Choosing a primary care physician

When you sign up, you'll choose your primary care physician – your regular family doctor, whose services are covered by the SSN. You choose them from a list of approved doctors provided by your ASL, and you can switch later. For children, there is the pediatrician of one's choice. Your family doctor is your first point of contact and will refer you to specialists if necessary.

EU Citizens: S1, EHIC, and Special Cases

➤ Retirees from the EU usually contact us using the Form S1 To: Your home country will cover the costs, but you will be registered with the SSN as usual and will receive a Tessera Sanitaria.

➤ EHIC for the transition period: With your European Health Insurance Card from your home country, you are covered for emergencies and necessary medical treatment during a temporary stay. However, it does not replace registration with the SSN once you are residing in Italy.

What You Need to Do Next

With your Tessera Sanitaria in hand, you've entered the Italian healthcare system. If you haven't already, be sure to pick up your Tax ID number Go ahead and register your Residenza and take care of important Insurances such as liability insurance. If you are not eligible for SSN, consider private health insurance. Our guide provides an overview of all options—mandatory, voluntary, or private. Health Insurance in Italy.

FAQ - Frequently Asked Questions About SSN

Who is required to register with the SSN?

Basically, anyone who moves to Italy. Depending on your status, registration is either mandatory and free of charge (e.g., employees, family members) or voluntary for an annual fee.

Do I need a Residenza to register for the SSN?

Generally speaking, yes. If your Residenza is still being processed, you can often register with the ASL using the domicilio listed on your Permesso.

What documents do I need?

ID card or passport, Codice Fiscale, and proof of residence (Residenza). Non-EU citizens also need a Permesso di Soggiorno, as well as proof of status, depending on their status.

Is SSN registration free?

For mandatory membership, yes. For voluntary enrollment, an annual fee applies—around 700 € for students, and starting at about 2,000 € for others (depending on income). Please check the ASL for current rates.

What is the Tessera Sanitaria?

The Italian health card. You can use it to see a doctor, visit a hospital, and fill prescriptions; the back serves as a European Health Insurance Card (EHIC/TEAM).

What is a medico di base?

Your regular family doctor, whose services are covered by the SSN. You choose him or her from a list provided by your ASL; for children, there is the pediatra di libera scelta.

Can EU retirees register with the SSN?

Yes, usually through Form S1. Your home country covers the costs, you are registered with the SSN as usual, and you receive a Tessera Sanitaria.

What are the benefits of having an EHIC before I register?

It covers emergencies and necessary medical treatment during a temporary stay. However, once you are residing in Italy, it does not replace regular SSN enrollment.

Can non-EU citizens (e.g., U.S. citizens) register?

Yes, with a valid Permesso di Soggiorno. Depending on the purpose of your stay, registration is either mandatory (free of charge) or voluntary (annual fee).

Where do I sign up?

At the ASL (Azienda Sanitaria Locale) in your place of residence or at the domicilio listed on your permesso.

Sources

  1. Ministry of Health – Enrollment in the National Health Service (SSN) (accessed in June 2026)
  2. Agenzia delle Entrate – Enrollment in the National Health Service (accessed in June 2026)
Tags: Emigrating to ItalyHealth ItalyHealth InsuranceLife in ItalySSN
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