Let’s be honest: travel insurance is probably the most unexciting thing you’ll buy for your trip to Italy. And yet it’s the one purchase we try to insist every guest make.

Most of our guests from the US and Canada do. Some don’t. Most of the time, nothing happens, and the people who skipped it feel very clever. But occasionally, work or family issues mean that your plans might change at the last minute, or your trip takes an unexpected detour via an emergency room. That’s when travel insurance stops being boring and becomes a great investment.

So here’s our friendly, slightly nagging guide to why you need it and what to look for. We don’t sell insurance and we don’t recommend any particular company. We just want you to come and cook with us without risking any of your savings.

Why we keep bringing it up

Part of the reason is our own booking terms. Like most small operations, we can’t refill a place at the last minute, so:

the 25% deposit you pay when you book is non-refundable;
the balance is due 120 days before you arrive;
if you cancel 119 days or fewer before your arrival, the full fee is payable.

Add flights, hotels in Florence or Rome before or after your week with us, and a rental car, and you have a lot of non-refundable money riding on everyone staying healthy and on schedule. Trip cancellation insurance is what gets that money back when life gets in the way.

What can go wrong (and occasionally does)

Before you leave: you or a close family member falls ill, you break your ankle the week before departure, there’s a family emergency, or a hurricane decides to visit your hometown.

On the way: missed connections, cancelled flights, luggage that decides to take its own chilly vacation in Frankfurt.

While you’re here: Tuscany is not a dangerous place, but a fall or twisted ankle can happen to anyone. So can a sudden illness, a kidney stone, or an allergic reaction.

“But I already have health insurance”

Good! Now check what it actually does outside your country, because the answer is often “not much”.

If you’re American:

Original Medicare generally doesn’t cover health care outside the US.
Medigap plans C, D, F, G, M and N (and some older plans) include foreign travel emergency coverage, but it pays only 80% of emergency care after a $250 deductible, only for emergencies that begin in the first 60 days of your trip, and up to a lifetime maximum of $50,000.
Medicare Advantage plans vary: some cover emergencies abroad, some don’t.
Private health plans vary too. Many treat care abroad as out-of-network, expect you to pay up front and claim later, and don’t cover medical evacuation at all. Call your insurer and ask.

If you’re Canadian: your provincial health plan is designed for care at home. As the Government of Canada puts it, it may cover none, or only a small part, of the cost of medical care abroad. Some workplace benefit plans and premium credit cards include travel medical coverage, but check the limits and the conditions.

What does medical care in Italy actually cost?

Here’s the good news: Italian hospitals are excellent, and emergency rooms (pronto soccorso) treat everyone who needs urgent care, whatever their nationality or whether or not they have insurance. As a visitor from outside the EU, though, you will usually receive a bill afterwards.

The costs of a straightforward emergency room visit is modest by North American standards. The real costs come with a hospital stay, surgery, and, above all, getting you home. If you need to be flown back by air ambulance, the bill for a flight from Europe to the US can exceed $100,000. That is not a typo. It’s also the main reason we sleep better when our guests are insured.

What to look for in a policy

Policies vary enormously, which is exactly why we can’t recommend one for everyone. Instead, here’s what to compare:

Trip cancellation and interruption. This reimburses your non-refundable costs if you have to cancel or cut your trip short for a covered reason, such as illness, injury or a death in the family. Insure the full value of your trip: our fee, flights, hotels, and anything else you can’t get back.
Emergency medical coverage. Look for a generous limit, and check whether it is primary (pays first) or secondary (pays only after your own health insurance), and whether the insurer can pay the hospital directly.
Medical evacuation and repatriation. Look for a high limit, and read the small print: some policies only take you to the “nearest adequate facility”, while others will bring you home to your own hospital.
Pre-existing conditions. Many policies exclude them unless you buy coverage within a short window after your first trip payment, often 10 to 21 days. If you or a family member has any ongoing health conditions, this matters a lot.
Cancel For Any Reason (CFAR). An optional upgrade that lets you cancel for reasons a standard policy won’t accept. It costs extra, usually reimburses 50% to 75% of your trip cost rather than the full amount, has to be bought soon after your first deposit, and generally requires you to cancel at least two days before departure. It isn’t available everywhere: residents of some US states, such as New York and Washington, may not be able to buy it.
A 24/7 assistance line. When something goes wrong at 2 a.m., you want a real person who can find an English-speaking doctor and talk to the hospital for you.
Baggage, delays, and missed connections. Less dramatic, but much more common.

When to buy it: sooner than you think

The best time to buy travel insurance is right after you pay your deposit. Two reasons. First, the most valuable extras, the pre-existing condition waiver and Cancel For Any Reason, usually have to be bought within a couple of weeks of your first trip payment. Second, a policy only covers things that happen after you buy it. Buying the day after you twist your ankle is, sadly, a little late.

What about my credit card?

Some premium credit cards include trip cancellation, trip interruption and even some emergency medical or evacuation coverage, usually only if you paid for the trip with that card. It can be a useful layer, but the limits are often low and the conditions strict, so read the benefits guide carefully and compare it with a full policy before relying on it alone.

Where to compare policies

We have no connection with any insurer, but these comparison sites make it easy to see policies side by side and filter for the features above:

Canadians can also ask their bank, check their workplace benefits, or speak to a licensed insurance broker.

If the worst happens in Italy

In an emergency, call 112 (general emergencies) or 118 (medical emergencies and ambulance).
Call your insurer’s assistance line as soon as you can. Many policies require you to contact them before or shortly after treatment.
Keep every receipt and every piece of paper the hospital gives you. Your insurer will want them all.
And tell us, of course. We know the local hospitals and doctors, and we’ll help however we can.

We hope you never need any of this. The best travel insurance is the one you buy, file away and completely forget about while you’re rolling out pasta in our kitchen. We’re cooks, not insurance agents, so do read your policy and ask the insurer questions. And if you have questions about your week with us, our FAQ is a good place to start, or just get in touch.

Featured photo: Surface / Unsplash