In addition to some of the sage advice you've already received on this thread, bear in mind that most credit card rental coverage doesn't apply in many of the countries overseas - particularly Italy. This is notoriously absent from most Visa and MC products, and I believe Amex may exclude them as well (but you might want to verify if their "Primary" Auto Rental Insurance applies (as it might well be worth the extra $14.95-$24.95 for the rental).