ASL, ASST, ULSS, AUSL, USL, ASP: Italian health by region
The same health agency in Italy is called something different in each region, and it is confusing. It is the local arm of the Servizio Sanitario Nazionale (SSN): where you enrol in public healthcare, get a tessera sanitaria and register with a medico di base. Below is the naming map by region and an overview of who enrols in the SSN for free and who pays. Eligibility is stable; waitlists, the voluntary fee and doctor-list availability are community-reported - verify current data.
Updated: - permesso.love editorial team
Why the agency has so many names
After regional reforms the single term "ASL" did not survive everywhere. In Lazio, Piedmont, Campania, Liguria and Apulia it is still the ASL. In Lombardy the territory is run by the ATS and hospitals by the ASST. In Veneto it is the ULSS (now AULSS), in Emilia-Romagna the AUSL, in Tuscany the USL, and in Sicily and Calabria the province-level ASP. The function is the same everywhere: SSN enrolment and a family doctor.
The SSN and tessera sanitaria: how to enrolWhat the agency is called by region
| Region | Local name | Main city | Page |
|---|---|---|---|
| Lombardia | ATS / ASST | Milano | Details |
| Lazio | ASL | Roma | Details |
| Piemonte | ASL | Torino | Details |
| Veneto | AULSS (ULSS) | Venezia | Details |
| Emilia-Romagna | AUSL | Bologna | Details |
| Toscana | USL | Firenze | Details |
| Campania | ASL | Napoli | Details |
| Liguria | ASL | Genova | Details |
| Sicilia | ASP | Palermo | Details |
| Puglia | ASL | Bari | Details |
In large regions the agency is split by number or zone (for example ASL Roma 1-6, ASL Napoli 1 Centro) - yours is set by your address.
Who enrols in the SSN: free or paid
| Status | Enrolment type | Cost |
|---|---|---|
| Employment | Obligatory (obbligatoria) | Free |
| Lavoro autonomo | Obligatory (obbligatoria) | Free |
| Family members (reunification) | Obligatory (obbligatoria) | Free |
| Students | Voluntary (volontaria) or private insurance | A fee, per the community around a couple of thousand euro a year |
| Residenza elettiva | Voluntary (volontaria) or private insurance | A fee, per the community around a couple of thousand euro a year |
You can enrol on the ricevuta of a filed permesso. The enrolment type is tied to the permesso motivo, and the voluntary fee depends on the region and income - the exact amount is set by the region, verify current data. The first year without a tessera sanitaria is often bridged with private insurance.
Choosing a family doctor (medico di base)
Once you are enrolled in the SSN a medico di base (family doctor) is assigned to you - without the plastic card people are often given a temporary paper cover for a few months. At sign-up they ask whether you want a specific doctor (if you know the name) or a man or a woman, and they try to find one near your home. The main local snag is that the doctor you want may already have a full list ("e pieno"): you are then offered another or asked to wait. You can change the doctor later. It is handled on the regional site (often via SPID), in an app, or in person at your agency's desk.
FAQ
How do you enrol in the SSN, and can you do it on the ricevuta?
Per the community yes: at your agency (the ASL, or in some regions the ATS, AUSL, ULSS, USL or ASP) you bring the passport, codice fiscale, the ricevuta of the filed permesso (or the permesso itself) and proof of address. For employees and lavoro autonomo enrolment is free and obligatory; for students and residenza elettiva it is paid and voluntary. Confirm the type and amount with your agency - lived experience, not a guarantee.
Not legal advice. Eligibility, the voluntary fee and local practice change - verify with your regional agency (ASL/ASST/ULSS/AUSL/USL/ASP), the questura and salute.gov.it.