Percorso Cittadino
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Italian Health Card 2026: Apply, Renew or Replace It

From eligibility and issue to replacement: check delivery, online services, EHIC and the digital version through official channels.

First published: 18 July 2026

Official sources checked: 15 August 2026

Important information

Percorso Cittadino helps you understand Italian administrative procedures but does not replace public authorities. Before submitting applications or making decisions, always verify the official institutional links provided on this page.

This guide explains how Italy’s health card is issued and renewed, how to request a replacement and how to use its EHIC, TS-CNS and digital functions without confusing their purposes or limits.

Entitlement to healthcare depends on enrolment with Italy’s National Health Service (Servizio sanitario nazionale, SSN) and the individual circumstances, not merely on possession of the card. For foreign citizens, AIRE registrants, stays abroad or incorrect details, instructions from the local health authority (azienda sanitaria locale, ASL) and competent bodies take priority.

Italian health card in 2026 at a glance

Requirements
Correct Italian tax code and SSN enrolment through the ASL
Cost
Free under the standard regime; separate AIRE outside EU/EFTA case
Validity
Normally 6 years; a newborn’s first card lasts 1 year
Replacement
Reserved area, PEC (certified electronic mail) with AA4/8, office or ASL
EHIC
Necessary treatment in covered countries under the applicable conditions
Digital card and CNS
IO is optional; CNS requires regional activation

Section 1

Quick answer

Identify the problem, check the relevant record and use the correct official channel without confusing the document with healthcare entitlement.

Where to start

  1. Define the problem

    Separate first issue, renewal, expiry, incorrect details, non-delivery, loss, EHIC, CNS and the digital document.

  2. Check status and details

    Verify the Italian tax code, SSN enrolment and card status through official services.

  3. Choose the competent body

    The ASL, Revenue Agency, region, Health Card System and IO support have different functions.

  4. Keep the result

    Save official receipts, certificates or PDFs and check that the relevant record has been updated.

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Section 2

Who this guide is for

The appropriate route changes according to the reason for the check and the person’s healthcare status.

First issue

For a person with a tax code who needs to complete or check healthcare enrolment.

Renewal or expiry

For a person awaiting automatic renewal or whose card shows a past date.

Newborns and children

For parents separating the first card, health-authority enrolment and the next card.

Foreign citizens

For people coordinating residence permits, receipts, SSN enrolment and card validity.

Loss or non-delivery

For a person who needs a replacement or wants to check the document status.

Temporary travel

For a person who needs to understand the EHIC scope and limits before departure.

Digital services

For a person activating TS-CNS or using the digital health card in IO.

AIRE outside the EU or EFTA

For a person separating Law no. 111/2026 from the process still awaiting implementation.

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Section 3

Health card, EHIC, CNS and digital version

One document can display different functions, but each has its own requirements and limits.

Italian health card
A document normally issued free under the standard regime, connected with the Italian tax code and the recorded healthcare position.
Italian tax code
A tax identifier which does not expire and does not by itself prove SSN enrolment.
EHIC
The European function for necessary treatment during temporary stays in covered countries.
TS-CNS
A chip card usable as a National Services Card after the required activation.
Digital health card in IO
An optional version available to adults for uses supported by the app.
Replacement certificate
A document issued by the ASL where provided for; it is not an unverified photograph or PDF.
Function and main limit
ItemMain useLimit to remember
Italian health cardHealthcare and Italian tax codeThe document does not itself create healthcare entitlement
EHICNecessary treatment abroad in covered countriesIt does not guarantee free or universal coverage
TS-CNSAccess to enabled online servicesIt requires a chip and regional activation
Document in IOSupported digital uses in ItalyIt must not be promised as a valid EHIC abroad
Card PDFConsulting or printing the valid documentIt is not equivalent to a replacement certificate in every context
Health-authority certificateTemporary evidence in the cases provided forIts scope and validity depend on the document issued
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Section 4

Issue and requirements

The tax code and healthcare enrolment must be correct before the document can represent the position.

Standard route

  1. Check the Italian tax code

    Confirm that the official code and personal details are correct.

  2. Complete healthcare enrolment

    Contact the ASL for SSN enrolment and the steps relevant to your position.

  3. Wait for issue

    The health card is produced on the basis of details transmitted by the competent public bodies.

  4. Check the status

    If the card does not arrive, use the Health Card System portal and seek help without filing uncoordinated duplicate requests.

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Section 5

Validity, renewal and expiry

The standard validity period is normally six years, but a person’s healthcare position can produce a different period.

Standard validity

The Italian health card is normally valid for six years.

Renewal

While entitlement continues, ordinary renewal is automatic and free.

Care in Italy

An expired card does not by itself cancel valid healthcare enrolment.

Travel abroad

If the EHIC is unavailable or invalid, ask the ASL for the applicable replacement certificate.

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Section 6

Newborns and children

A newborn’s first card has a shorter validity period and precedes the standard healthcare route.

From the tax code to the next card

  1. Tax-code allocation

    After the birth is registered, the Italian tax code is allocated through the prescribed public channels.

  2. First card

    A newborn’s first Italian health card is valid for one year.

  3. Health-authority enrolment and paediatrician

    Healthcare enrolment and selection of a paediatrician allow the next card, normally valid for six years, to be issued.

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Section 7

Foreign citizens and residence permits

Card validity, healthcare enrolment and immigration status must be coordinated without treating them as the same thing.

Card validity
It may be linked to the recognised healthcare period or immigration position.
Renewal receipt
It can be used for healthcare enrolment in the cases provided for by the applicable rules.
Provisional Italian tax code
It may allow a healthcare certificate to be issued while the position is completed.
STP code
It follows a separate regime, is valid for six months and can be renewed when the relevant conditions are met.

Checks to complete

  • Confirm the recognised basis and period of enrolment with the ASL.
  • After renewing a residence permit, return to the ASL to update healthcare enrolment.
  • Take the receipt and documents required by the official route without assuming they are sufficient in every case.
  • Distinguish a healthcare certificate, an ordinary Italian health card and an STP code.
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Section 8

Incorrect details and outdated records

Before requesting a new physical card, identify which public record contains the detail that needs correction.

Identify the error

  1. Check the personal record

    For name, birth or residence details, check the municipality and ANPR where the service is supported.

  2. Check the Italian tax code

    For inconsistencies in the Tax Register, use Revenue Agency channels.

  3. Check healthcare enrolment

    For the doctor, duration of coverage or SSN status, contact the ASL.

  4. Request replacement only afterwards

    A new physical card does not automatically correct information that remains wrong in a public register.

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Section 9

Loss, theft, damage and non-delivery

Official guidance refers to replacement or reissue and provides several routes according to the case.

Replacement routes
RouteWhat is neededWhen to use it
Revenue Agency reserved areaSPID, CIE or CNSOnline request in the supported cases
PECAA4/8 and ID, unless digitally signedUnder the competent office’s instructions
Revenue Agency officeDocuments required by the serviceAssistance and an in-person request
ASLRelevant healthcare and identity documentsAlternative replacement route under the official instructions

Before submitting the request

  1. Check the status

    Confirm whether the card is shown as issued, valid, dispatched or replaced.

  2. Select the correct reason

    Separate loss, theft, damage and non-delivery without inventing a basis for the request.

  3. Use one coordinated route

    Avoid simultaneous requests that can make the current status harder to reconstruct.

  4. Check the new card

    If it is a TS-CNS, replacement deactivates the previous card.

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Section 10

PDF copy, card status and certificates

Online status, a printout of the valid card and a health-authority certificate serve different needs.

TS or TS-CNS status

The Health Card System displays the available information about production and validity.

Print the valid card

Where supported, the official service provides the document in PDF format.

Health-authority certificate

It is issued for the applicable use and period and is not automatically the same as the PDF.

If the result is unexpected

  • Check that the Italian tax code and personal details are correct.
  • Ask the ASL to check enrolment and the length of coverage.
  • Use Revenue Agency assistance if the issue concerns issue, replacement or tax-record details.
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Section 11

EHIC and healthcare abroad

Coverage concerns medically necessary treatment during temporary stays, not every healthcare expense outside Italy.

Covered countries
The European Union, Iceland, Liechtenstein, Norway, Switzerland and the United Kingdom in cases governed by the applicable agreements.
Necessary treatment
Care that cannot wait until return, assessed according to the person’s condition and the duration of the stay.
Eligible providers
Public providers or organisations contracted with the healthcare system in the country of stay.
Financial conditions
Local rules, co-payments and any advance payments applying to people insured there remain relevant.

Before travelling

  • Check the expiry date and healthcare status.
  • Review the rules in the destination and the official contact points to use.
  • If the EHIC is unavailable, ask the ASL for a provisional replacement certificate.
  • Consider additional cover for risks outside the EHIC scope.
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Section 12

Using the health card as a CNS

The digital-access function requires a chip, activation and compatible tools.

Activation and use

  1. Check for the chip

    Only a card containing a microchip can be used as a CNS.

  2. Follow the regional route

    Activation and delivery of the codes depend on instructions from the competent region.

  3. Keep PIN, PUK and CIP secure

    Protect the codes and never disclose them to an unverified support provider.

  4. Prepare the device

    Use may require a compatible reader, drivers and software identified by the service.

Healthcare function

The card continues to represent the healthcare position within the applicable limits.

CNS function

Online access becomes available only after activation and for participating services.

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Section 13

Card without a chip and short-term entitlement

The absence of a chip can result from the length of entitlement and does not remove the document’s other functions.

Entitlement up to six months

In the cases provided for, a card may be issued without a microchip.

Entitlement under 30 days

The ASL issues the prescribed certificate instead of the ordinary card.

Remaining functions

A card without a chip remains usable for healthcare, the tax code and EHIC, but not as a CNS.

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Section 14

Digital health card in the IO app

The digital version is free and optional for adults, but the permitted use still needs to be checked.

Optional

Adding it to Documents in IO does not cancel the physical card.

For adults

The function is provided for adult users who activate it in the app.

Use in Italy

It can be used for supported SSN purposes, including offline according to the app’s methods.

Dynamic verification

The document must be opened in the app; offline it shows validity updated at the last online access, and a screenshot does not replace it.

Using it carefully

  • Add only a document issued to you.
  • Open it in the app when it needs to be verified.
  • Protect access to the phone and notifications containing personal data.
  • Carry the physical card or certificate where the context requires it.
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Section 15

AIRE and Law no. 111/2026

The new regime has a narrow scope and must not be described as an available process for every AIRE registrant.

People concerned

Italian citizens registered with AIRE who live outside the European Union and EFTA.

Card and contribution

The envisaged card is valid in Italy; the contribution is EUR 2,000 for a continuous year from issue and cannot be apportioned.

Children

The exemption depends on at least one parent or the guardian holding a valid card.

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Section 16

Costs, timing and status

Under the standard regime the document is free, but there is no single promised timeframe for every position and channel.

What to expect
AspectPrudent rule
Standard issueFree where the requirements are met
Ordinary renewalAutomatic and free while entitlement continues
ReplacementUse only the prescribed public routes
DeliveryCheck the status without promising a universal deadline
AssistanceContact the body managing the relevant detail or function
AIRE outside the EU/EFTASpecial Law no. 111/2026 regime, not yet operational as of 15 August 2026
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Section 17

Security and phishing

False expiry or replacement campaigns exploit urgency, personal information and payment requests.

Warning signs

  • An unexpected message claiming that the card is blocked or will expire urgently.
  • A link imitating the Revenue Agency, Health Card System, Ministry or an ASL.
  • A payment request for a renewal presented as compulsory.
  • A form asking for photographs of the card, identity documents, credentials or banking details.
  • Pressure to act immediately without opening the official portal independently.
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Section 18

Problems and support

Contacting the correct body avoids duplicate requests and answers concerning a different public record.

Problem and first contact point
ProblemFirst route to check
SSN enrolment or duration of coverageCompetent ASL
Italian tax code or tax-record detailsItalian Revenue Agency
Personal recordsMunicipality or ANPR where supported
Status, PDF or replacementHealth Card System or Agency, according to the function
CNS activation and codesRegion or the indicated regional service
Digital documentOfficial IO app support
EHIC or Law no. 111/2026ASL and current ministerial or statutory source

How to ask for help

  1. Collect the essential information

    Note the problem, displayed status, date and route already used without publishing complete documents.

  2. Open the institutional contact channel

    Obtain contact details from the body’s official website, not from an unverified message or search result.

  3. Keep the response

    Save the reference number, receipt or instruction received and check whether the record is updated.

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Section 19

Related guides

Learn more about the Italian tax code, Revenue Agency, residence, AIRE, digital identity, IO and security.

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Section 20

Frequently asked questions

Ten practical answers about issue, renewal, replacement, EHIC, foreign citizens and digital functions.

How do I obtain an Italian health card?

Under the standard route, the Italian health card is issued free of charge when the tax code is correct and enrolment with Italy’s National Health Service (Servizio sanitario nazionale, SSN) has been recorded by the competent local health authority (azienda sanitaria locale, ASL). Possession of the card does not itself create healthcare entitlement: if it does not arrive or the record is outdated, tax details and healthcare enrolment must be checked separately.

How long does the Italian health card last and is renewal automatic?

The standard validity period is normally six years and, while healthcare entitlement continues, ordinary renewal is automatic and free. Different periods apply to newborns, foreign citizens and people whose entitlement lasts for a shorter period, so the date printed on the card and the healthcare record held by the local authority should both be checked.

Can I receive healthcare in Italy with an expired health card?

Expiry of the physical card does not by itself remove entitlement to care in Italy while SSN enrolment remains valid. For a stay abroad, however, do not assume that an expired EHIC will be accepted: before travelling, ask the ASL whether it can issue a provisional replacement certificate.

How do I request replacement after loss, theft, damage or non-delivery?

Since 7 March 2025, replacement can be requested in the Revenue Agency reserved area using SPID, CIE or CNS. Official instructions also provide for PEC (certified electronic mail) with form AA4/8 and an identity document, which is not needed when the form is digitally signed, a Revenue Agency office or the ASL. There is no universal police-report requirement for every case: follow the route relevant to your circumstances.

Can I check the card status and download a PDF copy?

The Italian Health Card System portal allows users to check the status of a TS or TS-CNS and, where supported, print the currently valid card. The PDF must not be confused with a provisional EHIC replacement certificate issued by the ASL or with activation of the CNS function; contact the competent body if the displayed status is inconsistent.

How does a newborn’s first Italian health card work?

After the Italian tax code has been allocated, a first health card valid for one year is issued. Enrolling the newborn with the ASL and selecting a paediatrician allow the next card, normally valid for six years, to be issued. If the tax code has not been allocated or contains an error, the personal-data or tax-record issue must be resolved first.

What should a foreign citizen do when renewing a residence permit?

The validity of the health card may follow the recognised healthcare period or immigration status. After renewal, return to the ASL to update enrolment; the application receipt can be used in the cases provided for. A provisional tax code may lead to a healthcare certificate, while the STP code follows separate rules and is not the ordinary health card.

Does the EHIC cover all healthcare abroad free of charge?

No. The EHIC concerns medically necessary treatment during a temporary stay in a covered country and through public or contracted providers, under the conditions applying to people insured there. It does not guarantee free care, automatically cover private providers, planned treatment or medical repatriation, and it does not replace travel cover where that is appropriate.

What is the difference between TS-CNS and the digital health card in IO?

TS-CNS is the physical chip card which, after regional activation, uses the PIN and a compatible reader and drivers to access enabled services. PUK and CIP, where provided, follow regional instructions for management, recovery or unlocking. The digital version in IO is free and optional for adults and serves supported uses in Italy; it must not be presented as a guaranteed substitute for the physical EHIC abroad.

Can AIRE registrants outside both the EU and EFTA already obtain a card by paying under Law no. 111/2026?

The law has been in force since 27 July 2026 and concerns Italian citizens registered with AIRE who live outside the European Union and EFTA. As of 15 August 2026, however, the implementing decree on access and procedure was still missing, so it must not be promised that the EUR 2,000 contribution can already be paid or that enrolment and a card are immediately available.

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Section 21

Official sources

Institutional pages, services, support and legislation checked on the date shown at the beginning.

Sources include the Italian Revenue Agency, Italian Health Card System, Ministry of Health, European Union, IO app, Migrant Integration portal, Official Gazette, ANPR and CERT-AGID. Links are centralised in the guide’s source register.

Services, regional processes and healthcare conditions may change after 15 August 2026. Before acting, reread the relevant official page and check instructions from the ASL, region or competent body.

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