Health Insurance Card
Plain English
It's the plastic card that proves you're signed up to Italy's public health system (the SSN) and shows your codice fiscale on the back. You hand it over at the doctor, the pharmacy, the hospital, and any public specialist. It also works as your European Health Insurance Card when you travel inside the EU.
Why it matters
Without it, you pay the full price for medicines, blood tests, and visits. You also can't pick a free family doctor (medico di base). Once you have it, most basic healthcare is either free or almost free.
Real example
"After registering with the SSN at her local ASL office in Naples, Fatima got her tessera sanitaria in the post about three weeks later. She used it that same week to book her first free GP visit."
Common confusion
It looks almost identical to the plain codice fiscale card, so people confuse the two. The tessera sanitaria has an expiry date and proves you're actually enrolled in the SSN. The plain CF card just proves your tax code.
Official source
Sistema Tessera Sanitaria