Your step-by-step guide to getting the best expat health insurance plan

Health insurance policies are never one-size-fits-all and life circumstances have a habit of changing. The Local spoke to an expert from leading insurance broker ASN to help you get the best value bespoke insurance policy.

Your step-by-step guide to getting the best expat health insurance plan
Photo credit: Natasha Fedorova

Many factors affect whether your current health insurance plan is still right for you. Moving to a new country, for example, could mean that your policy is no longer compliant. Even things that seem insignificant, like joining a football team, may require you to renegotiate your coverage. 

We spoke to ASN’s Françoise Villoz to make sure you know the basics before taking out or renewing your health insurance policy.

Step 1: Take stock of yourself

Before negotiating your new policy, take note of any changes in your recent health status along with any other factors that might impact your insurance profile. These factors not only include illness or injuries but whether you’ve taken up a risky new hobby like bungee jumping or if you travel regularly to dangerous regions for work. Furthermore, if you have a medical condition for which you have been paying an extra fee as part of your insurance you might be able to get your health loading or medical exclusion dropped.

Click here to get a bespoke health insurance policy

“If you have recovered fully from a serious skiing accident that happened ten years ago and have not required any treatment since recovering, then your insurance company might be willing to take the loading out of your contract,” advises Françoise.

Photo: Deposit photos

It might go without saying, but before you get into the thick of the negotiation process, it is a useful exercise to ask yourself whether you are satisfied with your current provider. Delayed or partial (or too administratively complicated) reimbursement of claims, for example, might be reasons for you to consider looking for a new insurance provider partner. Similarly, if your premium has increased year on year, you may want to shop around.

Step 2: Research your options thoroughly

If you are satisfied with your current insurance provider (or don’t have time to trawl through all the other insurance providers out there), then the best way to renew your current plan is to call your current provider. If there’s been no change in your circumstances in the past year, then the renewal should be straightforward. However, if your current insurance provider doesn’t – or won’t – live up to your expectations, (or you simply want to find a better insurance provider for your specific situation), then you will need to do a little digging.

Click here to get a bespoke health insurance policy

Françoise points out that insurance companies usually have specialist areas and coverage expertise, and while your provider can usually not refuse you a renewal, it might not be able to update your insurance to cater to your new circumstances. For this reason, a rule of thumb in the research process is to first check whether a company offers comprehensive and favourable coverage for all of your needs in each area of your life. If not, then it’s time to jump ship.

“If you have taken up a sport such as football or tennis you need to make sure when you do your research that your chosen insurance provider covers not only sports in general but your sport in particular,” warns Françoise.

Lastly, even if you are a picture of health and your life circumstances have stayed roughly the same, if you have moved to a new country, you must acquaint yourself with the rules and regulations of your new home. If you don’t, you might find out the hard way that your insurance is not compliant, and that you need to get an additional local insurance.

Photo: Deposit photos

Step 3: Before you ring

Before you pick up the phone to start negotiating your new policy, there are a few things to be mindful of. No new provider will insure you if you’re pregnant (if you are, there is normally a ten- to twelve-month waiting period). Likewise, if you have cancer, you seldom have an option but to stay with your current insurance provider. Secondly, if you have a new medical condition, make sure to have all the details on the table in front of you, and be prepared to negotiate hard if you are looking to upgrade your policy. Before you begin browsing for a new insurance provider, be prepared that your options may be limited in certain countries – including the U.S. – and that, if you have relocated, your current provider might not have coverage in your new country of residence.

Click here to get a bespoke insurance policy

If your medical condition is severe – or if you have been refused an upgrade by both your current and prospective health insurance providers – you might want to consider consulting an insurance broker such as ASN International Insurance. Since brokers usually have strong partnerships with many of the major providers, in certain cases, this can mean the difference between getting a better bespoke policy or not.

“We have a big portfolio with many clients as well as strategic partnerships with many of the key insurance companies,” says Françoise. “Since it is in their best interest to maintain good relations with us, insurance companies are often more cooperative when clients with serious conditions are represented by one of ASN’s experts.”


When you receive your insurance proposals, make sure to carefully read both the general conditions (do double-check the cancellation terms!) and the small print of your contract. No-one’s trying to pull the wool over your eyes but you always need to be cautious when changing providers.

“Even if you have found a new insurance provider and you are sure they will take you on, you should never cancel your current contract before you have received final confirmation that your new provider will cover you as per the agreement,” says Françoise.

If you’re short on time but want a bespoke health insurance policy at the best price, consider getting in touch with an insurance broker like Françoise at ASN International Insurance. ASN does all the heavy lifting for you and will send your custom-built top three policy offers within two weeks.

This article was produced by The Local Creative Studio and sponsored by ASN.

For members


Pregnancy in Italy: What are all the tests you’ll need to have?

Italy’s healthcare system offers tons of free testing during pregnancy, but how many tests are there exactly, and are they free of charge? Here’s what to expect and when.

Pregnancy in Italy: What are all the tests you'll need to have?

Expecting a baby can be an anxiety-inducing experience, no doubt. Fortunately, Italy is rightfully famous for its healthcare system, which produces some of the world’s best maternal health outcomes.

Part of the secret to that success is a robust schedule of testing that residents can access for free as part of their pregnancy.

In fact, the amount of testing offered during pregnancy in Italy can be surprising to those who aren’t familiar with the Italian health service.

Here’s what to expect:

Getting started: the first appointment (6-11 weeks)

Before you can get any testing done, you will need to arrange for a first appointment with an obstetrician via a local hospital, private clinic, or family counselling center.

In the early stages, your pregnancy will be dated to the first day of your last menstruation, so be prepared to provide that date a lot. It will be included on all your paperwork as you go from provider to provider.

READ ALSO: Pregnancy in Italy: What are the options for public or private healthcare?

Your first appointment should generally be scheduled after the sixth week of pregnancy, so that the fetus is clearly visible on an ultrasound, and ideally before 11 weeks. Because there are sometimes delays in securing appointments, it makes sense to plan ahead as much as possible.

At this first appointment, you’ll get a general orientation to the process laid out below and be scheduled for future check-ups. You’ll get a basic physical and they’ll take a full medical history.

Then, you’ll be scheduled for your first battery of tests to establish a baseline of health and confirm your pregnancy.

On the first visit, or shortly thereafter, you’ll receive the following tests free of charge:

  • A first ultrasound to confirm your pregnancy and determine the age of the fetus;
  • A Pap (smear) test, if one has not been performed in the last three years;
  • A series of blood tests to check for blood type, blood sugar, red cell antibodies (the Coombs test), rubella, toxoplasmosis, syphilis and HIV; and
  • A urine test.

If you’re deemed at risk for Hepatitis C, chlamydia or gonorrhea, you may also receive tests for these as well.

The Bi-Test (11-14 weeks)

Starting at 11 weeks, you’ll be eligible for the so-called Bi-Test or Combined Test, which screens for common genetic and developmental disorders.

Until 2017, this test was only free for women over 35, but it’s since been made a standard part of pregnancy health screening in Italy.

A midwife monitoring a pregnant woman. (Photo by MYCHELE DANIAU / AFP)

The non-invasive test involves an additional blood sample and ultrasound between 11 and 14 weeks that checks for abnormalities in the fluid beneath the fetus’ neck.

Because the test is only about 92 percent accurate, if it detects any issues, your physician will refer you for follow-up testing — either non-invasive DNA testing, which is more accurate, or an invasive amniocentesis procedure, which samples a small amount of cells from your amniotic fluid and provides a definitive positive or negative result.

READ ALSO: 15 practical tips for pregnancy in Italy

If you miss the window for the bi-test, there’s an optional non-invasive blood test known as the tri-test, available from the third trimester, that can screen for the same issues. It also tests for neural tube defects, another common disorder.

These tests are optional but are covered by the national health service. In practice though, whether you can access this test for free depends on whether there is a trained, public technician in your area.

In some regions, only the invasive tests can be performed in the public system.

Regular checkups

After these initial tests, you’ll be scheduled for regular checkups every month to 40 days. At these checkups, you’ll receive a basic physical and blood pressure check and your doctor may listen for the fetus’ heartbeat.

You’ll also be regularly tested for toxoplasmosis, rubella, and your blood glucose levels, so be prepared to roll up your sleeves a lot.

Photo by National Cancer Institute on Unsplash

Sometime between 24 and 28 weeks, you’ll receive another urine test, and at 28 weeks, you’ll be scheduled for another round of the Coombs test, which checks for red cell antibodies.

All of these tests are simply part of ensuring your health and that of the baby is ideal as you head into the later stages of pregnancy.

Depending on your hospital or physician, you may also receive additional ultrasounds during this period. Most Italian women report receiving an average of 4 to 5 ultrasounds over the course of the pregnancy, despite only two being required by law.

Second ultrasound (19-21 weeks)

At minimum, your second ultrasound should occur between 19 and 21 weeks, and this is the big one — your fetus should be looking like a baby and you are likely to be able to determine the sex.

If you don’t want to know the sex of the baby, you should speak to your gynecologist in advance. They can withhold the information, or even provide it in a sealed envelope to a trusted friend if you are planning on organizing a reveal.

Third trimester: Tests, tests, and more tests

By the 28th week, you may be recommended for a follow-up ultrasound if your doctor has any concerns about the baby’s development.

You’ll also receive another blood test, including a Coombs test, and will be scheduled for tests for toxoplasmosis, Hepatitis B, HIV, syphilis, and vaginal streptococcus, to occur sometime between 33 and 38 weeks.

Lastly, you’ll also be required to do another urine sample between 33 and 38 weeks, to ensure you won’t have a urinary tract infection at the time of delivery.

More tests?

The above is just a baseline — your doctor may order additional tests if they are concerned about any aspect of you or your baby’s health.

If anything goes wrong with your pregnancy, you may be referred to specialist care. This should all be free of charge, so long as they are requested by a physician in the public system. (If you opt for private care, you may be required to pay fees for these same services.)

After delivery

The Italian national health service also covers postpartum care, including psychiatric screening and postpartum counselling. If you are experiencing signs of postpartum depression, it’s worth talking to your doctor about referrals to this care.

The cost of birthing and parenting courses are also covered by the government, so ask your physician about what is available in your area.

READ ALSO: Who can register for national healthcare in Italy?

All these tests are available free of charge to EU citizens regardless of whether or not they have an Italian health card (tessera sanitaria). Any non-EU citizens with a long-stay visa (permesso di soggiorno) may access them also with referral from a physician.

If you do not have a visa or are undocumented, you can access many of these services via a local family counselling center (consultorio familiare), which are obligated by law to provide care to all women irrespective of immigration status.

Keep in mind that if you opt for a private gynecologist or pregnancy clinic, you may have to pay extra for tests available for free from public hospitals. Price lists are rarely posted online, so do your research before choosing a provider.

For more information about healthcare during pregnancy in Italy, see the health ministry’s official website here.