Before you start

Residence registered with your municipio, 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 registration is free or paid for you
Employees, the self-employed, their family members and several permit categories register at no cost. Students, elective residents and others outside those categories pay the annual voluntary contribution. This single classification decides whether your first year costs nothing or €2,000.
In personWho: YouWeek 2–4
2
Register at the ASL district office for your address
Rome is divided between ASL Roma 1 to 6. Take your documents to the district counter for your address and choose a medico di medicina generale from the local list. Booking online in advance is possible for many districts and saves a long wait.
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 €2,000 for most adults, €700 for students and €1,200 for au pairs. It expires on 31 December whenever you pay it.
In personWho: You
4
Collect the tessera sanitaria
The health card carries your codice fiscale and doubles as the European Health Insurance Card on its reverse. It is posted to your registered address and is what pharmacies and clinics ask for.
OnlineWho: You
5
Learn how to book through ReCUP
Lazio's central booking system takes the prescription code from your GP by phone, online or at pharmacy counters. Waits vary enormously by specialty and by facility, and the same examination is frequently available far sooner at a hospital in an adjacent ASL that the first offer will not mention.
OnlineWho: You
6
Know the out-of-hours and emergency routes
Between 20:00 and 08:00 and at weekends the continuità assistenziale service covers your GP, reached in Rome and its province on 116117. For anything urgent it is 112. Rome's pronto soccorso departments triage by colour and non-urgent cases can wait many hours.
In personWho: You

Documents you’ll need

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

Things most newcomers don’t know

The €387.34 voluntary SSN fee stopped existing on 1 January 2024 and the internet has not noticed.

The 2024 budget law replaced the flat fee with an income-based charge — 7.5% on a first band and 4% above — with minimums of €2,000 for most adults, €700 for students and €1,200 for au pairs. Elective residents and postgraduate students in Rome are the two groups this hits hardest, and both routinely arrive having budgeted the old figure. It is not a small revision; for many people it is a five-fold increase or more.

Source: Ministry of Health; 2024 budget law

The contribution expires on 31 December however late in the year you pay it.

It is a calendar-year charge with no pro-rating. Paying in November buys six weeks. Students are commonly advised at the ASL counter to pay two consecutive years at once so a single academic year is covered end to end. Rome's large postgraduate and research population — the universities, the academies, the international schools — is exactly the group that gets caught.

Source: Ministry of Health

ReCUP will offer you the nearest slot, not the earliest one, unless you ask.

Lazio's booking system defaults to facilities close to your address, and waiting times between ASLs for the same examination differ by months. Asking the operator explicitly for the earliest available date anywhere in the region, or checking the regional waiting-time publication first, routinely turns a five-month wait into a five-week one. It is a normal thing to ask and almost no newcomer knows to.

Source: Regione Lazio

The medico di base is a genuine gatekeeper and you can change them at any time.

No blood test, scan or specialist referral happens in the Italian public system without a prescription from your assigned GP. The practical difference between a doctor with evening surgeries near your flat and one two buses away with two hours of walk-in a week is enormous, especially in a city Rome's size. Changing GP is a counter formality at the ASL and takes minutes — most people endure a badly chosen one for years without realising.

Source: Regione Lazio

Common mistakes to avoid

Budgeting the pre-2024 flat contribution of €387.34.
Paying the voluntary contribution in autumn and losing most of it at year end.
Accepting the first ReCUP appointment without asking for the earliest in the region.
Letting SSN registration lapse when the permesso is being renewed.
Choosing a GP by proximity to the ASL office rather than to your home.

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