health coverage in Italy

Believe me, it wasn't free several years ago and it isn't free now. It isn't free for Italians and it shouldn't be free for tourists, either.

They are supposed to ask for your name and address to send you a bill. Years ago, if you did not make clear you had a travel insurance, most employees registered tourists as undocumented foreigners and the administrative office decided not to waste time mailing bills nobody would have paid.

These days this way of treating foreigners is more and more uncommon. If you can't pay right away, sooner or later you should receive a letter from Italy asking for the (Italian) cost of the medical treatment you received.

Wow, thanks Dario, I had no idea. Several years ago when I was about to leave the hospital, I pulled out my visa and asked "What do I owe?" and was told "Nothing."

What type of coverage do you recommend for travelers over 75? I was interested only in medevac but, given what you say, I'm thinking I should look into something more.

You can go on Squaremouth or InsureMyTrip and find options for policies that cover medical expense and evacuation. My husband is over 75 and our policy cost around $360 for two of us for a three-week trip. There were cheaper policies with lower coverage limits.

Carry a standard policy. We carry a year around medical policy including evacuation that covers us whenever we are more than 500 miles from home. Generally it is pay your bill and we will reimburse you when you get home. The evac policy is to the nearest appropriate facility. We have never tested our policy and don't intend to either.

If health care was free in Italy, half of the US would be there for it.

Insuremytrip.com is great. I call them after i’ve narrowed down my choices to make sure i understand what i’m getting and if there’s something better that i missed.

MedJet , i was told yesterday, is the only company you can buy evacuation back to the US at your discretion, vs the doctor’s.

You might want to check Blue Cross/Blue Shield’s international coverage. Here’s a link,to GeoBlue. A friend of mine has been happy with one of their Trekker plans.

.....is the only company you can buy evacuation back to the US at your discretion, vs the doctor’s...... That is true and you pay for it since the premium is substantially higher.

You might want to check Blue Cross/Blue Shield’s international
coverage. Here’s a link,to GeoBlue. A friend of mine has been happy
with one of their Trekker plans.

BCBS is brutally expensive for travelers over 75.
I've been using Berkshire Hathaway (https://www.bhtp.com )coverage for family members in that age bracket. The rates are much more reasonable.

Perhaps the confusion is the services you received. In Italy at least, Emergency services are handled differently from Office visits and Non-Emergency Hospital care. Emergency services are just provided, payment is not really pursued/required. Yes, it costs somebody, the Italian Government/Municipalities/Taxpayers, but I am not really sure if there is a mechanism to bill your insurance carrier. If you pursued it, there is likely a payment option, but a number of non-residents have reported receiving care with no charge.

An office visit or a stay in a hospital (other than brief stays under emergency care) would result in a bill or demand for payment.

Paul, Thanks for clarifying! Betty

Thanks Lola & Susan for suggesting InsureMyTrip. Through it I found a med-evac TravelGuard policy (AIG) that also provides medical coverage for the duration of my trip. Doesn't get me home unless the local doc approves, but cheaper than MedJet.

I had GeoBlue last year for my trip, i’m told by insuremytrip that they are stellar, but i didn't need to use it so i don’t personally know. Their evacuation is at the doctor’s discretion.

The quote for MedJet (yesterday) for me, for a 6 wk trip, was $295. I’d like to get it, but it doesn’t cover medical treatment so i’d have to pay another $200 + change for medical as well.

Glad you found a policy you like Betty.

Emergency services are just provided, payment is not really pursued/required

I'm afraid you are a little too optimistic.

That's true only if ER nurses assign you a red code. In Lombardy a white code with annual income higher then 7,000 € pays 25 € per visit; many white codes are people who can't / do not want to enroll in the National Health Care system. 25 € is a lot of money for such people and many just exit the emergency room without paying. Their medical records are Filed as "undocumented patient, do not waste time".

Believe me, if I used ER services with a white code without paying those 25 € they would pursue my payment and they would never give up. I have an address, a chipped ID card and a family doctor that must approve all free specialist tests. They have a procedure to ask money from tourists who can obviously afford to pay a 25 € bill, but...

I had non-emergency treatment in Germany two years ago and if we had had EU medical cards there would have been no charge -- they apologized for having to charge me €25 (!)

If you are a member of AARP you can get a discounted policy on Medjet.

That's true only if ER nurses assign you a red code

Thank you for the information, I was going off what people have reported over the years, that clarifies my understanding. I am sure there are other costs as well, and I agree that one should not get the impression that care is free, but it is important to understand expectations if you do need emergency services in Italy, and that emergency services are viewed and handled differently than an office visit.

By the way, I think most travelers from the US would gladly pay 25 euro, or even a 100 or more for an emergency service while in Italy, in the US, just to walk into an Emergency Room costs several thousand Dollars, and even after Insurance, often hundreds for the visit out of pocket....and don't even get started about Ambulance costs, just hope you are conscious enough to refuse an Air Ambulance.

Betty,

"and would like to know if health care is still free in Italy--even hospital care?"

No, it's not "free" as someone has to pay for it. If you aren't billed by the hospital, I imagine the Italian taxpayer is on the hook for the costs.

I don't know what the procedure is for visitors that don't have travel medical insurance. Based from personal experience, I provided full information on my travel medical policy to both the ambulance and the hospital, and never did receive a bill. About half way through my hospital stay, one of the staff showed me a hand written note indicating the cost was already up to a few thousand Euro. I'm assuming the costs were paid by my policy.

I always use travel medical insurance, even if I'm only travelling to other provinces in Canada. Even though we have a country-wide medical system, since medical care is a provincial responsibility there could be additional costs in other provinces.

My father in law had to go to the ER last year in Milán, and as soon as he arrived, they asked for his passport and kept it until he left. He was handed a bill, that was about €700, code green or yellow, he paid it and then his insurance reimbursed it. But the hospital asked for his ID and kept it until he paid. Don't k ow if it's often like this.