From the Tessera Sanitaria to the Medico di Base, here is what foreigners in Italy need to know
Italy’s healthcare system can feel confusing at first, especially if you are used to a more private, appointment-based model. Offices may have limited calling hours, hospital check-ins can take longer than expected, and words like ticket, ricetta, ASL and medico di base quickly become part of daily life.
Yet once you understand how the system works, the Italian National Health Service — Servizio Sanitario Nazionale, or SSN — can be extremely valuable. It gives eligible residents access to general practitioners, public hospitals, specialist visits, prescriptions, preventive care and emergency services, often at low out-of-pocket cost compared with many other countries.
For foreigners living in Milan, Lombardy or elsewhere in Italy, learning how to use the system properly can save time, money and unnecessary frustration.
What is the Italian National Health Service?
Italy’s public healthcare system is called the Servizio Sanitario Nazionale, commonly known as the SSN. It is organized regionally, which means that procedures can vary slightly depending on where you live.
In Lombardy, for example, many services are managed through the regional health system and the Fascicolo Sanitario Elettronico, Italy’s electronic health record.
If you are legally resident in Italy and meet the requirements, registration with the SSN allows you to choose a family doctor, access public hospitals and book specialist medical visits. Depending on your status, registration may be mandatory or voluntary.
In everyday life, your most important healthcare document is the Tessera Sanitaria, the Italian health card. You will use it for prescriptions, medical appointments, pharmacy services, healthcare tax deductions and access to many public health services.
For more on the Italian health card, read Easy Milano’s guide: What is a Tessera Sanitaria and Why do I need it?
Step 1: Registering with the SSN and Getting Your Tessera Sanitaria
To access the Italian public healthcare system as a resident, you generally need to register with your local health authority. This is often still referred to as the ASL — Azienda Sanitaria Locale — although names and administrative structures may vary by region.
For many foreigners, the basic documents usually include:
- Valid identity document or passport
- Italian tax code, or codice fiscale
- Permit of stay, or permesso di soggiorno, where applicable
- Proof of residence, or registered domicile where permitted
- Any documents related to your work, study, family or residency status
If you are still sorting out your documents, Easy Milano has useful guides on how to get a codice fiscale and whether you need a permesso di soggiorno.
Once your registration is accepted, you will be able to choose your medico di base, also called your family doctor or general practitioner. Children are usually assigned a pediatra di libera scelta, a pediatrician within the public system.
In many cases, you may first receive a temporary paper certificate before the physical health card is issued or updated.
Step 2: Choosing Your Medico di Base
Your medico di base is your first point of contact for most non-emergency health needs. This doctor can examine you, prescribe medication, request blood tests, write referrals for specialist visits and issue medical certificates when needed.
However, the relationship may feel different from what many foreigners are used to. Italian family doctors often have many patients and very structured office hours. Appointments may be short, and administrative requests are often handled quickly.
Your doctor’s role is practical and essential. They act as the gateway to much of the public healthcare system.
A medico di base can usually help you with:
- General illnesses such as flu, fever, infections or minor health concerns
- Prescriptions for medication
- Referrals for specialist visits
- Requests for blood tests, scans or other exams
- Medical certificates
- Ongoing management of chronic conditions
If you are in Lombardy, you may be able to choose or change your doctor online through the Fascicolo Sanitario Elettronico, depending on availability. Some services may also be available through local pharmacies or ASST offices.
Understanding the Ricetta
One of the most important words to learn in the Italian healthcare system is ricetta. A ricetta is a medical prescription or referral issued by your doctor.
You may need a ricetta for:
- Specialist appointments
- Diagnostic exams
- Blood tests
- Prescription medication
- Certain therapies or follow-up visits
Having a ricetta allows you to access services through the SSN and pay the official co-payment, known in Italian as the ticket. This is not a “ticket” in the English sense. It refers to the fee patients may pay for certain public healthcare services.
Some people are exempt from paying the ticket due to age, income, disability, chronic illness or other recognized conditions. These exemptions are called esenzioni.
Step 3: Booking an Appointment with Your Doctor
Each medico di base works differently. Some use phone bookings, others use email, WhatsApp, apps, online systems or walk-in hours. Many still have very specific calling times, often early in the morning.
This can be frustrating at first. If your doctor only accepts calls between 8:00 and 9:00, it usually means exactly that. Calling outside those hours may not work.
Practical tips:
- Save your doctor’s office hours immediately.
- Ask whether requests can be sent by email or app.
- Keep copies of previous prescriptions and specialist reports.
- For recurring medication, ask how repeat prescriptions are handled.
- If calling, start early and expect the line to be busy.
Many doctors have a system for leaving prescription requests without needing a full appointment. In some offices, this may still be a physical mailbox; in others, it may be email or a digital platform.
Walk-In Visits and Waiting Rooms
Walk-in visits still exist in some practices, although they depend on the doctor. If you go without an appointment, expect a very Italian waiting-room experience.
There may be no receptionist. There may be a number system. Or you may hear the classic phrase: Chi è l’ultimo? — “Who is last?”
This is how people keep track of the order in which patients arrived. It may feel informal, but it is part of the social choreography of many Italian waiting rooms.
If your doctor’s system does not work for you, you can request to change doctors. In Lombardy, this may be done online, through the regional health system, at selected pharmacies or through the local health office, depending on your situation and the availability of doctors in your area.
Step 4: Specialist Visits, Hospitals and the CUP
For specialist visits, exams or hospital appointments, your medico di base will usually issue a ricetta. You can then book through the regional booking system, hospital website, pharmacy service, call center or CUP — Centro Unico di Prenotazione.
The CUP is the central booking and payment office used by many public hospitals and clinics.
In Lombardy, residents can book many public and accredited private healthcare services through Prenota Salute Regione Lombardia, provided they have the required prescription and health card.
On the day of your appointment, arrive early. Even if you already have a time slot, you may still need to complete accettazione, the check-in process, and pay your ticket before being seen.
For large hospitals, allow extra time for:
- Finding the correct department
- Taking a number
- Checking in at the CUP or reception desk
- Paying the ticket
- Waiting for your visit
Some private clinics are convenzionate, meaning they have an agreement with the public healthcare system. In these cases, you may be able to use the SSN and pay only the public co-payment, while often finding shorter waiting times than in large hospitals.
This is one of the most useful things to understand: public healthcare in Italy does not always mean only public hospitals. Some accredited private clinics also operate within the SSN.
Public or Private Healthcare?
Many foreigners in Milan use a mix of public and private healthcare.
Private international clinics can be easier when you need English-speaking staff, faster appointments or a more familiar patient experience. They are especially useful for urgent but non-emergency specialist visits, second opinions, dental care, physiotherapy or when you need documentation in English.
The public system, however, is often excellent for chronic care, hospital treatment, maternity care, emergency services, major surgery and long-term medical follow-up.
The best approach is often practical: use the public system when it serves you well, and use private care when speed, language or convenience matter more.
Emergency Healthcare in Italy
For emergencies in Italy, call 112, the European emergency number. You can also go directly to the Pronto Soccorso, or emergency room.
The Pronto Soccorso is not based on arrival order. Patients are assessed through triage and given priority according to urgency. This means that less urgent cases may wait longer, even if they arrived earlier.
For a broader list of useful numbers, see Easy Milano’s guide to Useful Contact Numbers in Italy.
Useful Italian Healthcare Words
Tessera Sanitaria — Italian health card
Servizio Sanitario Nazionale — National Health Service
SSN — Italian public healthcare system
ASL / ATS / ASST — Local health authority structures
Medico di base — Family doctor / general practitioner
Pediatra — Pediatrician
Ricetta — Prescription or referral
Ticket — Public healthcare co-payment
CUP — Central booking office
Accettazione — Check-in / registration desk
Esenzione — Exemption from healthcare fees
Pronto Soccorso — Emergency room
Farmacia — Pharmacy
Fascicolo Sanitario Elettronico — Electronic health record
Useful Phrases at the Doctor
I am sick.
Sto male.
I have a fever.
Ho la febbre.
I have a cold.
Ho il raffreddore.
I have a cough.
Ho la tosse.
I have stomach pain.
Ho mal di pancia.
I have a headache.
Ho mal di testa.
I feel pain here.
Sento male qui.
How often should I take this?
Ogni quanto devo prenderlo?
Do I need a prescription?
Mi serve una ricetta?
Can I have a referral for a specialist?
Posso avere una ricetta per una visita specialistica?
Can I book an appointment for today?
Posso prenotare una visita per oggi?
Is there anything earlier?
C’è qualcosa prima?
Common Specialist Names in Italian
Dermatologist — Dermatologo
Orthopedist — Ortopedico
Cardiologist — Cardiologo
Gynecologist — Ginecologo
Urologist — Urologo
Psychologist — Psicologo
Neurologist — Neurologo
Gastroenterologist — Gastroenterologo
Ophthalmologist — Oculista
ENT specialist — Otorino
Endocrinologist — Endocrinologo
Learning the System Makes Life Easier
The Italian healthcare system is not always intuitive. It can feel slow, bureaucratic and surprisingly informal at the same time. But once you understand the basic structure — tessera sanitaria, medico di base, ricetta, ticket, CUP and Fascicolo Sanitario — it becomes much easier to manage.
For foreigners living in Italy, the key is not only knowing your rights, but learning the rhythm of the system. Keep documents organized, save your doctor’s office hours, ask locals for recommendations and do not be afraid to change doctor if the arrangement does not work for you.
Italy’s healthcare system may require patience, but for residents who learn how to use it, it can become one of the most important supports of daily life.
Article by Easy Milano Editorial Staff
