Before you start

Residence registered with the comune, or a valid permesso and an address
Codice fiscale
Permesso di soggiorno or its receipt, for non-EU nationals
Proof of income, for voluntary registration

Step-by-step

1
Work out whether your registration is free or paid
Employees, the self-employed, their families and several permit categories register at no cost. Students, elective residents and others outside those categories pay the annual voluntary contribution.
In personWho: YouWeek 2–4
2
Register at the ASL Bari district office for your address
Take your documents to the distretto socio-sanitario counter covering the address on your lease and choose a medico di medicina generale from the local list. Ask whether the practice runs appointments or open surgeries.
In personWho: You
3
Pay the voluntary contribution if it applies
Since the 2024 budget law it is calculated on the previous year's worldwide income at 7.5% on a first band and 4% above it, with minimums of €700 for students, €1,200 for au pairs and €2,000 for most adults. It expires on 31 December whenever you pay it.
In personWho: You
4
Collect the tessera sanitaria
The health card carries your codice fiscale and doubles as the European Health Insurance Card. It is posted to your registered address.
OnlineWho: You
5
Learn the Puglia booking system and ask for the earliest slot anywhere
The regional CUP takes the prescription code from your GP by phone, online or at pharmacy counters. Waits vary sharply between facilities, and asking for the earliest slot anywhere in the region rather than the nearest is often the difference between weeks and months.
OnlineWho: You
6
Know where the emergency departments are
112 is the single European emergency number and 118 reaches an ambulance directly. The Policlinico di Bari and the Ospedale Di Venere are the main emergency routes in the city, and both triage by colour code.
In personWho: You

Documents you’ll need

Codice fiscale
Permesso di soggiorno or filing receipt
Certificate of residence or self-declared address
Employment contract or proof of self-employment
Proof of previous year's income, for the voluntary contribution

Things most newcomers don’t know

In Puglia the health deficit and your payslip are directly connected, which is unusual enough to be worth understanding.

Italian law makes a region that fails to cover its health-service deficit raise the regional IRPEF surcharge to recover it. Puglia's accounts to the fourth quarter of 2025 triggered exactly that: decree no. 3 of 28 May 2026, issued by the Regional President as commissioner, redetermined the surcharge for the 2026 tax period, published in the Gazzetta Ufficiale on 10 June 2026. The top band is now the statutory maximum of 3.33%. Most people experience the health service and the tax system as unrelated; in Puglia in 2026 they are the same story, and the mechanism is public and documented.

Source: Dipartimento delle Finanze; Regione Puglia

Puglia says ASL, and Sicily says ASP — the words are not interchangeable across southern Italy.

Puglia uses the ordinary Italian naming: Aziende Sanitarie Locali, one per province, so ASL Bari is what you register with and what to search for. Sicily, as an autonomous region, calls the equivalent body an Azienda Sanitaria Provinciale. Anyone moving between the two southern regions — or reading a guide written for one while living in the other — will hit this, and it is the kind of small thing that costs an afternoon at the wrong counter.

Source: Regione Puglia; Regione Siciliana

Southern regional health services sit below the northern ones on the national performance measures, and it shows up as travel.

The Ministry of Health scores every region against a common set of essential-care indicators, and the southern regions including Puglia have persistently trailed the northern ones. The consequence is not that care is unavailable — the Policlinico di Bari is a serious teaching hospital — but that the same examination can be months away at one facility and weeks at another. Ask the CUP for the earliest available slot anywhere in the region rather than accepting the nearest, every time.

Source: Ministry of Health

The voluntary SSN contribution stopped being a flat €387.34 on 1 January 2024.

The 2024 budget law replaced the flat fee with an income-based charge — 7.5% on a first band, 4% above — with minimums of €2,000 for most adults, €700 for students and €1,200 for au pairs. Bari has two large universities and attracts elective residents on modest budgets, and both groups routinely budget from pre-2024 pages that are still online and still confidently wrong.

Source: Ministry of Health; 2024 budget law

Common mistakes to avoid

Assuming the regional surcharge is unrelated to the health service — in Puglia in 2026 it is the recovery mechanism for it.
Searching for an 'ASP Bari' after reading a Sicilian guide.
Accepting the first CUP appointment without asking for the earliest available anywhere in the region.
Budgeting the pre-2024 flat contribution of €387.34.
Letting SSN registration lapse while the permesso is being renewed.

Some of this may be out of date. Spotted something inaccurate? Help us keep it right for the next newcomer.