I work for a T-Mobile retail location, and have a deep knowledge of how the company works. I may not always...
The most economical option would be to purchase a pre-paid T-Mobile phone, which has the Wi-Fi calling feature. While you are in Italy, if you can connect to a Wi-Fi source you can make as many calls as you want for no extra charge. Wi-Fi calls assume your calling from the US (so, do not call anywhere in Italy), so a call to a number in the US would be no issue. Wi-Fi calls also do not go against your minute balance if you do not have an unlimited plan.
It's an awesome feature most people overlook.
Saving the world from high cellphone bill prices!
Youre better off using skype while over seas to make calls for the cheapest option. Prepaid phones from the US dont work over seas, if you have a plan phone you can add a world calling feature to enable this roaming. Its expensive to roam internationally.
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