The voluntary registration fees for students have changed to a minimum of 700 euro per year for students and a minimum of 2000 euros per year for non-students, or students with dependant family members.

Fees will be payed with F24 form. 

We are waiting for further details from ATS, the Ministry of Health and the Lombardy Region. please be aware that the content of this article may be totally or partially outdated.

Until further notice, people who payed 149.77 euros could to start / renew their registration until 31/03/2024 and then by April they will have to pay the integration (process to be announced). Furthermore, the fee already paid is non-refundable.

Students from European Union countries, the European Economic Area, and Switzerland:

- if you stay in Italy for a short period: there are no formalities to take advantage of health services in the Lombardy region: in case you need a visit or to go to the hospital, show a valid ID, and the European Health Insurance Card (EHIC / TEAM) of the State of origin.

 
- if you settle in Italy for a longer period: you should register with the National Health Service. You can temporarily transfer your health coverage from your EU country to Italy to take advantage of Italian public healthcare like an Italian citizen, including a local general practitioner, by obtaining the S1 Form from your country of origin. Portable document S1 is issued by the competent authority in your country of origin and entitles you to transfer your health coverage in Italy for the period of your stay: start and expiry date are indicated on the form.

So our first tip is: if you are entitled to public health coverage in the EU, before coming to Milano for a long stay, remember to ask your local authorities to issue you the Europuen Health Insurance Card and the S1 Form for long stays. 

We are aware that often happens that students can't get an S1 form from their local authorities - according to the local policies or some other reason. In this case, you can can use EHIC during your stay as mentioned above, but as a temporary travel coverage it is not accepted to register as permanent resident in Milano.

EHIC is accepted as proof of healthcare coverage only for the registration as temporary resident with the EHIC.

You can voluntarily enroll in the SSN and benefit from its services, by paying a fee, or "contribution".

Enrolment in SSN entitles you to have a general practitioner and benefit from public healthcare services as an Italian citizen (Coverage on the Italian territory only).

The voluntary registration (registrazione volontaria) validity period always starts on 1/1 and expires on 31/12 of the current solar year, no matter when you enroll.

For students without dependents, the cost is €700 per solar year.

For people who are no longer students, researchers not enrolled as students, and students with dependent family members*, the minimum contribution is 7,50% over the past year's income: the minimum amount applies:€2000 per solar year.

Foreign Students without depending relatives, who wish to enroll voluntarily to the NHS, willl be able to submit the application online, and get a response via e-mail.

1. Go to the application platform.

    

2. When you open the platform, click on “PROSEGUI” on the bottom right. Select “Iscrizione al Servizio Sanitario Regionale - Studenti Extracomunitari” if it’s your first time enrolling. If you wish to renew your subscription, select “Rinnovo al Servizio Sanitario Regionale - Students Extracomunitari” (the last option).

    

3. Once you selected the relevant option for you, click on “APRI RICHIESTA”.

    

4. In this page, you’ll be asked if you already have a permit of stay/residence permit card.

    

5. If you do or you are a citizen from the EU and Schengen area, go ahead and select “Sì, sono in possesso del Permesso di Soggiorno per Motivi di Studio o cittadino UE”.

    

6. If you are still waiting for your residence permit card, select the other option “No, non sono ancora in possesso del Permesso di Soggiorno per Motivi di Studio”.

    

7. Fill in the your personal information

   Nome: your name

   Cognome: your last name

   Codice fiscale: tax code

   Sesso: sex

   Luogo di nascita: place of birth, the country in which you were born

   Data di nascita: date of birth

   Nazionalità: nationality

   Domicilio / residenza estera: your domicile abroad

   Via di Domicilio / Residenza: street name

   Civico: street number

   Email and confirmation of your email
    

8. Place your Italian phone number in “Cellulare” and click on “INVIAMI SMS CODICE DI CONFERMA”. You’ll receive a message on your phone with a code that you’re going to put in the following field: “Inserisci Codice di Conferma ricevuto via SMS”.

    

9. In the following part of the form, you'll be asked to upload these documents (make a good pdf scan of each, front and back if applicable):

   If you have your permit of stay /residence permit card already, please upload a scan of it. If not, you’ll be asked to upload a scan of your passport personal data page and visa

   A scan of your Tax Code certificate or Tax Code card 

   Certificate of enrolment into your university

   The receipt of payment of your contribution 

   Self-certification of your domicile in Milano

    

10. By clicking on “CLICCA QUI PER CONSULTARE L’ELENCO MEDICI DAL SITO ATS MILANO” you’ll be able to see which doctors are available in your area. Choose three preferred doctors and place their name and last name in “Inserisci Nome e Cognome del Medico”.

Accept the privacy policy and click on “INVIA PRATICA” to submit your application.

You will get a reply via e-mail in days from the Scelta e Revoca office.

Contribution for the NHS must be paid to Regione Lombardia using the universal tax payment form F24.

You can pay F24 at the post office, at a bank counter or at tobacconist enabled to receive the payment, or at 'Agenzia delle Entrate Riscossione' counters or - if you have an Italian bank account - via online banking.

Download and fill out the form (see example attached)
 

• in the section "Contribuente" with your personal data:

Tax code / codice fiscale
surname / cognome, name/ nome
date of birth / data di nascita (dd/mm/yyyy) sex/ sesso country of birth / Stato estero di nascita 
municipality of residence / comune (e.g.Milano) province /prov. (e.g. MI) street and number / via e numero civico

• Skip to sezione regioni and fill out:

Region code/ Codice regione: 10
Fee code/ Codice tributo: 8846
Year of reference/ Anno di riferimento:2024
Amount paid / Importi a debito versati: 700,00*
Total / Totale 700,00 To be paid / Saldo 700,00* 

• Skip to Firma and sign - on Saldo Finale section write Euro 700,00*
   

*for January 2024 enrolments, if you already got enrolled until 29/02 by having paid 149,77 at the post office, you will write and pay with F24 the difference: 550,23 euros 

You can go to this link https://www.ats-milano.it/portale/Cerca-medico-o-pediatra and see available general practitioners (look for MMG doctors) (green dot) in your area.

You may also ask neighbours classmates and friends to suggest the name of a general practictioner in the area

When doctors have reached their maximum patients capacity, the dot is red

For the purpose of enrolling in the NHS, the Scelta e Revoca office will ask you for a choice of three GPs in case your first choice is unavailable. 

How to tell if the GP can speak English/my language? (Atm, there is no way to tell from the database. However, you can see the birth date and the graduation date on a doctor's file: younger doctors have a better chance to be able to speak English)

Make a shortlist of 3 GPs (first, second and third choice) in your area for the application process 

After your application, ou will get an e-mail from the office, confirming that you have been enrolled for the year and the name of your doctor. 

You should get the health card at home via post (make sure your mailbox has your name on it).

Since 'Scelta e Revoca' officers pick up your domicile data (address) from the revenue office tax code database.

Many students, who have got their tax code from the Consular office or through their university, need to update this record.

It is fundamental that you update the address "tax domicile" on tax records and that the address you give on the enrolment form and the address on your tax records are the same.

You can do so by using this form as "change of data and providing the new 'tax domicile' - your address in Milano. Submit the form via e-mail along with a copy of your ID to the nearest Revenue Agency branch ("Ufficio Territoriale") by stating that you need an update of your tax domicle to allow your enrollment in NHS / SSN

For one-to-one support, please take an appointment at the One-Stop-Shop

You can voluntarily enroll in the SSN and benefit from its services, by paying a (relatively inexpensive) fee, or "contribution".

Enrolment in SSN entitles you to have a general practitioner and benefit from public healthcare services (on the Italian territory only).

The voluntary registration (registrazione volontaria) validity period always starts on 1/1 and expires on 31/12 of the current solar year, no matter when you enroll.

For students without dependents, the cost is €700 per solar year.

For people who are no longer students, researchers not enrolled as students, and students with dependent family members*, the minimum contribution is 7,50% over the past year's income: the minimum amount applies:€2000 per solar year.

They will apply in-person at the nearest Scelta e Revoca office.

The contribution must be paid in one single payment.

It is never retroactive nor fractionable (that means: they are not taking charge of any event before the date of enrolment and that you can't enroll for a part of the solar year only).

This is the step-by-step procedure for voluntary enrolment in public health services:

1. Find the ASST office ("Azienda Socio Sanitaria Territoriale" - it is the administrative entity that manages local health services) competent in the area where you reside. Areas of competence are based on the "Municipal" (Municipi are the smaller administrative zones of Milano, often shown with a number). 
   Try to find out in which "Municipio" you live: ask your landlord, a neighbor, or any shop owner nearby... or look up this map. Then you may make an appointment in person at the "Scelta e Revoca" office - the department in charge of assigning and changing General practitioners to citizens and enrolling new users.

   You can access "Scelta e Revoca" offices by taking an appointment online (see below)
    

2. Fill out the universal tax payment form F24. Pay the amount at Poste, banks, or tobacconists.
3. On your appointment
   • Students from European Union countries, the European Economic Area, and Switzerland that applies voluntarily:
     • Bring with you: an application form, tax code, valid identity document (both in original plus one photocopy) and a self-certification of residence/domicile, and receipt of payment of the contribution.
        
   • Students from non-European countries already in possession of a residence permit for study:
     • Bring with you: an application form, passport, residence permit, tax code (in original and one photocopy), certificate of enrollment in the course of study, and receipt of payment of the contribution.
        
   • Students from non-European countries in possession of the application receipt for a residence permit for study only (some limitations apply*):
     • you will need to bring: your passport, tax code, entry visa for study reasons, the receipt/attestation of having applied for a residence permit (all in original, plus one photocopy), certificate of enrollment in the course of study (issued by your university /institute), receipt of payment of the contribution
        
     • *Please note: for students without an issued residence permit it is not possible to register any dependents.
        
     • *The voluntary registration is set as valid for 3 months and can be extended by providing the same documentation (via e-mail) to the Scelta e Revoca office, until obtaining the residence permit for study. 
       Once in possession of the actual residence permit, you may send to the Scelta e Revoca office a scan of the residence permit and the documentation and have it registered: the deadline for your coverage, then, will be set to 31 December of the current year.
        
4. The officer will also assist you in choosing a local general practitioner in your area from a list You can also bring with you a shortlist of some GPs in your area. Please consider that GPs who have reached the maximum number of patients might not be available to choose from.
    
5. As a result of the registration process, the officer will give you a paper document which must be shown as a health card at the time to request any health service.
6. A plastic health card - not valid for outside Italy - will arrive via private ordinary mail one month later

Scelta e Revoca offices are the counters where you can choose and change your GP (and enroll in the Italian NHS)

Here are all the addresses:

If you live in Municipio (zone) 1,2,3,4,8. You will refer to with ASST Fatebenefratelli Sacco offices, located in:

• via Andrea Doria, 52 (M1, M2 Loreto)
• via Bizzozzero (entrance for the public: Piazzale Accursio, 7) (Tram 14, 19)
• via Serlio, 8 (MM3 Corvetto)
• via Sassi, 4 (M1,M2, Trains Cadorna)
• via Rugabella, 4/6 (M3 Missori)
• via Don Luigi Orione, 2  (M2 Cimiano)
• via Carlo.Farini, 9 (M5 Garibaldi, Tram 4, 2 )

For the above counters, book an appointment / call number on: https://prenota.zerocoda.it - → “scelta/revoca/cambio del medico” dove → “Milano”

Infoline (Italian language): 02.6363.4729/4446 mon-fri 8.30-13.30

info e-mail: sceltarevoca.info@asst-fbf-sacco.it

If you live in Municipio 6, 7. You will refer to with ASST Santi Paolo e Carlo offices, located in:

• piazza Bande Nere, 3 ( M1 Bande Nere)
• via Monreale, 13 (M5 Segesta)
• via Masaniello, 23 (bus 67, 76)
• via Stromboli, 19  (M2 Sant'Agostino)

For the above offices, book an appointment / call number on: https://prenota.zerocoda.it - → “scelta/revoca/cambio del medico” dove → “Milano”

Infoline (Italian language): 02.8184.7900/5609 da mon-fri 13.30 - 15.30

info e-mail: sceltarevoca.bandenere@asst-santipaolocarlo.it

If you live in Municipio 9. You will refer to with ASST Niguarda Ca'Granda offices, located in:

• via Ippocrate, 45 (M3  Trains Affori FN)
• viale Zara, 81 (M3 M5 Marche)
• via Livigno, 2/a (M3 Maciachini Bus 90/91)

For the above offices, book an appointment on:
https://sportellovirtuale.ospedaleniguarda.it/#/queue/home 

infoline: 02.6444.5743 mon-fri 13.30 -15.15 - e-mail: sceltaerevoca@ospedaleniguarda.it 

It is a good idea to send your documents and doctors shortlist to the proper office over via e-mail to see if everything is ok.

Remember to include in the e-mail your personal data, tax code, and telephone number.Specify in the subject that you are asking for information or an in-person appointment for the first enrollment (Appuntamento per prima iscrizione al SSN)

When you book, or there office need sto see you you'll be given a physical appointment at the scelta e revoca office to apply for it.

If you are already registered with SSN, renewals can be done provided you indicate on the payment slip the year for which you pay and you provide a certificate of enrollment in a course of study stating that you will be enrolled for the next year.

Send the usual documentation and the new payment receipt through the online application form or (if you belong to a category that has to apply in-person) your Scelta e Revoca office by e-mail and remember to write to the officers that you are renewing the enrolment for the subsequent year. 

Usually, if you or your family did not pay contributions in Italy, you can have access to the voluntary membership for students (see above)

• If you are an Italian citizen, and register your the residence in Milano you will be enrolled mandatorily (with full coverage + you don't have to pay contribution) to the NHS.

• Use the application platform and select Prima iscrizione al servizio sanitario regional, click on Apri richiesta, select Cittadinanza Italiana, Maggiorenne, Residente. Click on Apri richiesta, fill out your personal details, attack clear pdf scan of your ID, Tax code,application receipt, certificate or self-certification of residence. and a shortlist of 3 GP.

• If you are an Italian citizen living abroad and if you don't wish to register your residence in Milano, you can enroll voluntarily. 

• If you are Italian citizen living abroad in a state with a bilateral agreement and you don't wish to register your residence in Milano, you will  make use of the bilateral agreement according to its regulations
   
• If you are an Italian citizen living abroad in a EU country and if you don't wish to register your residence in Milano but you have S1 form you can register with Ufficio Estero.

If you graduate and apply for / get the residence permit in attesa occupazione with DID (Declaration of availability to work), you will be enrolled mandatorily (with full coverage + you don't have to pay contribution) to the NHS for one year.

In all other cases, if you are no longer a student, e.g., you are on a research position which does not pay IRPEF contributions and it is nt exempt by law,  you are entitled to voluntary registration.

In this case the contribution, is calculated on the previous year income (7.50% with minimum of 2000€).

As for students, voluntary registration, regardless of when it is activated, lasts until 31/12 of the year.

You will need to take an appointment in-person at the Ufficio Scelta e Revoca competent for your area closer to you. They will assess your situation and tell you how to proceed with your registration.

The voluntary membership is valid all over the Italian territory only. 

If you travel or have a course in another EU country, you should get additional coverage, e.g. good travel insurance. 

Please also note:

Students from non-European countries with a bilateral agreement with Italy:

In general, bilateral social security agreements guarantee only urgent services for temporary stays except for pensioners and posted workers. Therefore it is advisable to register voluntarily with the methods specified above.

The voluntary registration with the SSN always expires on 31/12 of the current year, it is never retroactive nor fractionable and entitles the general practitioner and health services only on the Italian territory. 

For technical reasons, first-time applications must be done after the 1st of January of the year in which you want to enroll.

The voluntary registration with the SSN does not entitle you to:

a. Issue of the European Health Insurance Card (TEAM) 
b. Issuing of legal certificates required by bilateral agreements in force
c. Issue of the certificate according to art. 15 of Presidential Decree 618/80
d. Issue of portable document S2 (high specialization care abroad)

The following details are very specific to some situations, however it is good to know:

Additional protocol to the immigration agreement between Brazil and Italy.  Form IB-2 covers only emergencies (first aid) during a temporary stay of a Brazilian citizen in Italy. If a student wants the full  coverage, they have to enrol voluntarily (see above).

There is a Bilateral Social Security Agreement between Italy and Australia that covers only for 6 months and only for urgent benefits assisted nationals in the respective State. If a student wants the full  coverage, they have to enrol voluntarily (see above).

People who have or who applied for a residence permit for:

• Employment or self-employment or Waiting for employment with DID.
• Family reasons (visa for family reunification or family cohesion) - non-EU family member of Community/Italian citizen
• Medical care (only for pregnant women)
• Expected adoption/Custody/Psycho-physical recovery of the chil
• Alternative detention measures.
• International Political/Humanitarian Asylum Application
• Political asylum
• Humanitarian reasons
• Subsidiary/International Protection
• Special welcome measures for exceptional events
• EC or EU permit holders for long-term residents (Former Residence Card)

can enroll mandatorily (without paying the contribution) at Scelta e Revoca office with: 

• Valid residence permit or receipt of the application for a residence permit issued by the competent authorities (Police Headquarters, Prefecture or Post Office) together with documentation attesting the reason for the request.
• Identity document  (except asylum seekers)
• Tax Code certificate or card
• Documentation proving, in case of work reasons, that the activity is subject to Italian tax legislation (IRPEF and IRAP): work contract, payroll, VAT opening or registration documentation.

  The newest research contracts who are subject to contributions and  some older research contracts with the statement "esenti IRPEF ai sensi art4 13 agosto 1984 n.476" are also eligible for the mandatory membership.