Before you start

Residence registered with the comune, or a valid permesso and an address
Codice fiscale
Permesso di soggiorno or its receipt, for non-EU nationals
Proof of income, for voluntary registration

Step-by-step

1
Work out whether your registration is free or paid
Employees, the self-employed, their families and several permit categories register at no cost. Students, elective residents and others outside those categories pay the annual voluntary contribution. This classification is the whole cost question.
In personWho: YouWeek 2–4
2
Register at the USL Toscana Centro district office
Take your documents to the district counter covering your address and choose a medico di medicina generale from the list. Students should ask specifically about the practices closest to their campus, which are used to foreign registrations.
In personWho: You
3
Pay the voluntary contribution if it applies
Since the 2024 budget law it is calculated on the previous year's worldwide income at 7.5% on a first band and 4% above it, with minimums of €700 for students, €1,200 for au pairs and €2,000 for most adults. It expires on 31 December regardless of when you pay.
In personWho: You
4
Collect the tessera sanitaria
The health card carries your codice fiscale and doubles as the European Health Insurance Card. It is posted to your registered address and is what pharmacies and clinics ask for.
OnlineWho: You
5
Learn Tuscany's booking system
Specialist visits and tests are booked through the regional CUP using the prescription code from your GP, by phone, online or at pharmacy counters. Waits vary by specialty and by facility, and asking for the earliest slot anywhere in the region rather than the nearest one is normal practice.
OnlineWho: You
6
Know the out-of-hours route
Between 20:00 and 08:00 and at weekends the continuità assistenziale service covers your GP and is reached across Tuscany on 116117. For anything urgent it is 112 — and Tuscany's answering centre is in Florence itself, the largest of its kind in Italy.
In personWho: You

Documents you’ll need

Codice fiscale
Permesso di soggiorno or filing receipt
Certificate of residence or self-declared address
Employment contract, proof of self-employment, or enrolment certificate
Proof of previous year's income, for the voluntary contribution

Things most newcomers don’t know

The student contribution rose from under €150 to €700 on 1 January 2024, and Florence is where that lands hardest.

The 2024 budget law replaced the old flat voluntary fees with statutory minimums — €700 for students, €1,200 for au pairs, €2,000 for most other adults. With one of Europe's largest concentrations of international students and study-abroad participants, Florence has thousands of people a year budgeting from pre-2024 university welcome packs and consulate pages. It is not a small adjustment and it needs to be in the first-year budget.

Source: Ministry of Health; 2024 budget law

The contribution expires on 31 December whenever you pay it, which is a trap for an academic year.

It is a calendar-year charge that does not pro-rate. Register in October for a course running to the following June and you have bought ten weeks of cover. This is why counters routinely advise non-EU students to pay for two consecutive years at once. Anyone planning around an academic year rather than a calendar year needs to do this arithmetic before paying.

Source: Ministry of Health

Private travel or student insurance is not a substitute once you are entitled to register.

Many arrivals buy a policy for the visa and keep it instead of registering, on the assumption that it is equivalent. It is not: private cover does not give you a medico di base, and without a GP you cannot get prescriptions, referrals or access to the public specialist system at ticket prices. Where registration is free — employees and their families — keeping private insurance instead is simply paying for less.

Source: Regione Toscana

You can change your medico di base at any time, and almost nobody knows it.

Nothing in the Italian public system moves without a prescription from your assigned GP — no blood test, no scan, no specialist. The difference between a doctor with evening surgeries near your flat and one across the city with two hours of walk-in a week is enormous. Changing is a counter formality at the USL and takes minutes. People endure a badly chosen GP for years because they assume the assignment is fixed.

Source: Regione Toscana

Common mistakes to avoid

Budgeting the pre-2024 student contribution of under €150.
Paying the voluntary contribution in autumn and losing most of it at year end.
Relying on private student insurance instead of registering where registration is free.
Letting SSN registration lapse while the permesso is being renewed.
Keeping an inconvenient GP because you assume the assignment cannot change.

Some of this may be out of date. Spotted something inaccurate? Help us keep it right for the next newcomer.