My 76 year old mother and I (her fourth trip to Italy, my first) stayed in a double room, no view, for 2 nights in mid-September 2011 (second stop on my 6-location whirlwind tour of Italy after 2 nights in Milan). I loved the hotel, and Bellagio, and am booking to come back, as a solo traveller, next September. Yes, it's up a flight of 38 steps and there's no help (it's clear from all the pictures Bellagio is a series of beautiful up/down lanes and there is not extra staff on hand at the hotel to help you, so pack light). Yes, the rooms with a lake view are beautiful (I peeked into one as the maids were cleaning), and in hindsight I wish I'd booked one for my mother and I as she spent more time in the room reading (jet lag) and happy hour would have been lovely looking over the lake. Yes, the pictures are really what you get, which is great...the outdoor deck for breakfast was wonderful with it's little-bit-more than peek-a-boo view of the lake. And breakfast was good, fresh fruit, yoghurt, hand made cappucino/latte, sweet breads (brioche, croissants, etc.)...I can't remember anymore if they had any meat and cheese selection...I don't think so, but I might be wrong on this point.
As for getting in/out, we took the train from Milan to Varenna, then the boat to Bellagio, arriving around 4pm, and that worked out wonderfully. There was a 24-hour general strike (9pm Sat to 9pm Sun) so we took the 8:30am bus to Como (small, lots of us crammed in as it turned out just about the only train in all of Italy NOT running that morning was the train from Varenna back to Milan) which was cheap (around 8 euro) and easy (dropped us all off right in front of the train station). We did the tour of Villa Balbianello, which I didn't think was worth 45 euros each, but it was a pretty place.
Room Tip: The lake view from view rooms is really, really pretty.
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