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Travel Medical Insurance - is it really necessary? (Italy)

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This from Italy's official government tourism board: Italy has no medical program covering U.S. and Canada citizens. Therefore, U.S. and Canadian tourists are advised to take out an insurance policy before traveling.

Yet, when I was there in October '07 and was taken by ambulance to one hospital and then referred to a second, neither asked for payment of any kind. When I asked about the bill, they both indicated "no charge".

SO, what is the story? Why would two hospitals treat a foreigner for free if they were not somehow reimbursed for it? They sure wouldn't do it here in the US.

Any ex-Pats living in Italy? Anyone natives that can explain it?

Bottom line, do I need to purchase Travel Medical Insurance? I gotta know.... I've been a slacker on this and we leave next Tuesday!

Thanks!

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