Tessera Sanitaria in Italy for Ukrainians: How to Get Your Health Card

She walked into the ASL to register with a doctor, and got hit with “your permesso?”, “codice fiscale?”, “residenza?” - and three more papers nobody warned her about. One Ukrainian woman from Naples shared on a forum: “Went to the ASL three times, got sent home for documents every single time. And when I finally had everything - turns out my medical records from Ukraine needed to be translated through the tribunale. Another 100 euros and a week of waiting.” The Tessera Sanitaria isn’t just a plastic card - it’s your key to free healthcare in Italy. Without it, you’re paying for everything out of pocket. Let’s figure out how to get it on your first visit and what documents to prepare in advance.

What’s a Tessera Sanitaria and what it gives you¶

The Tessera Sanitaria (health card) is a document confirming your registration with the SSN (Servizio Sanitario Nazionale - Italy’s National Health Service). It’s your state-provided health insurance, essentially.

The card shows your personal details, codice fiscale and expiration date. You’ll need it every time you see a doctor, visit a pharmacy, go to a lab or check into a hospital.

What the Tessera Sanitaria covers¶

• Medico di base (family doctor) - free visits, prescriptions, referrals to specialists
• Pediatra - a dedicated doctor for children under 14
• Specialists - cardiologist, orthopedist, dermatologist and others, with a referral from your medico di base
• Tests - blood work, urine, MRI, CT scans, X-rays - with a referral
• Hospitalization - free treatment at SSN hospitals
• Vaccinations - including mandatory ones for children
• Prescriptions - most medications at reduced prices or free
• Emergency care - Pronto Soccorso (ER) with no restrictions

Without a Tessera Sanitaria, you can only count on emergency care and basic services under the STP code (Straniero Temporaneamente Presente - temporarily present foreigner). STP gives you access to emergency medicine, but you can’t register with a family doctor.

Who can get a Tessera Sanitaria¶

Not every foreigner in Italy automatically qualifies for the SSN. It depends on your status.

Mandatory registration (free)¶

If you have a permesso di soggiorno of one of these types, SSN registration is free and mandatory:

• Protezione temporanea - temporary protection for Ukrainians (extended until March 2027)
• Lavoro subordinato - employed work
• Lavoro autonomo - self-employment
• Motivi familiari - family reunification
• Asilo/Protezione internazionale - asylum
• Lungo soggiornanti - long-term residence

Most Ukrainians in Italy fall under protezione temporanea - and for them registration is completely free.

Voluntary registration (paid)¶

If you have a student visa, au pair arrangement or another permit type without mandatory registration - you can register voluntarily. But you’ll have to pay. Since 2024, the fee jumped from 387 to 2,000 euros per year. For students - 700 euros per year. It’s not cheap, but it covers everything from your family doctor to hospitalization.

How to register at the ASL: step by step¶

The ASL (Azienda Sanitaria Locale) is your local health authority, responsible for healthcare in your area. That’s where you go to register with the SSN and get your Tessera Sanitaria.

Step 1: Gather your documents¶

You’ll need:

Document	Details
Passport	Original + copy
Codice Fiscale	Card or certificate from Agenzia delle Entrate
Permesso di soggiorno	Or ricevuta (receipt of application)
Proof of residence	Certificato di residenza, rental contract or dichiarazione di ospitalità
Dichiarazione di non svolgimento di attività lavorativa	Only for temporary protection - to get the X22 exemption

If you don’t have residenza (registration with the comune) yet, some ASL offices accept a rental contract or dichiarazione di ospitalità instead of a certificato di residenza. But this varies by region - one ASL will let it slide, another will send you to get residenza first.

Step 2: Find your ASL¶

Each ASL covers a specific area. You need the ASL for your place of residence (not your workplace). Find the address on your regione’s (region’s) website or just google “ASL [city name] iscrizione SSN”.

Hours are typically Monday to Friday, 8:30-12:30. Some offices also open in the afternoon, but showing up in the morning means shorter queues.

Step 3: Submit documents and choose a doctor¶

They’ll give you a form to fill out on the spot. After checking your documents, the operator registers you in the system and asks you to choose a medico di base (family doctor) from a list. Usually the list is posted on the wall or shown on a computer screen.

How to pick a doctor: - Ask other Ukrainians who their doctor is and whether they’re happy with them - Check Google Maps reviews for specific doctors - Look at the office address - pick someone nearby - Pay attention to anni di pratica (experience) - more experienced is usually better

After registration, you’ll get a temporary paper certificate - it works as a full Tessera Sanitaria until the plastic card arrives by mail (usually 2-8 weeks).

Esenzione X22: free healthcare for Ukrainians¶

This is the key benefit for Ukrainians with temporary protection. The esenzione X22 code exempts you from ticket sanitario (copays for medical services).

What does this mean in practice? Normally in Italy, even with a Tessera Sanitaria, you have to pay a ticket for certain services - 20 to 50 euros for a specialist visit or lab tests. With code X22, you pay nothing.

What X22 covers¶

• All visits to your medico di base
• Specialist referrals
• Lab tests
• Diagnostics (MRI, CT scans, X-rays, ultrasounds)
• Hospitalization
• Prescription medications (most of them)

The X22 code is valid until December 31, 2026. It’s assigned automatically when you register with the SSN as a holder of protezione temporanea - you just need to submit a dichiarazione di non svolgimento di attività lavorativa (a statement that you’re not employed).

If you’re already working - you still don’t need to pay tickets, because employees with a permesso have mandatory SSN registration with full coverage. The exemption in that case comes through other codes (for example, income-based).

Which medical documents from Ukraine need translation¶

For the actual ASL registration and getting the Tessera Sanitaria, translating medical documents is usually NOT required. Your passport, codice fiscale and permesso are enough.

But there are situations where translation becomes necessary:

When translation is required¶

Situation	Documents	Translation type
Chronic illness	Hospital discharge, diagnosis, prescriptions	Traduzione giurata (sworn)
Prescription medications	Prescription from a Ukrainian doctor, discharge summary with medication details	Traduzione giurata
Pregnancy	Prenatal record book, test results, ultrasounds	Traduzione giurata
Disability	MSEK certificate, medical reports for Commissione medica ASL	Traduzione giurata with asseverazione
Children’s vaccinations	Vaccination record card	Traduzione giurata
Allergies	Allergist report, test results	Traduzione giurata (recommended)

Why this matters¶

An Italian doctor can’t read a document in Ukrainian. Even if they recognize the diagnosis in Latin, they need an official translation to make treatment decisions, write prescriptions or order tests.

Real-life example: a Ukrainian woman with diabetes arrived in Italy and visited her medico di base. The doctor could see she was on insulin, but without a translated medical summary couldn’t determine the diabetes type or prescribe the correct medication by Italian standards. She had to redo all tests from scratch - and that meant weeks of waiting. If she’d translated her endocrinologist’s report in advance, the doctor would’ve written the right prescription immediately.

How much does translating medical documents cost¶

Translating medical documents from Ukrainian to Italian through a sworn translator costs on average:

• Translation - 30-50 euros per page (depends on complexity and language pair)
• Asseverazione (oath at the tribunal) - about 80 euros for a package of up to 7 pages
• Marche da bollo - 16 euros per every 4 pages of translation

So translating a single 2-page medical report comes to roughly 140-180 euros with all fees.

You can cut costs by translating several documents at once - the asseverazione is paid once for the whole package. Or use ChatsControl for the initial translation and then have it certified by a sworn translator.

Medico di base: how it all works¶

The medico di base (medico di medicina generale) is your family doctor in Italy. Something between a Ukrainian therapist and a family practitioner. They’re your first point of contact for any health issue.

What the medico di base does¶

• Sees patients with or without appointments (depends on the doctor) - typically 2-3 hours in the morning and 1-2 hours in the evening
• Writes prescriptions (ricetta medica)
• Issues specialist referrals (impegnativa)
• Provides sick notes (certificato di malattia) for your employer
• Conducts basic examinations - blood pressure, palpation, auscultation
• Can administer vaccinations (not all doctors)

If you don’t speak Italian¶

This is a common issue for Ukrainians, especially early on. A few tips:

• Prepare a list of symptoms and questions translated into Italian in advance (Google Translate works fine here for basic communication)
• Ask a friend who speaks Italian to come with you
• Some ASL offices have a mediatore culturale (cultural mediator) - ask about this when you register
• Some doctors speak English - check Google Maps reviews or ask at the ASL

Pronto Soccorso: emergency care without a Tessera Sanitaria¶

Even if you haven’t registered with the SSN and don’t have a Tessera Sanitaria yet - you’ll get emergency care. It’s guaranteed by law.

You can go to the Pronto Soccorso (hospital emergency department) with any acute problem. If you don’t have a Tessera Sanitaria, they’ll assign you an STP code (Straniero Temporaneamente Presente) and treat you.

The STP code covers: - Emergency care - Treatment of urgent and essential conditions - Preventive medicine (vaccinations) - Care for pregnant women and children

But STP is a temporary solution. Once you get your permesso and register at the ASL - you’ll get a full Tessera Sanitaria with access to all services.

What to do if your Tessera Sanitaria expires or gets lost¶

Renewal¶

The Tessera Sanitaria is tied to your permesso di soggiorno’s validity. If your permesso is renewed - go to the ASL with the new permesso (or ricevuta) and renew your registration. A new plastic card will be mailed to you.

For Ukrainians with protezione temporanea extended until March 2027, visit your ASL with the updated permesso or ricevuta to renew your Tessera Sanitaria.

Loss or damage¶

If you’ve lost or damaged your card, you can order a new one: - On the Agenzia delle Entrate website (requires SPID or CIE) - By calling 800 030 070 (free) - In person at an Agenzia delle Entrate office

The new card will arrive by mail within a few weeks. While you wait, you can ask the ASL for a temporary certificate.

Tessera Sanitaria is NOT the same as TEAM¶

A common misunderstanding: the Tessera Sanitaria for protezione temporanea holders does NOT work as a TEAM (Tessera Europea di Assicurazione Malattia - European Health Insurance Card). If you travel from Italy to another EU country, this card won’t cover medical expenses abroad. You’ll need separate travel insurance.

Those with a permesso per lavoro or lungo soggiornanti can get a TEAM - you need to request it at the ASL.

FAQ¶

How long does it take to get a Tessera Sanitaria?¶

The ASL registration itself takes 15-30 minutes if your documents are in order. You get a temporary certificate right away. The plastic card arrives by mail in 2-8 weeks.

Do I need a passport translation to register at the ASL?¶

No. Your original passport is enough for SSN registration - no translation needed. Translation is only required for medical documents if you want to show the doctor your medical history, diagnoses or prescriptions from Ukraine.

Can I choose a doctor who speaks English or Ukrainian?¶

There’s no official language filter at the ASL. But you can ask the operator during registration - sometimes they know which doctors speak foreign languages. It’s also worth checking Google Maps reviews or asking local Ukrainian communities.

What is esenzione X22 and who qualifies?¶

Esenzione X22 is an exemption from copays (ticket sanitario) for medical services. Ukrainians with protezione temporanea who are not employed qualify. The code is valid until December 31, 2026 and covers all SSN services - from lab tests to hospitalization.

How much does SSN registration cost for Ukrainians?¶

For Ukrainians with temporary protection, a work permesso or a family reunification permesso - registration is free. For students - 700 euros per year. For other categories, voluntary registration costs 2,000 euros per year (since 2024).