The procedure to get a Tessera Sanitaria (Health Insurance Card/ SSN Card) depends on which type of permit you have.
1. Residence Permit (Permesso di Soggiorno)
2. Residence Permit Receipt (Ricevuta Permesso di Soggiorno)- in case you don't have the Residence Permit yet.
3. Residence Certificate (Certificato di Residenza)- optional
3. Postal Payment receipt for the Insurance- only for getting insurance on Student Permit or with Freelancers/ Entrepreneur's Work Permit.
4. Work Contract- only in case of Employee Work Permit
Student Permit (Permesso di Soggiorno per Studi):
When you apply for your Permesso di Soggiorno (Residence permit), you had also applied for the European Union Health Insurance, this is voluntary insurance. The voluntary registration validity period always starts on 1/1 and expires on 31/12 of the current solar year, no matter when you enroll, and gives access to the general practitioner and health services only on the Italian territory. The first application shall be done after January the 1st of the year in which you want to enroll.
Follow the steps below to activate your Health Insurance with this type of permit:
Step 1. Search for the nearest office
Search for the nearest ASTT/ ASL office. For me it was https://goo.gl/maps/fSfFF1YEYVXPFEkz6
Azienda Socio Sanitaria Territoriale (ASST) or Azienda Sanitaria Locale (ASL) is the administrative entity that manages local health services competent in the area where you reside. The areas are called "Municipi" – i.e. the administrative zones of Milan.
Based on your region you can either book the appointment online, or go there directly in person for activation of the insurance.
Step 2. Go to the office
Take the following documents to the ASST/ ASL office.
1. Permesso di Soggiono (or Permesso receipt),
2. Health Insurance payment receipt,
3. Passport, Certificate of Residence (Optional), and
4. Codice Fiscale
Once there, take a token number at the entrance and wait for your number to be called.
Step 3. Verify documents and get your allotted doctor
Inside the appointment booth, they will ask you for the documents mentioned above. In case you have any preference for the doctor, let the person know (You can go through the list of available doctors here. Red dots indicates that capacity of a number of patients for that particular doctor has reached). I have been requesting the same doctor ever since I moved to Milan but in case you have no idea which doctor you should get, the ASL staff allots one for you by default. This default doctor is usually from your neighborhood.
They will also issue you a form called "Allegato 1" ("Annex 1") which must be shown as a health card at the time to request any health service. this form will mention your Health insurance details and details of the General Practitioner (/ Doctor) allotted to you.
Step 4. Receive your Health Insurance Card
In case you already have applied and received your Certificato di Residenza, you will receive this Health card at your home address through post. But in case you haven't, it will arrive at your University's student office. For Politecnico Students, this is Via Golgi office.
Enrolment at the SSN is valid for one year from the date of application. Should you stay longer you can follow a similar procedure to renew your coverage by using the online portal. Apart from the first enrollment that must be done in person, the greatest part of all the next operations can be done online.
Your card will look like this:
Search for Work permit (Permesso di Soggiorno per Attessa Occupazione):
In the case of a Search for a work permit (as of 2021) the applicant does not need to pay for the health insurance.
For this type of permit, you need to follow the same steps the only difference is in step 2 instead of the Health Insurance receipt you need to take Certificato di 'Dichiarazione di immediata disponibilità'/ DiD (Declaration of immediate availability Certificate) with you.
Work Permit as an employee (Permesso di Soggiorno per Lavoro Subordinato)
In the case of a Work Permit as an employee, your company pays for your annual insurance and thus you do not need to pay anywhere, the process again is the same as that of the Student Permit but in Step 2 instead of the Health Insurance receipt, you need to carry a copy of work contract.
Work Permit as a Freelancer/ Enterpreneur (Permessi di Soggiono per Lavoro Autonomo)
The prices for the Health Insurance as a Freelancer/ Entrepreneur changes from region to region and even on the profile of each applicant, so make sure you consult someone who can help you with this (ASL staff or Servizio Immigrazione (CAFF) offices that are scattered around the city).
The process is exactly the same as the Student permit. The only thing that will change is the amount on the postage receipt.
Note for Insurance with all types of permits:
In case your address was already registered in the City registry and yet you did not receive your card at that address, you can visit your nearest Agenzia Entrate office and inquire. They will tell you where it went and if required send you a new card to the correct address (Given that the address request is the same as that in their registry)
You can also download the soft copy of your Health card (which is a scanned copy of your physical card) from this site. Use your SPID to log in and you can download your card. You will also see the status of your card on this portal (Processing/ Shipped/ Expired, etc., and in the case of last 2 it will also show the date it was shipped or expired)