SettledkitThe tessera sanitaria for foreign residents in Italy (2026)
You do not apply for the tessera sanitaria (health card) separately. It is produced automatically once you are registered with the national health service (SSN), your codice fiscale is correct, and your health office has sent your details electronically. It is posted to the address the tax agency has on file.
Your right to care comes from your registration, not from the plastic card: your doctor prescribes using your codice fiscale, and the pharmacy can read it from the prescription.
How it gets issued
- You register with the SSN at your local health office (ASL; in Lombardy, the ASST "Scelta e Revoca" desk) and choose a family doctor.
- The health office sends your details to the national Tessera Sanitaria system.
- The card is posted to the address held by the Agenzia delle Entrate: - if you are registered as resident, that address comes from your Comune, so register any move with the Comune; - if you are not resident yet, the Agenzia uses the address you gave when you got your codice fiscale; update it at an Agenzia office (form AA4/8).
Cards are sent by post only; for a replacement card the Agenzia gives about 3 to 4 weeks. No official time is given for a first card; if it has not arrived after a few weeks, check its status below.
Card not arrived? Check its status
Use "Verifica dello stato della Tessera Sanitaria" on the Sistema TS portal (sistemats1.sanita.finanze.it). It gives one of three answers:
| Status | What it means | What to do |
|---|---|---|
| No card found ("Non sono presenti Tessere Sanitarie") | Your health office has not sent your data, or your codice fiscale has a problem | Go back to the health office and ask them to check |
| Being issued ("In corso di emissione") | It is in production | Wait |
| Sent ("Spedita") but not received | It went to the wrong address or was lost | Check your address at any Agenzia office and ask for a new card for non-delivery |
What the card does
- It is your health card at the doctor, the pharmacy and for booked visits.
- It is also your codice fiscale card.
- It can work as a CNS (Carta Nazionale dei Servizi) for some online public services once activated.
- The back is the European Health Insurance Card (TEAM/EHIC). For EU, EEA and Swiss citizens registered with the SSN it covers necessary care in the EU, Norway, Iceland, Liechtenstein and Switzerland. If you are not an EU citizen, it is not valid in Denmark, Iceland, Liechtenstein, Norway or Switzerland: take travel insurance for those countries.
- If the back of your card shows asterisks, you have no TEAM.
Why your card expires early, and what to do at renewal
For permesso holders on mandatory (free) registration, the card normally expires with the permesso, not after the usual six years. At renewal:
- Apply to renew your permesso at least 90 days before it expires (see our renewal guide).
- Take the post office receipt to the health office, so your registration does not lapse while you wait.
- When the new permesso arrives, take it to the health office again; a new card is then issued.
If you need to travel to another country where your TEAM is valid after your card has expired and before the new one arrives, ask the health office for a substitute TEAM certificate. Travelling outside Italy while your permesso is being renewed has its own strict limits; check with your Questura before you book.
On voluntary registration, coverage ends on 31 December of the year you paid for, whatever the date on your permesso, so renew and pay each year.
If your coverage would last less than 30 days, no card is produced; the health office gives you a paper substitute certificate.
Downloading a copy
Once your card has been issued, you can download a PDF copy of your latest valid card from the Agenzia delle Entrate reserved area or the Sistema TS portal (login with SPID, CIE or an activated CNS).
Voluntary registration: no EHIC
If you are on voluntary SSN registration (typically students and au pairs who chose SSN registration over private insurance, and elective-residence holders who do not work), you get the same care in Italy as an Italian resident, but not the European health card for other countries. Buy travel insurance for trips abroad.
Lost or stolen
Request a new card online in the Agenzia delle Entrate reserved area or the Sistema TS portal (with SPID, CIE or CNS). If you cannot, send form AA4/8 with a copy of your ID by PEC, book an appointment at any Agenzia office, or ask your health office. It arrives by post in about 3 to 4 weeks. If it was stolen or lost, it is advisable to report it to the police.
Leaving Italy for good
Foreign citizens leaving Italy permanently must return the card, even if it has not expired, to their health office or any Agenzia delle Entrate office.
Sources: sistemats1.sanita.finanze.it (FAQ sulla Tessera Sanitaria; FAQ sulla TEAM; verifica dello stato); agenziaentrate.gov.it (la tessera sanitaria; FAQ cittadini; iscrizione al Servizio Sanitario Nazionale); salute.gov.it (assistenza ai cittadini extra UE); europa.eu Your Europe (EHIC for non-EU nationals); regione.lombardia.it. Checked October 2026.