The Tessera Sanitaria is your Italian health insurance card.
“Tessera” = Card “Sanitaria” = Health
The Italian health insurance is managed by the agency ASL (Aziende Sanitarie Locali). The locals pronounce the agency ASL as a word “aah-zil” (versus saying the initials “A.S.L.” – this may seems like an insignificant point as you read this, but when I moved to Rome and asked where the ”A.S.L” was located, no one knew. But, they did know where the ”Aah-zil” office was located :))
The Italian national medical system is managed by the SSN (Servicio Sanitario Nacional).
The Tessera Sanitaria (healthcare card) is used each time that the citizen goes to the doctor, gets/buys medicine in a pharmacy (farmacia), books an examination in a laboratory, or benefits from a specialist in hospital and ASL.
- It contains biographical data and welfare information
- It contains the tax code (Codice Fiscale) on magnetic band format as well as barcode
- It is valid throughout Italy
- It grants the holder the right to obtain health services throughout the European Union
- It’s a plastic card, similar to a bank debit card.
- The front of the card also includes Braille characters for the blind.
- On the back of the card is the tax code barcodes, the magnetic strip, and the words, Tessera europea di assicurazione malattia (TEAM), meaning “European health insurance card”.
Being registered with the ASL, provides the holder to:
- low or no-cost treatment
- hospitalization and treatment (including tests, surgical operation and medication during hospitalization)
- basic medical care (General Practitioners and pediatricians)
- specialist medical care by pediatricians, midwives and other specialist doctors
- either free or subsidized medication
- laboratory tests, aids and devices
- ambulance service and other free services provided by the local healthcare authority (e.g. family planning clinics)
Where to Apply:
Apply at your local ASL office. Find your local ASL here: this website – only in Italian)
By selecting the region/province you will see the full list of ASL agency locations with the specific:
- link to the website of that agency/ASL location
- contact details of the URP (Ufficio Relazioni con il Pubblico) – Office of Public Relations or other offices from which to request information
- phone number of CUP (Central Reservations) or, where there is a unified center, the reference – the section of the website of the ASL that shows useful information to make a reservation
Once in Italy, you may register with the SSN at the ASL agency in your area. The following documents are generally what you will need to register: (varies based on your immigration status in Italy)
- Permit of stay or the receipt issued by the Post office at the moment of the application
- Passport with visa if non-EU citizen
- Tax identification number (Codice Fiscale)
- Self certification of your domicile (the same address you have written in your permit of stay) or certificate of residence
- if necessary: Receipt of payment ‘Bollitino’ from the post office (depending on your foreigner/straniere status)
Please remember that you must pay the fee before you go to the ASL.
The health card will be issued immediately and free of further charges**.
Upon registration at the ASL, you also choose a General Practitioner*** from the list that will be shown to you (or possibly your region lists the available doctors online on the local ASL website).
** The term ‘free’ is used lightly. There are some charges for services/medication …it all depends on what your base doctor prescribes. If you’re American, you can think of it as a co-pay. There are co-pays for services & medication in Italy. Personally, I feel the charges are reasonable compared to a USA based insurance program – but all services are not free. The negative of the cost effective system in Italy is that you may have to wait a period of time before you can see a specialist.
***Remember to ask for a General Practitioner or a Pediatrician that can speak foreign languages. In cities like Rome, the agency will most likely give you a list of doctors and you’ll need to pick from the list. The agency has no idea which languages the doctors speak or from my experience, they don’t care much to help you.
TIP: try to find a name that is not Italian is my only recommendation. In Rome, I found a doctor with a Polish name and I lucked out that they spoke some English. When I moved to a small town, the ASL actually had their local doctor list online on their website, but no languages were listed and the agency personnel didn’t know. I called every doctor on the list to check about the languages spoken – none spoke English.
It all depends on your status/reason for living in Italy. (Read more)
In general: if you have an Italian work contract or are married to someone who has a work contract, the health insurance/Tessera Sanitaria is free.
If you are a student: payment of 149.77 euro
Persons, with a valid Visa without a work permit pay 387.34€ annually (based on when this was written 2014)
1) If you are in a fee-based category, PAY the fee AT THE POST OFFICE FIRST.
2) Go to a Tabaccheria or somewhere and make a printed copy of your receipt
3) Once you have your receipt & copy, THEN go to the ASL agency with your documents to register.
icon-bug Confusion Factor:
If you are non-EU and are staying in Italy for more than three months, you need a Visa/Visto. If you have a Visa type which requires you to have private insurance for the first year, I am not quite sure of the ‘WHEN’ you are permitted to apply for the Italian national health system – ASL & SSN. I don’t know if there is a minimum amount of time you need to be in Italy before you may register as a resident/ASL/SSN.
Example: I came to Italy with an Elective Residency Visa. To get my Visa, I had to show I had international health insurance coverage for one year. I paid for a policy from a company like Bupa International (costs starting from $3,000 US or something like that. All I remember, it was expensive!!). After one year, I had registered with the Anagrafe in Roma (records office) and was a ‘certified resident’. At this point, I went to the ASL and started my health coverage with the Italian system, ASL. Because I didn’t have a work Visa, but instead an Elective Residency Visa, I had to pay 387,34€.
I wonder IF I could have registered as an official resident of Rome/Italy early on, let’s say after 3 months of living in Italy…Would I have been able to cancel my expensive private international insurance and register with the ASL???
icon-thumb-tack More key information:
The paid health care is an annual registration (January-Dec) and expires on December 31st of each year. It does not get prorated – meaning if you arrive in Italy in October and you register with payment, you will be required to pay the full year amount (eg 149.77€ student fee).
- Registration is made on an individual basis and dependent family members are not included. If you come to Italy with your family, your family members may be voluntary registered with the SSN – Servizio Sanitario Nazionale, depending on the reasons for their stay as mentioned in the permit of stay. For dependant family members that are registered on your permit of stay, you will have to pay an extra fee of 387.34 euro (confirm the specifics with your local ASL office. Rules change often in Italy).
- Attention: if you have only the receipt issued by the Post office of the application of the permit to stay, you can only apply for a temporary one-month registration with the SSN after payment of the relevant fee; the temporary health card can be renewed until 31st December of the same year and will have “ISCRIZIONE PROVVISORIA” (temporary registration) written on it.
- If your permit of stay is being renewed, you can register for a maximum period of 4 months.
TEAM = Tessera Europea di Assicurazione Malattia
SSN= Servizio Sanitario Nazionale
ASL= Aziende Sanitarie Locali