Tessera Sanitaria in Rome: How to Get Your Italian Health Card and What to Do If You Lose It
Italy's green health card does three things at once: national health access, digital services chip, and European health cover. Here's how to get it, update it, or replace it.
In a nutshell
The Tessera Sanitaria (Italian health-insurance card) is the green plastic card you present at the doctor's surgery, pharmacy, and hospital. You don't apply for it separately — it arrives in the post automatically once you have enrolled with the SSN (Servizio Sanitario Nazionale — Italy's national health service). It actually does three things: it is your healthcare document, it doubles as a Carta Nazionale dei Servizi (national services smart card) with a chip for accessing public services online, and on the reverse it carries the TEAM (European Health Insurance Card), which covers you for necessary treatment in all other EU countries.
At a glance
| Cost | Free. Replacement is also free. |
| Timeline | 30–60 days after SSN enrolment. Replacement: 15–30 days. |
| Where in Rome | ASL (Azienda Sanitaria Locale — your local public-health authority) desk in your district (for SSN enrolment). Replacement also available online or by freephone. |
| Documents | ID document, Codice Fiscale (Italian tax ID), permesso di soggiorno (non-EU citizens), self-declaration of residence. |
Three functions, one card
This isn't just a health card. The card that arrives in the post plays three distinct roles.
As a Tessera Sanitaria it lets you collect prescribed medicines, present yourself to your GP or a specialist, and book appointments and tests through the ReCUP booking system or at a desk.
As a TS-CNS (national services chip card) it contains a microchip with a PIN you can use to access the Lazio Electronic Health Record (Fascicolo Sanitario Elettronico), INPS (Italy's social-security agency) online services, and the Agenzia delle Entrate (Italy's tax-revenue agency) portal — and in some cases as a digital signature tool. To activate this function you need to collect your PIN from an ASL desk.
As a TEAM card on the reverse, it covers you for medically necessary treatment in all 26 other EU countries without paying out-of-pocket as a private patient.
Documents required — by situation
The card comes from your SSN enrolment, so the documents requested are those you bring to the ASL desk.
Italian citizens:
- Valid identity card (carta d'identità) or passport
- Codice Fiscale
- Self-declaration of residence
EU citizens:
- National identity document from your EU country
- Codice Fiscale (issued by the Agenzia delle Entrate)
- Proof of registration at the Anagrafe (civil-registry office at the Comune, handles residency) if you've been resident for more than 3 months, or employment contract if you are a worker
Non-EU citizens:
- Valid passport
- Permesso di soggiorno (residence permit) in force, or postal receipt from your renewal kit
- Codice Fiscale
- Self-declaration of residence or domicile
Dependent family members:
- ID and Codice Fiscale of the family member
- ID of the SSN-enrolled holder
- Family record (stato di famiglia) or self-declaration of the relationship
Newborns and minors:
- Birth certificate or child's passport
- Child's Codice Fiscale
- Parent's ID
Getting the card for the first time
The process is straightforward and involves no extra red tape.
First, get your Codice Fiscale from the Agenzia delle Entrate if you don't already have one. Nothing can start without it.
Then go to the CUP / Anagrafe Sanitaria (health-registration) desk at the ASL branch for your Municipio (city district) and enrol with the SSN. The same day you receive your enrolment form with your patient code. The central system then automatically generates the card and mails it to your declared address within 30–60 days.
If the card still hasn't arrived after 90 days, go back to the ASL desk to verify your address and request a replacement.
Lost, stolen, or damaged card
A replacement is always free. You have several options:
- Online at sistemats.it with SPID (Italy's digital identity for accessing online public services) or CIE (Italian electronic ID card) — the fastest route
- App IO in the Documents section
- Agenzia delle Entrate app (iOS/Android) with SPID or CIE
- Agenzia delle Entrate freephone 800 030 070 (free from a landline)
- ASL desk with a valid ID
- Agenzia delle Entrate office — any of the 7 territorial offices in Rome
The replacement card arrives in 15–30 days.
Renewal and expiry
The card expires at different intervals depending on your status.
Italian citizens and resident EU citizens: renewed automatically every 6 years. A new card arrives at your address with no action needed on your part.
Non-EU citizens: the card expires with your permesso di soggiorno. When you renew your permit, bring the postal renewal receipt to the ASL: your SSN enrolment is extended and the new card is issued once the renewed permit has been processed. In the meantime your old card still works for healthcare.
Voluntary enrolees: validity tied to the calendar year of enrolment (1 January – 31 December).
Mistakes to avoid
- Not telling the ASL when you move. If you change address and don't update your records, the renewal card goes to your old address and you never receive it.
- Clicking on sites that sell the Tessera Sanitaria. The card is free and only printed by Sogei on behalf of the Agenzia delle Entrate. Any website or intermediary asking for payment to obtain one is either useless or a scam.
- Using a card with incorrect details. If you notice a mistake in your name or date of birth, stop using the card and go straight to the Agenzia delle Entrate to have it corrected. A corrected card is issued in roughly 30 days.
Special cases
Expired permit, renewal in progress: your old card still works for essential care and your GP. Bring the postal receipt from your renewal kit to the ASL to formally extend your SSN enrolment.
Foreigner with a Codice Fiscale but no SSN enrolment: you receive a plain plastic card bearing only your tax code — no chip, no TEAM on the reverse. Request it from the Agenzia delle Entrate using form AA4/8.
Newborns: the child's card is generated automatically once the Comune (city hall) transmits the birth registration to the Anagrafe Tributaria (the national tax-registry database). It arrives in the post within 30–60 days, made out in the child's name.
Card lost while abroad: call the international line at +39 06 96668933, or request a replacement online with SPID or CIE from anywhere in the world.
Activating the TS-CNS digital chip: go to an ASL desk with your card and a valid ID. You receive your PIN in a sealed envelope in about 10 minutes. To use it you need a smart-card reader or a smartphone with NFC.
Official sources
- Agenzia delle Entrate — Tessera Sanitaria and Codice Fiscale
- Agenzia delle Entrate — Health card for foreign nationals
- Sistema TS — national portal
- ASL Roma 1 — Tessera Sanitaria and TEAM
- Fascicolo Sanitario Elettronico Lazio
- Salute Lazio
Legal references: DL 30/09/2003 n. 269 art. 50; Legge 24/02/1992 n. 196; DPCM 26/02/2010; D.Lgs. 07/03/2005 n. 82 artt. 64–66; Decreto MEF 17/03/2008; Regolamento UE 883/2004.