Why do I need travel insurance?

We usually spend more than 60 days continuously over the summer in Italy.  Most travel insurance policies are limited to 30 days/trip and extending them can be really quite expensive.

But why do we need travel insurance?  As we have European Health Insurance Cards (EHIC) won't we be covered already?

The EHIC has certain conditions and restrictions and will not cover repatriation if needed. Here is some useful information http://ec.europa.eu/social/main.jsp?catId=559

Check with your Bank or Credit Card Company as they often offer complimentary Travel Insurance with certain accounts.

You would have to pay any top up fee in the country as a national would (eg mutuelle in France or  Ticket charge in Italy).

There is no longer a refund via the NHS. It was removed two years ago.

We have european multi-trip cover with our bank account, Nationwide, with UK Insurance (direct line I think) they do long extensions at an incredibly reasonable price. Worth a try or look at your bank account.

Info here
http://www.nationwide.co.uk/products/current-accounts/flexaccount/travel-insurance

Thank you all. Good stuff!  We already have free cover from our credit card but like Nationwide (Cassini) it's limited to 31 days/trip.

Gala.  Where it says 'does not guarantee free services' do we actually know which 'free services' (if any) are excluded in Italy?  Or is this the 'Ticket charge' that Cassini refers to?

Yes, the ticket charge plus any other expenditure that any Italian citizen or resident is deemed to pay. Basically, you get the same rights and treatment that the locals get. Admin knows quite a lot about this, I have never used medical services in Italy. Fingers crossed! 
Here is some additional info from the NHS http://www.nhs.uk/NHSEngland/Healthcareabroad/countryguide/Pages/healthcareinItaly.aspx

With your S1/EHIC you are entitled to free emergency treatment. Thats all. If you need anything more than that, you pay.  No repatriation, no recovery, no private room with a telly.

Yes, it is basic emergency and if related to an existing condition, it should not be regular treatment unless previously authorized by NHS. Same goes for medication, so if you have a chronic condition, take your medication with you, although Italian doctors would be able to prescribe if lost, etc. in that case, it would be handy to have a summary of your medical history. Complicated? Yes, it is. All that information should be on line....

Ask your credit card insurance provider if they will do a long stay extension. Of course  if you are driving  through other countries like France or Switzerland or Germany you need the top up cover provided by your travel insurance. The French Health System will not treat you without frequent payment; unless they can bill your insurance company. Believe it.

My husband has had two hospital admissions in Italy.  On both occasions treatment has been superb and all they ever did was photocopy his passport and we paid nothing.  However, neither occasion required any ongoing treatment - I suspect we may then have had to pay, although probably like the UK, the Italian hospitals are not set up to collect payment.

On the second occasion, he had a brain infection so I had no idea where it would end (all good due to excellent care) so I immediately contacted our travel insurers.  By luck my husband had just returned from the UK which meant his 30 days cover started again (although see later).  We only ended up using the insurance for a translation of his discharge summary, which they later denied they should have done when I complained about the quality of the translation (Google), but that is another story.  We had to supply proof of when he left the UK (his boarding card sufficed). 

If you look at the small print of the travel insurance policies all the ones I have seen clearly say they are for a prebooked trip of less than x number of days originating in the UK.  I keep all our boarding cards, etc to prove when we have travelled in case needed.  We would never have proof of when we were to return but although they did ask for it when we claimed, he had to remain in Italy for two weeks due to medical advice and then I said that his decision was to remain there to rehabilitate - I did tell them we had a home in Italy and all seemed OK.  However, there was really no money involved, just the translation which they did inhouse.  Had it been a big claim they may have looked for a get-out and demanded proof he had booked to return to the UK within the 30 days.

Another problem I came across is if you travel anywhere outside the EU from Italy.  Your UK travel insurance isn't valid as all trips have to start and end in the UK.  I came across this when I wanted to go to Australia from Italy.  I was already in Italy when I decided to go, but had only just returned from the UK.  We have two insurance policies with two different bank accounts.  One of them wouldn't cover me at all but the other, after management consultation, said that on this occasion they would cover me - my daughter was pregnant and I said she needed me, although I made it clear it wasn't a medical emergency.  I think I was lucky and someone used common sense, but I wouldn't rely on that in the future.  They both did say that if it was a medical emergency they would probably cover me in those circumstances.

It isn't possible to buy travel insurance if you are already abroad (except as an ex pat which starts to get complicated).  It also isn't possible to extend your insurance if you are already abroad so I have now extended ours to 90 days as we normally return to the UK within that period, if only for a flying visit.  Although it isn't needed within Italy most of the time, I do worry what would have happened if my husband's infection had been caught even hours later and he had seizures and the outcome had been worse, or if we had a bad car accident en route.  I also want the peace of mind that if I have to go over the Australia at a moment's notice I can.

If anyone knows of a better way around this, let us know.  I would happily pay for a policy that was designed for people like us who spend about six months in Italy.  We also travel around, sometimes outside the EU, and ski and dive.  It can't be that strange a scenario but we always seem to have to be checking whether we are covered, and at the end of the day are never sure as we don't have that much confidence in a lot of the call centre staff.

So far so good - but you never really know about an insurance until you claim and by then it is too late!

Hospitals are definitely geared up to take payment from you in Italy. We all have to pay every time we go. Usually emergency treatment (also for Italians) is free. The big problems occur when you need repatriation (alive or otherwise) or the hospital says it wasn't an emergency. In the case of a true emergency you would get free healthcare in Italy with your EHIC card.
If you need follow up care then you have to pay like we do which means each consultant appointment, prescription, test etc. In most regions now you also pay €10 for each 'ticket' that is written out. Sometimes it is cheaper to pay for tests privately!

As for travel insurance, have you checked the cover provided by backpacker insurance? It usually covers you for the long period you choose (from 3 months) and your travel does not have to start in the UK.  Like these people.

Direct Line do up to 90 days.

Most backpackers insurances won't quote for the 'elderly' (my husband is over 65) and also expire if you return to the UK, or only allow very limited visits to the UK.  The ones supplied in the UK are on the basis that you are a UK resident and registered with a UK GP.  You also have to start your trip in the UK.

The one I sent the link for covers you up to 69. I don't know if that's old enough for your husband. The long-term cover is single trip usually although short-term trips back to the UK are covered.

Also, for the 60+, another problem is the definition of pre-existing condition. At that age, most of us have chronic health problems and there can always be a worsening of any condition. This will mainly affect private travel insurance. The EHIC will cover pre-existing, providing you do not travel to another EU country to get a treatment that would be available in your home country... Unless you get a prior agreement from your own health authorities. And this should be in writing.

Id say have a look at American express, or ditch the standard travel insurance and go for Europewide health insurance - IMG do one and various others - if its health insurance which worries you, then trying to squeeze it into a travel insurance policy is never going to be adequate.

At the moment extended travel insurance suits us better.  I would only want to deal with an English speaking company and it is the travel elements that we need - translation, help abroad, etc.  Our main residence is UK, our GP is UK and we would always return to the UK as soon as we could for anything serious.  It just seems silly that we have to return home for the insurance to be valid again - I think the drive to and fro to Italy is when we are at our most vulnerable for terrific bills - if I was an insurance company I would prefer us to stay put for six months!  Our present solution of extended world wide travel insurance for trips up to 90 days seems to give us the best option - and only go to Australia via the UK.

The backpack option came out at a really high figure - enough for quite a few trips back to the UK to re-instate our normal travel insurance!

I really just want an easy life with one insurance that I know covers all eventualities, but life isn't that easy!

I found some EHIC top-up insurance which was interesting. It seemed quite expensive to me but then I don't have anything to compare it to.

Flying pigs wrote: - enough for quite a few trips back to the UK to re-instate our normal travel insurance!

Flying pigs articulates all the very same dilemmas that OH & I face (but so much better than I could).

One option I'm considering is every 30 days going to Pisa, flying to Stansted with Ryanair on the early morning flight and returning the same day on their early afternoon flight.

The other option we have thought of is actually booking tickets when it is very cheap and using the email confirmation as proof of travel if needed, but not actually travel.  These days you can even print your boarding pass without having to get on the plane - what further proof can one give, even if you did actually travel?  We are starting to get devious.

We have a multitrip ticket for the ferry crossings and recently haven't even reserved a ferry, just turned up and used one of the tickets - that way we don't ever have anything to show we have travelled - with 'open' borders it is getting quite difficult to prove where you were when.

You and I are sooo on the same wavelength Flying pigs!    Like you we're also getting to be devious! 

My problem is whether the travel insurance people might challenge whether a boarding pass is proof of travel.  After all your passport is scanned in and out at the airport.  Is that passport information confidential?

It seems to be becoming impossible to live life in a totally honest way.  From the bank account where the manager actually arranges round robin direct debits so that I can have the account that requires two a month to the Three Feel at Home business where they have told me that I should buy a PAYG SIM to take abroad and use to phone the UK and then throw it away (it will only work for two months abroad).  All this deviousness becomes stressful in the end - I just want a simple life, but because we don't conform to the 'norm' of a 9-5 job, one house, one location, one holiday, one boring life scenario I am beginning to get more and more crafty which goes against the grain.  No-one can quote an honest up-front price for anything - mobile phones, internet, double glazing, etc, etc.

Sorry, rant over - I'll go back to sticking my head in the sand.

Without doubt I have on MANY occasions looked back and thought ' am I stupid doing that', because I have always TRIED to play things with a straight-ish bat, because I think it is the right thing to do.

When I look at what other people are doing and have been doing in my 10yrs+ of being in Italy, they must think of me as a bit of a mug !

But as I say, I am now starting to think other things !!

A boarding pass is not considered proof of travel. The official airline's manifest is the only valid proof. This is compiled after the plane has left on the basis of the passenger's list and the final control made upon boarding, when the bar code on the boarding pass is checked.
I may add that, except for repatriation - and it is not always possible or advisable to repatriate a patient and assistance "in situ" may be necessary - I fail to see too many reasons in favour of private travel insurance if you already have your EHIC and you are traveling within the EU. Flying Pigs will definitely need it whenever she travels to Australia (although Australian hospitals will not refuse treatment and the situation is quite different from the USA).

My own bit of deviousness (or possibly cowardice or stupidity) is that I refuse to go to the doctors here for anything in case they put me on medication and I have then got a known condition that could invalidate my insurance. Of course I would have to if I got anything serious unless I die first from sticking my head in the sand.