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Servizio Sanitario Regionale (Regional Health Services) in Tuscany

Servizio Sanitario Regionale Card

COMMUNITY CITIZENS (EU/EEA/Switzerland)

  1. Short Stays (< 90 Days) and the European Health Insurance Card (EHIC/TEAM)
    • If you stay in Italy for less than 90 days, the EHIC (TEAM) issued by your home country covers all medically necessary treatments.
    • In this case, you cannot register with the SSR nor choose a General Practitioner (GP) in Italy.
  2. Stays Longer Than 90 Days: Mandatory vs. Voluntary Registration
    • Mandatory Registration applies if you fall into one of the categories below. To register, go to the local ASL (Azienda Sanitaria Locale) office in Florence with the documents described later:
      1. Employees (subordinate workers with a fixed-term or open-ended contract) in Italy: covered for the entire duration of the employment. Registration is free (if already covered by a home‐country system with an S1 form, otherwise you register directly with SSR).
      2. Self-employed persons (freelancers with Partita IVA): covered for as long as your Italian activity continues.
      3. Seasonal Workers in Italy: covered for up to 3 months, renewable for an additional 3 months if the same employment continues.
      4. Family members (dependents) of an EU citizen worker in Italy who do not receive health coverage from their home country institution. They register under the “family rights” provision.
      5. EU citizens legally residing in Italy for more than 5 consecutive years: indefinite coverage, with the right to choose a GP.
    • In all of these cases, SSR registration is free and lasts as long as your valid permit or employment lasts.
    • Voluntary Registration is available if you live (or have begun the residence procedure) in Tuscany but do not qualify for mandatory registration, and you do not already have coverage from your home country (e.g., with forms E106/E109 or E104/SO 41). To register voluntarily:
      1. Pay the annual contribution (via F24) to the Region of Tuscany (see details below).
      2. Submit your proof of payment to the ASL in Florence.
      3. You will receive—often by email—an attestation of SSR registration.
      4. The contribution is valid for the entire calendar year (January 1–December 31) and must be renewed by December 31 of each year to maintain coverage.
      5. Note: Persons in Italy for tourism or for short-term medical treatment are not eligible for voluntary registration.
    • Main Categories Eligible for Voluntary Registration (EU/EEA/Swiss)
      • Students (including those on scholarships or research fellowships)
      • Au-pair residents
      • Religious-based migrants (e.g., missionary volunteers)
      • Elective residents (no work activity, living on personal resources)
      • Volunteers in NGOs
      • Family members over 65 who arrived after November 5, 2008
      • Diplomats or staff of international organizations (if not covered by their institution)
      • Other categories covered by specific bilateral agreements.
  3. Required Documents (Mandatory & Voluntary Registration, ASL Florence)
    • Mandatory Registration:
      • Valid identity document (passport or EU ID card).
      • Codice Fiscale.
      • Valid residence permit (“permesso di soggiorno” for stays > 90 days) or receipt for its renewal.
      • Employment contract (for employees) or proof of self-employment (Partita IVA registration, Chamber of Commerce certificate).
      • Form S1/E106/E109/E104–SO 41 (if you already receive coverage from your home country)
    • Voluntary Registration (in addition to all of the above):
      • Proof of F24 payment of the annual SSR contribution for the current year.
      • Form E106/E104–SO 41 (if you have coverage in your home country). If not, a self-declaration stating you have no home-country SSN.
    • Go to the Stranieri Desk (Sportello Stranieri) at ASL Toscana Centro – Florence (e.g., Via Buonarroti, 48, or the appropriate local district office). Present all required documents to receive a temporary health card (STP or European-style card). The definitive card arrives by mail at your declared residence in approximately 2–4 weeks.
  4. Choosing Your General Practitioner (GP) or Pediatrician
    • After SSR registration, you can select your GP (if you are adult) or your child’s pediatrician from the list available at the ASL Sportello Stranieri or online on the Tuscany Health Observatory portal (“Scelta MMG/Pediatra”).
  5. EHIC/TEAM vs. SSR Card
    • As long as you are covered under the EHIC/TEAM (for short stays), use the EHIC for urgent or medically necessary care.
    • Once you register with SSR (mandatory or voluntary) for stays > 90 days, you no longer use the EHIC: you use the regional health card (STP if temporarily present, or SSR if fully registered), valid throughout Italy.
  6. Useful Links (Tuscany/Florence)

NON-COMMUNITY CITIZENS (Non-EU/EEA Citizens)

  1. Residence Permit > 90 Days: Mandatory SSR Registration
    • Any foreign national holding a permesso di soggiorno for employment (fixed-term/indeterminate), self-employment, political asylum, family reunification (dependents), international protection, refugee status, or similar is required to register with SSR—free of charge—for the entire validity of the residence permit.
    • Documents Needed:
      • Valid passport (or other recognized travel document).
      • Codice Fiscale.
      • Valid residence permit or receipt of application/renewal (you may receive a provisional registration with the receipt, then complete it once you have the actual permit).
      • Proof of residence or domicile (e.g., lease contract or a self-declaration if awaiting formal registration).
      • Completed SSR registration form (available at ASL offices or online).
      • Additional documents if you are registering family members (e.g., marriage certificate, birth certificate translated/legalized).
  2. Residence Permit < 90 Days (Tourists, Short-Term Medical Treatment)
    • Cannot register with SSR.
    • Only urgent or emergency care is provided (births, vaccinations, urgent hospitalization). All other healthcare is fully paid.
  3. Voluntary Registration Options (Non-EU/EEA)
    • If you hold a permit for study (including PhD/research), au-pair, elective residence, religious purposes, volunteer programs, unsponsored sports activities, diplomats or international organization staff, or if you are a parent over 65 rejoined after November 5, 2008—you can choose either:
      1. Obtain Private Health Insurance valid throughout Italy (mandatory at Questura when applying for the permit).
      2. Register Voluntarily with SSR, paying an annual contribution (per Ministerial Decree of October 8, 1986, updated by Law 213/2023).
    • 2025 Tuscany Annual Contributions (approximate):
      • Students with no dependents: € 700
      • Au-pair with no dependents: € 1,200
      • Students or Au-pair with dependents: € 2,000
      • All other cases: Calculated on income (7.5 % on income up to € 20,658.28, plus 4 % on income from € 20,658.28 to € 51,645.69; minimum € 2,000)
    • How to Pay: via F24 (Codice Tributo 8846, Codice Regione 17, Causale “Contributo SSR anno 2025”) to c/c postale n. 289504 intestato to “Regione Toscana.”
    • Documents to Submit (typically via email to stranieri@uslcentro.toscana.it or at Sportello Stranieri ASL Firenze):
      • Receipt of F24 payment.
      • Valid permit or renewal receipt.
      • Codice Fiscale.
      • Self-declarations or forms (E104/SO 41 if covered in home country; for elective residence: proof of sufficient financial means).
      • Once accepted, you will receive an attestation of registration, and you can collect a temporary SSR card.
    • The voluntary contribution covers one calendar year, is non-refundable, and must be renewed by December 31 every year to avoid losing coverage.
  4. Foreign Minors
    • All foreign minors, regardless of permit length or status, can register free with SSR by presenting a birth certificate and a permit application/receipt (or valid permit).
    • Their registration can be renewed until they turn 18, even if the permit lapses (except for short-term tourist/medical visitors).
  5. After Registration
    • You obtain a temporary health card (STP if temporarily present, or SSR if fully registered).
    • The permanent card arrives by mail at your address.
    • Choose a GP (adults) or pediatrician (minors) via the Tuscany Health Observatory portal or at the ASL Sportello.
    • You are entitled to all Essential Levels of Care (LEA) and any additional services provided by Tuscany.
  6. Useful Links (Tuscany/Florence)

Final Steps for Both Categories

  1. Gather All Required Documents
    • (EU/EEA/Swiss) Valid ID, Codice Fiscale, permit/receipt if > 90 days, proof of income/employment or voluntary contribution receipt.
    • (Non-EU) Valid passport, Codice Fiscale, valid permit or receipt, proof of residence, and any additional documents (e.g., marriage/birth certificates if registering dependents).
  2. Visit the ASL Toscana Centro – Florence, Sportello Stranieri (e.g., Via Buonarroti 48 or local distretto)
    • Submit all paperwork.
    • You will receive a temporary health card valid immediately for all covered services.
  3. Receive the Definitive Health Card
    • The permanent regional health card (Multiservizi) is mailed to your declared residence within 2–4 weeks.
  4. Choose Your GP or Pediatrician
    • Access the Tuscany Health Observatory portal or visit the ASL office to finalize your doctor selection.
  5. Access Healthcare Services
    • Once you have your card and GP assignment, you are fully entitled to the LeveI Essentiali di Assistenza (LEA) and any additional services offered by the Regione Toscana, exactly as an Italian citizen.

Azienda USL Toscana Centro – Florence

For any further questions, you can contact:

This ensures both EU/EEA/Swiss citizens and non-EU/EEA citizens can correctly register with the SSR in Tuscany, choose a GP, and access all essential healthcare services.