It depends on your case.

A) ARE YOU A FOREIGN NATIONAL WHO IS REQUIRED TO REGISTER WITH THE ITALIAN HEALTH SERVICE (SERVIZIO SANITARIO NAZIONALE SSN) TO HAVE HEALTH CARE IN ITALY? (e.g. Non EU)

B) ARE YOU A FOREIGN NATIONAL WHO IS NOT IN COMPLIANCE WITH ENTRY AND RESIDENCE REGULATIONS? (STP: Temporary Present Foreigner, e.g. non EU citizens without VISA)

C) ARE YOU A FOREIGN NATIONAL WHO IS REGULARLY RESIDENT IN ITALY AND IS NOT REGISTERED (AND CANNOT BE) WITH THE ITALIAN HEALTH SYSTEM (SISTEMA SANITARIO NAZIONALE SSN)? (e.g. you are in Italy for a short stay of 3 months or less (business visits, tourism, …)

D) ARE YOU A EUROPEAN CITIZEN, BUT YOU ARE NOT REGISTERED IN THE HEALTH SYSTEM OF YOUR COUNTRY OF ORIGIN, YOU ARE INDIGENT, YOU ARE ILLEGALLY PRESENT ON THE ITALIAN NATIONAL TERRITORY?

E) IF YOU ARE NOT AMONG THE PEOPLE WHO CAN REGISTER WITH THE ITALIAN HEALTH SYSTEM (SISTEMA SANITARIO NAZIONALE SSN), YOU CAN MAKE A VOLUNTARY REGISTRATION

Law references: Art 34 cc 1,2 Legislative Decree 286/98; Art 42 cc 1,2,3,4 Presidential Decree 394/99; Ministry of Health Circular No. 5 dated 03/24/2000) 

There is an obligation to register with the Italian Health Service (Servizio Sanitario Nazionale SSN) for foreigners who:

1) have applied for a residence permit (permesso di soggiorno) for the first time

2) or are awaiting renewal of their residence permit (permesso di soggiorno) for one of the following reasons:

– subordinate work (lavoro subordinato)

– seasonal subordinate employment (lavoro subordinato stagionale)

– self-employment (lavoro autonomo)

– awaiting employment (attesa occupazione: unemployed persons who must be registered with the job centre/centro per l’impiego)

– family reasons (motivi familiari)

– Family reunification (ricongiungimento familiare; excluding persons over 65 years of age, who entered Italy after November 5, 2008 and are required to get an insurance policy or the voluntary registration with the Regional Health Service (SSR) – Dlgs 5/07 – Dlgs 160/08; eire. Health Ministry DGRUERI VI prot. 4537!09 and 9682/09; note R.L. n 84775 of17/07/09)

– family cohesion (coesione familiare)

– fostering and waiting for adoption (affidamento e attesa di adozione)

– application for Italian citizenship (richiesta di cittadinanza italiana)

– residence card and long-term residents (carta di soggiorno e soggiornanti lungo periodo)

– study reasons (motivi di studio) (foreign nationals already registered on the residence permit of one of their parents, regularly staying and registered with the Regional Health Service (SSR); or unaccompanied minors in the care of social services. Once turned 18 years old, they are issued a residence permit for study reasons and mantain their already acquired right to free registration with the Regional Health Service (SSR))

– Application for international protection (richiesta di protezione internazionale) (refugee status or subsidiary protection) exemption from co-payment as unemployed Italian citizens Legislative Decree 251/07; Legislative Decree 25/08; Legislative Decree 159/08)

– Refugee status, international protection (asilo politico, protezione internazionale) ( D.lgs 251/07; D.lgs 25/08; D.lgs 159/08 -Humanitarian reasons (motivi umanitari) (art 20 c.1 – art.5 c.6 O.lgs 286/98)

– Subsidiary protection (protezione sussidiaria) Dlgs251/07 ;Dlgs25/08; Dlgs 159/08

– Social protection (protezione sociale) (Art. 18 c.1 0./gs 286/98)

– Stateless status (status di apolide)

– Unaccompanied minors in foster care (minori di 18 anni non accompagnati in affidamento) art 19 c.2 -D.fgs 286/98)

– Minors to whom the juvenile courts allow to stay in Italy for reasons related to health status (pursuant to Article 31 of Legislative Decree 286/98)

– Minors staying for psycho-physical recovery (OGR No. 4323/99; eire. R.L. 6/08/99)

– Pregnant or childbearing women and the father of the child, who was previously not in compliance with entry and residence regulations  (registration with Regional Health Service (SSR) throughout pregnancy and 6 months after child’s birth. Art 19 c 2 o.lgs 286/98)

– Parents with residence permit for child care (assistenza minore) carrying out normal work activity {Circular M1mstero Health No. DGRueri/VI/LJ.b.a/8489/ P of 16/04/09)

– Foreigners hosted in reception centres art. 40 c.l 0./gs 286/98)

– Detainees, on semi-release or under alternative measures to punishment, whether regular or irregular (prisoners are exempt from co-payment) oJgs zJ0/99

– Awaiting regularisation or emersion from illegal work (emersione) (renewable six-month registration) telex min health 3/04/00;DGR2444/00,note R.L n 20776 of 12 /12/10

– Health reasons (motivi di salute) (issued in case of extension of residence permit to foreign nationals who have contracted illness or sustained an accident that does not allow them, upon expiration of their residence permit, to leave the national territory (not to be confused with healing reasons (motivi di cura))

WHERE CAN I REGISTER WITH THE REGIONAL HEALTH CARE SYSTEM (SISTEMA SANITARIO REGIONALE-SSR)?

At the Health Authority (Azienda Sanitaria Locale – ASL) of your place of residence or domicile or in the location where you wish to receive the therapy.
If the foreign national holds a residence permit for which mandatory registration is foreseen, the Health Authority (Azienda Sanitaria Locale – ASL) must proceed with the registration, without verification of additional requirements. Health care is extended to family members who are tax dependent and regularly residing. In the absence of residence (residenza), it is sufficient to indicate the actual domicile (effettiva dimora) as on the residence permit.*

WHICH DOCUMENTS DO I HAVE TO SUBMIT FOR THE REGISTRATION?

1. Self-certificate of residence or declaration of actual domicile (autocertificazione di residenza o dichiarazione di effettiva dimora)
2. Copy of residence permit (permesso di soggiorno) or application for renewal (the postal receipt/ ricevuta postale is also accepted)
3. Self-certification of social security number (codice fiscale)
4. Self-certification of the reason for issuing the residence permit (permesso di soggiorno) or applying for renewal (in case the reason entitling to compulsory registration is not stated on the residence permit or if the foreign person holds an electronic residence permit (Permesso di Soggiorno Elettronico P.S.E.).

You can apply for the so-called STP card (Art.35 cc 3,4,5,6,0/gs 286/9.8; art.

In fact, foreigners who are not in compliance with entry and residence regulations (STP) are guaranteed urgent health care, which is the care that cannot be deferred without endangering the person’s life or harming his or her health;

essential care: services related to conditions that are not life-threatening in the immediate term but could lead to health damage or life-threatening conditions over time;

In particular, preventive medicine interventions:
– Pregnancy and maternity care;
– The Services are provided by: Family counselling centres (consultori); outpatient clinics and specialised laboratories; hospitals.

DO I HAVE TO PAY FOR TREATMENT?

You are exempt from paying expenses related to pregnancy and voluntary termination of pregnancy (IVG)

WHO ISSUES THE STP CARDS (TESSERINO STP for temporarily present foreign nationals)?

Local Health Authorities (Aziende Sanitarie Locali ASL, or AST);
Hospital Authorities;
University Polyclinics.

(a) after recording the foreign person’s personal information, date of birth, address and nationality

(b) together with a self-declaration of the applicant’s indigence (by means of a form es.I. STP)

HOW LONG IS THE STP CARD VALID FOR?
 6 months, and it is renewable.

AM I REPORTED TO THE AUTHORITIES WHEN ACCESSING THE FACILITIES?
No, access does not imply any type of reporting to the authorities.

That is, are you in Italy for a short-term stay of 3 months or less (e.g. for business, tourism)?
You are then required to take out private health and accident insurance and must pay the health care fees in full. You might only need to pay the reduced fare if you are covered by the regulations arising from agreements with the following countries:

Australia, Tunisia, Argentina, Brazil, San Marino, Cape Verde,
Monaco, Croatia, Serbia, Macedonia,
Bosnia-Herzegovina,Montenegro, Vatican City and Holy See.

You have to get the ENI code (European Non-Enrolled or Europeo non iscritto), which is the tool by which the Italian regions can ensure the enforcement of the right to health care for indigent citizens of the European Union who are irregularly present on the Italian territory and are neither enrolled in the National Health Service (Servizio Sanitario Nazionale SSN) nor insured by the a foreign fund. The right is enshrined in the Constitution. The ENI code is issued by local health authorities (Aziende sanitarie locali ASL).

In Rome, it is issued at: Via delle Fratte di Trastevere 52, Rome.

Admission hours:
Monday through Friday 7:30 a.m. to 12:30 p.m.; blood draws: until 10:00 a.m.;
Monday, Tuesday, Wednesday and Thursday in the afternoon from 2:00 p.m. to 5:30 p.m.;
Saturday 8:00 a.m. to 12:30 p.m.

Foreigners holding a residence permit (permesso di soggiorno) of a duration of more than three months and who are not among those who are enrolled by right in the National Health System (Sistema sanitario nazionale SSN) (including family members older than 65 who entered Italy after November 5, 2008) may apply for voluntary registration in the Regional Health System (Sistema Sanitario Regionale SSR).

THE MINIMUM CONTRIBUTION IS EQUAL TO €387.34 PER CALENDAR YEAR AND IS NOT DIVISIBLE
Assistance is also extended to legally residing dependents.

Foreigners who hold residence permits for:
– study reasons (motivi di studio) (including for periods of less than 3 months); STUDENTS €149.77
– Au pair €219.49

In the latter 2 cases, the amount is not divisible and does not extend to family members;
In order too extend assistance to family members, a payment of €387.3 can be made.

WHERE TO MAKE THE PAYMENT?
Postal account No. 370007, registered in the name of LAZIO region.

HOW LONG DOES VOLUNTARY RE LAST?
It expires on December 31 every year. 

WHICH DOCUMENTS ARE NEEDED FOR REGISTRATION WITH THE NATIONAL HEALTH SERVICE (Servizio Sanitario Nazionale SSN)?
1. Self-certificate of residence or declaration of actual domicile (autocertificazione di residenza o dichiarazione di effettiva dimora)
2. Copy of residence permit (permesso di soggiorno) or application for renewal (the postal receipt/ ricevuta postale is also accepted)
3. Self-certification of social security number (codice fiscale)
5. Receipt of payment to postal account No. 370007, registered in the name of the Lazio region
6. For students: self-certificate of enrollment in a course of study
7. Declaration of “au pair” status