To understand how to use your insurance, and to make the best choice, it is important that you know how it works, so you will know what to ask for. Don’t be scared by the jargon, it is really quite simple.
Here are the key terms you need to understand:
DEDUCTIBLE: this is the fee you need to pay before your insurance starts covering you. After your deductible is met (for year or type of service) the rest is covered.
e.g.If you have a €200 deductible, you will need to pay for a minor medical bill, but for fees exceeding €200 you will be covered. If your deductible is yearly, after you pay the first two bills of €100 all other bills will be covered.
COINSURANCE OR CO-PAY: this is a percentage or a flat fee you need to pay for every medical bill. It can vary depending on the type of expense (out-patient, in-patient, emergency).
e.g. If you have a 10% coinsurance and your bill is €150 you will pay €15 to the doctor and your insurance will cover the rest.
Deductible and co-pay can be combined!
E.g. Let’s say your policy has €50 deductible and 10% co-pay. If your bill is €150 you will pay €60 and the rest will be covered by your insurance.
VALIDITY: the initial and final date of coverage. This will be relevant for your stay permit (Permesso di Soggiorno).
OUT-PATIENT COVERAGE: it means you are covered for medical appointments also for non-emergency issues. Most insurances will cover illness or injury, as long as they occur while you are abroad.
EMERGENCY COVERAGE: it means you are covered for emergency medical issues, ambulance, ER, etc.
POLICY MAXIMUM: it’s the total amount your policy will cover. Above this maximum, any medical bills would be your responsibility.
To obtain a stay permit (Permesso di Soggiorno) your policy needs to cover at least up to €30.000. Most policies will have a higher maximum.
PRE-EXISTING CONDITIONS: most insurance policies do not cover pre-existing medical conditions, or only do so after a few months after you sign up.
If you have a chronic medical condition, diabetes, or you are under ongoing treatment for a disease, or if you are subject to other long term medical issues likely to continue while you are abroad, make sure you choose a policy that covers you also for pre-existing conditions.
DIRECT BILLING: some policies allow providers to send them the bill directly, while others will ask you to pay out of pocket and then claim for refund. Some of the policies accepting direct billing will accept it only if you go to providers of their Network or their PPO (preferred providers). These are medical providers that have pre-agreed reduced fees with them and direct billing in place. Other policies will allow you to choose your preferred medical service and then will send a Guarantee Of Payment to the provider, confirming that they are willing to pay your bills directly. This option allows you to choose your provider freely, without having to pay upfront.
For more extensive information on Health Insurance for American Students, you can check this page as well.