One Italian in three pays for medical visits and tests out of pocket and those who cannot do so are forced to give up treatment. The health situation in our country is worsening, and there are no prospects of a trend reversal on the horizon between the public debt which continues to grow and the progressive aging of the population.
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The latest Istat final balance, relating to 2022, reports that “out of pocket” spending (i.e. the sum of tickets and private spending incurred in accredited structures) has reached 21.4% of the total, compared to three -quarters still paid by the State and less than 3% managed by voluntary financing schemes, such as insurance companies).
Coverage for the main risks
“Given the trend, citizens will have increasingly significant healthcare needs and the financial sustainability of the National Health Service will be put to the test. From this perspective, private health policies could represent a valid solution to alleviate some of this pressure,” he explains Davide Berti, private banker and founder of Welong Academy, a platform for training financial consultants and analysts. These are insurance contracts that offer financial coverage for the insured’s medical and healthcare expenses.
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“The policy can cover expenses such as hospitalization, hospital stay, physiotherapy and/or rehabilitation, the purchase of medicines (before, after or during hospitalization), diagnostic tests (such as those linked to an illness or injury, subsequent upon signing the contract). Naturally, in the event that the insured makes use of the structures of the national health service, the guarantee only covers expenses not covered by it. Then you can ask for a refund of the tickets.” says Valentina Riboldi, expert in Altroconsumo law, with a focus on insurance issues. What doesn’t it cover? “Often the policy does not insure against disbursements such as preventive check-ups, dental care, aesthetic interventions, dietary care, corrections of physical defects, injuries resulting from abuse of alcohol, narcotics, hallucinogens and psychotropic drugs”, he adds. Even if the offer is so wide that it becomes difficult to speak by categories.
The parameters that affect prices
For the services offered, there is a premium that varies significantly in light of the type of coverage and the age of the policyholder. “For a family it is possible to hypothesize a range between 700 and 2 thousand euros per year,” says Berti.
How to understand if it is worth it? Without prejudice to the fact that a complete evaluation of this type can only be done ex-post, we can hypothesize an evaluation of which are recurring and which could vary, comparing the average annual expense with the cost of a potential policy. Without neglecting the psychological aspect, that is, the tranquility that the fact of being able to count on coverage in case of unexpected events can convey, especially in areas where the public health system is most lacking.
Beware of…
Berti points out that there are three aspects to evaluate before proceeding with taking out a health insurance policy. First of all the contractual conditions: it is important to analyze the exclusions (the events not covered by the insurance) and the deductibles (the pre-established fixed amount that remains the responsibility of the insured in the event of damage). It is also important to find out about covered healthcare: some companies offer advantages to customers who use the national health service or affiliated circuits. Finally, any professional advice, which can help you choose the best policy for your needs.
Riboldi adds a further point of attention. “Care must be taken when filling out the health questionnaire (preliminary step to the signing of the contract, ndr). It is advisable to talk to your doctor first and you need to declare the whole truth regarding the latest tests, diagnosed and treated illnesses, any injuries and hospitalizations. Inaccurate declarations or reticence, even innocent ones, can lead to the total or partial loss of the right to compensation,” he concludes.