Your health card expires with your permit: the new one does not arrive by itself
If you are not an Italian citizen, your tessera sanitaria (health card) lasts as long as your residence permit. Once you renew the permit, the new card is not sent automatically: you have to go back to the ASL and renew your registration. Here is how, and what to do if you lost the card.
Redazione Bahay 5 min read
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The tessera sanitaria (health card) is the green card with your codice fiscale (tax code) on it. You need it at the doctor, at the pharmacy, at the hospital, to book a test: anywhere they ask you for «la tessera». It is free and personal: one for each member of the family, children included.
One thing applies to you and not to an Italian citizen, and it is the one that costs everybody the most time: your health card lasts as long as your residence permit. When the permit expires, the card expires too.
The mistake almost everyone makes: renew the registration first
An Italian citizen gets the new card at home automatically, shortly before the old one expires, without asking anyone.
You do not, and it is not an oversight: the card is only issued if your registration with the Servizio Sanitario Nazionale (SSN, the National Health Service) is still valid, and your registration is tied to your permit. So when you renew your residence permit, the sequence is this:
- you collect your new residence permit (or the receipt of the renewal application);
- you go to the ASL — the local health authority for the area where you live — and renew your SSN registration;
- from there the new health card is issued and posted to the address you gave.
If you skip the second step, nothing loud happens: the card simply never arrives, and you find out the day you need it. It is the same journey you made the first time, explained in full in Registering with the National Health Service: for most people it is free.
What to bring to the ASL
- your new residence permit, or the receipt of the renewal application together with the expired permit;
- your codice fiscale or your old card;
- an identity document;
- the address where you actually live, because that is where they post the card.
That last point deserves a second: the card arrives by post. If you moved house and told no one, the card travels to the old address. Waiting does not fix it.
If the card is lost, or never arrived
You ask for a duplicate, and it costs nothing. There are several ways, and the first two do not require going anywhere:
- online, in the reserved area of the Agenzia delle Entrate (Revenue Agency) website — you log in with SPID (the Italian public digital identity), with the Carta d'Identità Elettronica (electronic ID card) or with the Carta Nazionale dei Servizi;
- by email or PEC (certified email), sending the AA4/8 form with a copy of your identity document;
- at an Agenzia delle Entrate office, by appointment;
- at your ASL.
One thing that wastes time: if the card is merely about to expire, do not ask for a duplicate — the new one is issued on its own, provided your registration is valid. A duplicate is for a card that was lost, stolen or damaged, or that never arrived.
While you wait, you are not left without care
The right to care does not depend on the piece of plastic: it depends on your SSN registration. If your registration is in order and the card is not there yet, at the ASL, at the doctor and at the pharmacy you can be identified with your codice fiscale and an ID document. Ask your ASL what they issue in the meantime: it varies from region to region, and it is worth getting something in writing.
The card is also a key to online services
On the back of the health card you will read TS-CNS: the same card can work as a Carta Nazionale dei Servizi, that is, as a way to log into public administration websites. It does not work out of the box: it must be activated, and you need the codes (PIN) collected at an ASL or Regional desk, plus a card reader.
For most people SPID is simpler, and you get it with no readers and no appointments. But if you already have the card in your hand and want to use it, you can.
One last thing, about deadlines
The date on the health card is one of the few that nobody reminds you about: no alert, no letter. If you use Bahay Italia, add it to your deadlines together with your residence permit — the two dates are the same, and when one moves the other moves with it.
When to get help
If the card has not arrived for months, if the registry office has you at an address where you no longer live, or if they tell you your registration «does not show up», that is the moment to go to a municipal immigration desk, a patronato or an association: these are situations that unlock in half an hour when someone knows where to look, and that can last months on your own.
