SSN: what it is, how it works, and who is entitled to register

The Servizio Sanitario Nazionale (SSN) is the Italian public healthcare system that guarantees access to essential medical care and health protection for all those who are entitled to it. Registration with the SSN is a fundamental step not only for Italian citizens but also for foreign citizens, both EU and non-EU, who are legally residing in the country.

What the SSN is and what it is for

The SSN is a universal system, created with the goal of ensuring healthcare services for all residents in Italy. Upon registration, individuals receive a health card, a document that allows access to medical visits, hospital care, diagnostic tests, and, most importantly, the choice of a general practitioner or pediatrician. The system operates according to the principles of equality and solidarity: all registered individuals enjoy the same rights and obligations regarding contributions and healthcare, regardless of nationality.

How SSN registration Works

Registration is carried out at the ASL (Azienda Sanitaria Locale – Local Health Authority) in the municipality of residence. If official residence has not yet been obtained, registration can be done at the ASL of the municipality indicated as domicile on the residence permit. Registration can be of two types:

1. Mandatory – applies to those who are legally required to register and therefore access the system without the need for private insurance.
2. Voluntary – applies to those who are not covered under mandatory registration but still wish to access healthcare through the SSN, upon payment of an annual contribution.

Who is entitled to mandatory registration

Among non-EU citizens, mandatory registration applies to those who are employed (either as employees or self-employed), to dependent family members, to those residing in Italy for family reasons, international protection, adoption or foster care, as well as to unaccompanied foreign minors. EU citizens may also be entitled to mandatory registration: for example, employed or self-employed workers, unemployed individuals registered with the Employment Center, family members of Italian or EU citizens already registered, and those who have acquired permanent residence after five years of legal stay.

Voluntary registration

If a citizen, whether EU or non-EU, does not fall under the categories eligible for mandatory registration—for example, holders of residence permits for study purposes or elective residence—they can still access healthcare through voluntary registration with the SSN. Alternatively, they must take out private health insurance valid in Italy.

Voluntary registration requires payment of an annual contribution, which was recently increased to €2,000. Reduced rates are available for certain categories, such as students or au pairs.

And what about those who are not registered?

Those who are not registered with the SSN, even if in Italy, are still entitled to urgent or essential care—for example, in cases of serious illness, accidents, pregnancy, child healthcare, or mandatory vaccinations. This principle ensures that health protection, a fundamental right recognized by the Constitution, is never completely denied.

Conclusion

The SSN remains a crucial tool in safeguarding the right to health for everyone, both Italians and foreigners. Knowing the procedures and requirements for registration is essential to access healthcare services safely and legally, avoiding difficulties and protecting both one’s own health and that of the community.

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The content of this article is intended to provide general information on the topic. For doubts or specific cases, it is advisable to seek specialized legal advice tailored to your particular situation.