Medico di base in Italy: how to register

The medico di base (also called medico di famiglia or MMG, medico di medicina generale) is your family doctor and the main free entry point into Italy's public healthcare (the SSN). You register with them when you enroll in the system and get the free tessera sanitaria card, and it is through the family doctor that most of the further steps go: appointments, prescriptions, and referrals to specialists. This is not legal advice but an overview based on community experience; check the details with your local ASL.

What does the medico di base do and what is free?

Contacting the medico di base you are registered with is free: you call the doctor and book an appointment, and at the visit you present the tessera sanitaria - the same document you show at the hospital, when getting prescriptions and referrals to specialists. As one participant told it, a referral to an endocrinologist was obtained the next day and at no charge.

Based on community experience, for registered patients the family doctor does the following:

• runs appointments by booking;
• writes prescriptions (ricette) for medicines at the SSN's reduced prices;
• gives referrals (impegnativa) to specialists, for tests, and for ultrasound - and explains where to go with each of them;
• issues basic certificates and manages chronic patients.

A specialist appointment by referral is then booked through the hospital CUP. If your city has no free slot, they usually offer a neighboring city. The appointment with the medico di base itself remains free. According to the community, you can book by referral not only at the CUP window, but also by phone through the regional numero verde, and in a number of regions - right at the pharmacy: there at the counter they tell you where to go, and immediately give the nearest date (one participant got to the ENT this way, paying only a ticket of about 20 euro). Where pharmacies do not perform this role, they book through the ASL or hospital.

One more detail about prescriptions: according to the community, control over prescription medicines in Italy has tightened, and many pharmacies no longer sell specific drugs without an Italian prescription. So for the medicine you need it is best to get an impegnativa (a prescription-referral) from the medico di base in advance, rather than count on the pharmacy dispensing it "out of old habit."

In seven years in Italy we were given fewer extra referrals and pills than in seven months in Moscow. Here they treat by evidence-based medicine, quickly and only when it is really needed, not just in case.

I needed an endocrinologist. I called my medico di base, got an appointment the next day and for free, they wrote referrals for tests and an ultrasound, and I paid only a partial ticket. And that was while I was still figuring out the system without SPID - the staff were friendly and explained everything.

The therapist gave a referral to the ENT and said to book through the pharmacy. At first I did not believe it, but at a big pharmacy on the square I asked at the counter - they sent me to the second floor and booked me for the nearest date. I paid only the ticket. For us the pharmacy really replaces the CUP, but for acquaintances in a neighboring region it does not work that way - ask on the spot.

How much medicines, tests, and appointments cost

Medicines prescribed by your doctor cost noticeably less than retail - one community expert puts the difference at 70-80 percent, and you can buy them at any pharmacy. Basic treatment with the card is free, though some tests are paid.

For tests and a specialist appointment made by referral you pay a partial co-payment - the ticket. According to the community, for tests one participant paid about 45 percent of the cost. Among the specific examples quoted in the chats: a gynecological exam with an examination and ultrasound - about 20 euro; a private appointment with an endocrinologist, when there was no public slot - around 130-160 euro. These are one-off accounts, not a fixed rate - verify the current details at your ASL and hospital.

Another practical point: by presenting the tessera sanitaria at the pharmacy, you can claim part of your medical expenses (prescription medicines and even contact lenses bought with the card) as a deduction that reduces taxes. More about the card itself - in the article SSN enrollment and the tessera sanitaria.

Basic treatment with the card is free, prescription medicines are many times cheaper than retail, and some tests are paid via the ticket. And do not forget to keep the pharmacy receipts: prescription expenses can later be claimed as a tax deduction.

How to register with a doctor through the ASL

To enroll in the system and choose a doctor, you go to your local ASL (in some regions it is called ULSS, for example in Padua). You bring the originals of your passport and ricevuta (proof of filing for the permesso), as well as a printed codice fiscale and copies. At the ASL they enter you into the system, print the documents on the spot, and register you with a medico di base. How to get the ricevuta and the card itself - in the articles the KIT and the permesso and Codice fiscale and residenza.

The ASL office is not always in your city: in very small towns there may not be one, and then you will have to go to the nearest city that has it. The easiest way to find your ASL is by searching "ASL + your city" (or "ULSS") on Google Maps. Part of the procedure in some municipalities can be done online.

When registering (and when changing the doctor) the ASL asks whom you want: if you know the name of a specific doctor - you name them, otherwise you say whether you prefer a man or a woman, and they will try to find someone near your home.

An important caveat about document status: sometimes the choice of doctor (and pediatrician) is limited while you have no plastic permesso and no plastic tessera sanitaria. With a temporary paper card some ASLs (in the community such a case happened in Milan) do not give a registered family doctor - you have only insurance coverage, and you seek care as needed.

Any ASL office that knows how to do it can register you - even an office in a neighboring city of the same province. Do not fixate on the office strictly in your own town, look for one where they actually know the procedure.

Both of us adults were registered with the same English-speaking family doctor - so at first it was easier to communicate. And the child was registered separately with a pediatrician. It is convenient when the adults are with one doctor.

We have a child with a disability. After the ricevuta, at the ASL they registered a doctor in literally 2-3 days, and he immediately wrote referrals for tests and to the disability commission. There were no months-long waits.

Pediatrician for children and vaccinations

According to the community, children are registered not with an adult medico di base but with a separate pediatrician (pediatra), who is registered separately from the parents' family doctor but at the same ASL. The pediatrician manages the child, writes prescriptions and referrals.

Doctors' channels of communication differ: some medici di base take only calls through a secretary, some pediatricians communicate on WhatsApp, and the ASL sheet may list only a phone. This is worth finding out in advance.

The family doctor usually has a fixed weekly schedule of appointments - as a rule, a couple of slots in the morning and afternoon, sometimes an evening session; some slots go on a walk-in basis, some by booking. According to the community, reaching them can be hard: the robot may answer "e pieno" (all full), and a text or WhatsApp the doctor answers not right away. If you do not remember which doctor you were assigned, or have lost their contacts - the data is visible in the fascicolo sanitario elettronico personal account (the region's electronic health record): the home page usually shows your medico di base. You can enter the fascicolo via SPID or CIE.

We got the tessera, a doctor was assigned, but reaching them is a quest: the robot keeps saying "e pieno," texts and WhatsApp go without a reply for two days. In the end it was simpler to go into the fascicolo sanitario elettronico - the home page immediately showed my medico di base with the appointment schedule. I advise opening the personal account first, instead of hammering the phone.

Children's vaccinations are arranged separately and differently: somewhere at a special vaccination center, somewhere through the ASL, and somewhere through the pediatrician - the rules differ by region and city, so ask at your ASL. An existing foreign vaccination card is transferred into the Italian system: the staff translate the Russian records on the spot, enter them, and issue a certificate for school.

For sports, a simple medical certificate from the pediatrician is usually enough for non-competitive activities (swimming pool, gym, dance). For competitive sports a certificate from a sports doctor (medico sportivo) with additional examinations is needed.

Our first pediatrician did not pick up the phone and did not open the door during office hours. I changed them online via a regional link (Lombardy) in about two minutes - instead of standing for hours in line at the ASL. I was thrilled that it turned out to be so simple.

How to change the family doctor or pediatrician

A registered family doctor or pediatrician can be changed at the ASL - the procedure is called scelta e revoca (choice and revocation). In many regions this is done online: one participant changed a pediatrician via a regional link in about two minutes instead of several hours in line at the ASL. You can change for free and without explaining reasons.

The reasons to change a doctor are, according to the community, the typical ones: the doctor is unavailable - does not answer calls, the door is locked during the stated office hours. If the new doctor is on the list, the switch happens immediately or within a short time.

How to check the code on prescriptions and referrals

An important trap: always check that the prescriptions and referrals the doctor issues carry your assigned code. According to the community, for one participant a vaccination was recorded for their spouse under the wrong code, and this blocked the next dose until the ASL administrator fixed the system.

Advice for the future: always check that the prescription and referral carry your own code. My wife had a vaccine recorded under someone else's code - the system would not let the next dose be administered until the admin at the ASL fixed the record by hand. An extra minute of checking saves weeks of sorting things out.

How to view test results online

To access medical results online (for example on the ASL website), you usually need SPID or CIE, and in some cases - a tessera sanitaria plus a PIN. If you do not have SPID yet, results can be picked up in person at a hospital window. How to get a digital identity - in the article SPID for a foreigner.

What to do without a card and during pregnancy

While you still have no card at all (only a ricevuta, a codice fiscale, and a temporary tessera), emergency and serious care is still provided: according to the community, one participant was treated in emergencies even without a tessera. But for non-emergency needs - prescriptions, getting onto a doctor's list - a card is needed, and travel insurance does not replace it. Where to go in an emergency and outside office hours - in the article Emergency care, guardia medica, and STP/ENI.

Pregnant women are registered with a doctor and given care for free even without documents: with a certificate of pregnancy any consultorio (women's clinic) sees them free of charge, and the ASL then arranges the card. According to the community, a pregnant woman cannot be deported.

We were driving around Rome with a feverish child. The public ambulance turned out to be impractical - a long wait plus a requirement for a COVID test, so we called a private pediatrician right to the hotel. He prescribed an antibiotic and noted that in Italy almost everything is on prescription except fever reducers.

If you plan to go to doctors, get onto a list, and get prescriptions - arrange a tessera sanitaria, do not rely on tourist-visa insurance: it does not cover these needs.

Appointments outside office hours and on weekends with the family doctor or pediatrician are, as a rule, private and paid

• the community quoted a price for a weekend pediatrician visit of around 170 euro. Many keep a private paid pediatrician as a backup for emergencies.

Related articles

• SSN enrollment and the tessera sanitaria - how to get into the system and get the card.
• Emergency care, guardia medica, and STP/ENI - care outside office hours and without a residence permit.
• Codice fiscale and residenza - first steps after arrival.
• The KIT and the permesso - the ricevuta, without which you will not be registered with a doctor.
• SPID for a foreigner - logging into personal accounts and medical results.
• ASL catalog by region - where to find your ASL office to register with a doctor.

Official sources

• The Ministry of Health: salute.gov.it - the SSN, medico di medicina generale, pediatrics, the vaccination calendar.
• Digital identity for online ASL services: spid.gov.it, agid.gov.it.
• Tax deductions and linking the codice fiscale: agenziaentrate.gov.it.
• The local ASL (or ULSS) website - choosing and changing the doctor (scelta e revoca), registering a child with a pediatrician, the vaccination rules in your region.

Frequently asked questions

Who is the medico di base and why do you need one?

According to the community, this is your family doctor (medico di famiglia / MMG), the free entry point into the public SSN healthcare. They run appointments, write prescriptions and referrals (impegnativa) to specialists, for tests, and for ultrasound. The tessera sanitaria card is the document you take to the hospital, to an appointment, and for prescriptions. This is not legal advice.

Can you register with a doctor while you only have a paper tessera, not the plastic?

According to the community, it varies depending on the ASL and the region. Some get a doctor right away by the ricevuta and a temporary paper card, while in some places (in the community this happened in Milan) until you get the plastic permesso and the plastic tessera they do not register you with a doctor - there is only insurance coverage, and you seek care as needed. Check with your ASL.

How do you change the family doctor if you are not happy with them?

According to the community, you change the doctor at any time through the scelta e revoca procedure - at the ASL counter or online in the region's personal account. It is free and without explaining reasons. One participant changed a pediatrician online in about two minutes via a regional link instead of hours in line. This is not legal advice.

Who are children registered with and what about vaccinations?

According to the community, children are registered not with an adult doctor but with a separate pediatrician (pediatra) at the same ASL. Vaccinations are arranged differently: somewhere at a special vaccination center, somewhere through the ASL or the pediatrician - the rules depend on the region and city, ask at your local ASL. A foreign vaccination card is transferred into the Italian system. This is not legal advice.

How much do medicines and referral appointments cost?

According to the community, medicines on a doctor's prescription are noticeably cheaper than retail (an expert quotes 70-80 percent lower), basic treatment with the card is free, but some tests are paid. For tests and a specialist appointment by referral you pay a partial co-payment - the ticket. Specific amounts are time-sensitive, verify the current details at your ASL.

I cannot reach the assigned doctor - what do I do?

According to the community, the family doctor has a fixed weekly schedule (a couple of slots in the morning and afternoon, some on a walk-in basis), and reaching them can be hard: the robot answers e pieno, and a reply to a text or WhatsApp does not come right away. The easiest way to view the contacts and name of your medico di base is in the fascicolo sanitario elettronico personal account (the region's electronic health record) - the home page usually shows your doctor; login via SPID or CIE. You can also book a specialist by referral through the region's numero verde or at a pharmacy. This is not medical or legal advice.

Related materials - Healthcare and the SSN

• Health and SSN in Italy: tessera sanitaria
• Tessera sanitaria: how a foreigner gets one in 2026
• Italy ambulance number: 118, pronto soccorso
• Disability status in Italy for foreigners

Next stepFill the KIT (Mod. 209)Field-by-field over the real Modulo 209: what to write, an example and a tip per field, by motive.

Documents for this topic

• Registry of Russian-speaking Doctors and Medical Specialists in Italy (updated May 2025)
• State-Regional Agreement on Medical Assistance to Foreigners in Italy (2012, Rep. N 255/CSR)
• Mod. APR/4 and APR057: residenza change checklist