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tessera sanitaria health insurance card

How to Get a Tessera Sanitaria?


TESSERA SANITARIA:
WHAT IS IT?
HOW CAN I GET ONE?

In order to get your Tessera Sanitaria (Italian Health Insurance Card) you will have to have:

  • Your passport
  • A valid permit to stay or the receipt you get when you ask for it
  • A valid Codice Fiscale (Italian Tax Code) issued by the Agenzia delle Entrate (Italian Revenue Agency)
  • Self-declaration of residency or place of abode (the address written on your permit to stay) – you can use this template
  • The receipt of payment for the registration to the SSN from the post office (if required –  see below)
  • A pen (it’s incredible how hard it is to borrow one when you need it!) and some entertainment (you might need to wait).

Remember to bring with you a copy of all documents to leave for the application (many public offices will refuse to make copies for you).

With this documents and copies at hand, you have to go to one of the ASL locations (Local Health Authority) in the municipality where you’re staying, close to the address indicated in your permit to stay.

Flip side of the Italian National Healthcare Service Card Tessera Sanitaria

Flip side of the Italian National Health Card

YOU RECEIVE YOUR PERSONAL TESSERA SANITARIA WHEN YOU REGISTER WITH THE ITALIAN NATIONAL HEALTH SERVICE (SSN – SERVIZIO SANITARIO NAZIONALE).

The Tessera Sanitaria is the Italian Health Insurance Card that all residents need to show when using the Italian National Health Service (SSNServizio Sanitario Nazionale): you will need it when going to a doctor, purchasing a drug in the pharmacy, doing blood analyses, undergoing specialist examinations, diagnostics or requiring admission to a public hospital. 

Flip side of a Tessera SanitariaThe Tessera Sanitaria (Italian Health Insurance Card) is not required for seeing a private doctor, either a general practitioner or a specialist, and to buy medications or to do blood tests prescribed by a private doctor. 

THERE ARE TWO TYPES OF REGISTRATION WITH THE ITALIAN NATIONAL HEALTH SERVICE. 

circulating Immuno-complex, Rheumatoid Factor, Anti citrulline antibodies, ANCA, Lupus anticoagulant.

Foreign non-European Union citizens staying for work, family, international protection, pregnant women, fostering or adoption are entitled to be registered without paying the Italian National Health Service (SSN – Servizio Sanitario Nazionale). This is called mandatory or by rights registration.

Others (e.g. students, au pairs, religious staff, etc) who are staying for more than 90 days may apply for voluntary (or “optional”) registration: they have to pay a yearly lump sum. Only students and au pairs can opt to register with the Italian National Health Service even if they stay for less than 3 months.

Tourists cannot register with the Italian National Health Service (SSN – Servizio Sanitario Nazionale).

 

Useful Links: 

List of all Italian ASL offices

How to get a Codice Fiscale

THE SIX STEPS FOR REGISTERING TO THE ITALIAN NATIONAL HEALTH SERVICE (SSN SERVIZIO SANITARIO NAZIONALE).

Please be aware that even if you are entitled to a mandatory (i.e. automatic) registration, you need to follow these steps in order to register with the Italian Health National Service (SSN – Servizio Sanitario Nazionale). But, the payment at the post office is required only if you are applying for a voluntary registration (see above for the difference between “Mandatory” and “Voluntary” registration). 

Step 1 – The first thing to do to register with the Italian Health National Service (SSN – Servizio Sanitario Nazionale) is to find your local ASL (Local Health Authority) office. You should go there first to check if there are any specific requirements, what is the exact fee to pay, and how to fill out the payment form at the Post Office. 

Step 2 – Get your Codice Fiscale (Italian Tax Code, you must obtain this first!). You will need to go to the tax authority for this (Agenzia delle entrate). 

Step 3 – Go to a Post Office to pay the annual fee by completing a postal order (Bollettino Postale – a paper form to be filled out to make payment at the post office) with the information gathered at the ASL (Local Health Authority). Pay and keep the receipt, you will need to show it when applying for  your Tessera Sanitaria (Italian Health Insurance Card).

Find your bollettino postale for paying the registration to the National Healthcare Servica and get your Tessera Sanitaria

Bollettino Postale: You may need some help to fill it out

 

Step 4 – Make a copy of the receipt you got at the postal office and go to your ASL (Local Health Authority) office again and this time bring with you:

  • The payment receipt from the Post Office
  • Your Passport
  • Your Codice Fiscale (Italian Tax Code)
  • Your Permit to Stay (if expired, bring your appointment receipt for renewal at the Questura)
  • A document certifying your address of residence (or a self-declaration of your own residence where you declare that you live at your current address: here’s an example)
  • If you are a student or au pair, a document confirming you are enrolled in your school or your au pair contract.
  • Any other documents the ASL (Local Health Authority) told you to bring when you went to check in Step 1
  • Entertainment (you may end up waiting for several hours, be prepared! Bring a book, a well charged smartphone, a talkative friend…)
  • A pen

After registration, you will be invited to choose your public Primary Care Physician (Medico di Base or Medico di Famiglia). They will show you the list of names and the addresses, but they won’t be able to tell you if the doctor speaks any English. Also, if you do not know the street names, it may be hard for you to choose one who is conveniently located. It’s better to go prepared, knowing already the name and address of the doctor you wish to register with. In any case, you can always change your doctor by going to the ASL (Local Health Authority).

Step 5 – Keep the receipt you receive after completing the registration, you will use it as a proof of registration until you receive your Tessera Sanitaria (Italian Health Insurance Card) – it will be delivered at your home address by mail.

Step 6 – Bring your registration documents to the Primary Care Physician (Medico di Base or Medico di Famiglia) you picked, so that he/she can register you as an official patient. Expect that each Medico di Base will be part of a small practice with its own business hours and way of doing business. Make sure to take note of office hours and the doctor’s phone number, in case you need to ask for a house call (available if you are too sick to get to the office).

HOW MUCH DOES IT COST TO APPLY FOR A TESSERA SANITARIA (ITALIAN HEALTH INSURANCE CARD)?

If you are entitled to “Mandatory registration” (see above) you don’t have to pay to register with the Italian National Health Service (SSN – Servizio Sanitario Nazionale). If you are not entitled to “Mandatory registration” but you are allowed to register (i.e. “Voluntary registration”) to the Italian National Health Service (SSN – Servizio Sanitario Nazionale) (e.g. students and au pair) you will need to settle a yearly payment. This can be a lump sum for students and au pairs or a variable amount depending on your last year gross income.

Applicants for optional registration (except students and au pairs) must self-certify their gross income.  If the applicant does not have a personal income, the cost of the registration is calculated on that of the family he is dependent on.How much does it cost registering with the National Healthcare Service and get a Tessera Sanitaria

Currently, the annual contribution is € 387.34 for an annual income between 0 and € 5165.00. The rate (“aliquota percentuale”) for an income exceeding € 5165.00 and up to € 20,658.28 is 7.5% rate, while it’s 4% for amounts exceeding € 20,658.28 and up to the limit of € 51,645.69. This means that, for instance, if your gross income for the previous year was € 40,000 you would pay 7.5% up to € 20,658 and 4% for the remainder of € 19,342 yearly for registering to the NHS (i.e. € 2,322).

Without regard to the gross income, the amount of the contribution cannot be less than € 387.34 or higher than € 2.788,86 with the currency exchange rate applicable at the date of the application.

Group of young students and au pairs who are registered with the Italian National Healthcare Service and have their own Tessera Sanitaria

Students and Au Pairs Privileges

If you are staying for study purposes or au pairs you are entitled to two major benefits. You can:

  1. Apply for registration to the Italian National Health Service (SSN – Servizio Sanitario Nazionale) even if staying for less than 3 months
  2. Pay a fixed yearly lump sum: € 149.77 for students and € 219.49 for au pairs (for the latter the sum is usually paid by the member of the family who has signed the au pair agreement)

In any case the payment for optional registration refers to the calendar year (January 1st – December 31st) and cannot be split up (this means that if you pay in November, you have to pay again in January).

For students and au pairs the registration to the Italian National Health Service (SSN – Servizio Sanitario Nazionale) is personal and therefore the dependent family members are excluded (the annual contribution is paid according to the annual income as explained above).

HOW CAN I KNOW WHEN THE TESSERA SANITARIA (ITALIAN HEALTH INSURANCE CARD) WILL ARRIVE?

If you have not received your card yet you may check the status of your Tessera Sanitaria (Italian Health Insurance Card) by visiting this website.

If no Health Card is issued yet, you will get the message: “Non sono presenti Tessere Sanitarie“: you must contact the ASL (Local Health Authority) where you have requested it.

If the message is “In corso di emissione” means that the card is being issued and you have to wait for the process and the shipment to be completed.

If the message is “Spedita” means that the card has been shipped and if you have not received it yet, you must contact any office of the Agenzia delle Entrate (Revenue Agency) to verify the correct registration of your residence or place of abode.

I’VE LOST MY TESSERA SANITARIA (ITALIAN HEALTH INSURANCE CARD), HOW CAN I GET A DUPLICATE?

You can ask for a duplicate online on this webpage or in your ASL (Local Health Authority) or in any office of the Agenzia delle Entrate (Revenue Agency). 

HOW CAN I RENEW MY TESSERA SANITARIA (ITALIAN HEALTH INSURANCE CARD)?

The Italian National Health Service (SSN – Servizio Sanitario Nazionale) registration issued to non-EU foreigners will remain valid until the expiry of the permit to stay.

In order to renew the health card, you must bring to the ASL (Local Health Authority):

  1. Your Passport.
  2. The documents confirming the request for renewal of the permit to stay, such as the receipt you get when you pay at the post office or the one issued by the Questura
  3. Your Codice Fiscale (Italian Tax Code).
  4. A certificate of residence (or a self declaration of residence in which you state to live at your current address. You can find a draft here)

With this documentation, the ASL (Local Health Authority) issues the applicant’s temporary registration (6 months) waiting for the confirmation of the renewal of the permit to stay. This temporary registration entitles to the same level of assistance. Once the new permit has been issued, you need to bring a copy of it to the ASL (Local Health Authority), which takes note of it, confirms the registration to the Italian National Health Service (SSN – Servizio Sanitario Nazionale) and issues the new Tessera Sanitaria (Italian Health Insurance Card) with the same expiration date of the new permit to stay.

If you are entitled to the “Mandatory registration” to the Italian National Health Service (SSN – Servizio Sanitario Nazionale) (see above) you will not have to pay. If you are registered by choice (e.g. students and au pairs) you will need to bring to the ASL (Local Health Authority) also the receipt of the payment at the post office for the registration to the Italian National Health Service (SSN – Servizio Sanitario Nazionale), as you did for the initial registration.

Even if you don’t renew your registration to the Italian National Health Service (SSN – Servizio Sanitario Nazionale), your Tessera Sanitaria (Italian Health Insurance Card) continues to be valid, even after the expiration date, as a substitute for the Codice Fiscale (Italian Tax Code).

We wish to thank Ms Nancy Hampton for her contribution in improving this article.

If you’re curious to see this experience through the eyes of an expat in Rome, check this blog post written by an American in Rome.

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