Travel Insurance for the USA (2026): What You Need, What to Avoid, and How to Choose

US healthcare costs are among the highest in the world. An emergency room visit typically costs $1,000-5,000+, hospital stays average $10,000+ per day, ambulance rides run $500-3,000+, and a simple CT scan can cost $1,000-3,000. Without travel insurance, you're personally responsible for these expenses.

For the USA, prioritize policies where medical coverage is the primary benefit with robust limits. Given US healthcare costs, evacuation and repatriation coverage is equally critical—a medical evacuation can cost $50,000-100,000+. Choose policies designed for high-cost destinations, not basic travel add-ons.

No. The EHIC/TSE only provides coverage within EEA countries and Switzerland. The USA is completely outside this system, so you need private travel insurance for any healthcare coverage while visiting the US.

Coverage varies significantly between policies. Some cover only emergencies unrelated to pre-existing conditions, some offer limited coverage if conditions are declared, and some exclude them entirely. Claims can be denied if the insurer links your emergency to a pre-existing condition. Disclose any conditions when getting quotes to find appropriate coverage.

Standard travel insurance policies typically exclude skiing and snowboarding. You'll need a sports or winter sports add-on for coverage. Also verify that ski patrol evacuation from slopes is included—mountain rescue operations can cost thousands without proper coverage.

With coordinated care, you call your insurer's assistance line, they direct you to a facility, help with approvals, and coordinate payments directly. With reimbursement-only policies, you pay everything upfront out of pocket, collect all documentation, then submit a claim and wait for repayment. For the USA's high costs, coordinated care policies provide significantly better protection.

Not automatically. Travel insurance may include personal liability coverage, but rental car damage and collision coverage are usually separate products. Your rental agreement, credit card benefits, and optional add-ons may overlap or leave gaps. If you're planning to rent a car, specifically ask about driving-related coverage when getting quotes.

For urgent or life-threatening situations, call 911 immediately. As soon as you're safe, contact your insurer's 24/7 assistance line. Request and keep all documentation: diagnosis reports, itemized invoices, proof of payment, prescriptions, and discharge notes. Documentation is essential for smooth claims processing.

Some policies allow purchase after departure, but options are limited and terms may be different. Most policies require purchase before your trip begins for full coverage. If you're already in the USA, look for policies specifically designed for 'already traveling' situations.

Common exclusions include skiing/snowboarding without a sports add-on, high-altitude hiking or off-trail trekking, alcohol-related incidents, and situations where you didn't contact assistance before seeking treatment. Always review the policy's activity exclusions before your trip.

If you've booked non-refundable flights and hotels, expensive tours, theme parks, concerts, or multi-city itineraries with internal flights, cancellation coverage can be valuable. Note that cancellation coverage often must be purchased close to your initial booking date—buying insurance right before departure may limit or exclude this benefit.

A single trip policy is best for one USA trip with fixed dates. If you travel internationally 2+ times per year (including the USA and other destinations), an annual multi-trip policy often provides better value. Compare the total cost and coverage limits to determine which suits your travel patterns.