Travel Insurance for United States — What You Need & Costs

Look, travel insurance isn’t mandatory for the US like it is in some countries. You won’t get stopped at the border because you skipped it. But here’s the brutal truth: medical care in America costs way more than anywhere else on earth. A simple ER visit can hit $1,000+ without insurance. That’s why medical coverage isn’t just recommended—it’s non-negotiable. Skip it, and you’re gambling with your bank account.

What you absolutely need: medical coverage (including emergency evacuation). Evacuation is critical. If you get hurt in a remote mountain town or during a hurricane, getting to a real hospital might require a helicopter. Standard plans cover this, but cheap "medical only" policies often exclude it. Pay the extra $10-15 for evacuation. It’s the difference between a manageable bill and financial ruin.

What’s often a waste? Trip cancellation coverage—unless you’ve paid non-refundable deposits for things like a booked wedding venue or a guided safari. If you cancel because you’re bored, most policies won’t cover it. And don’t pay for baggage delay or "accident" coverage. US airlines usually compensate for lost luggage, and credit cards often cover minor trip interruptions. Save your cash.

Typical costs:

• Basic medical-only (with evacuation): $20-$40 for a 7-day trip.
• Comprehensive (medical, evacuation, cancellation for non-refundables): $40-$80 for 7 days.

You’ll pay more for longer trips or if you’re over 65. Avoid "budget" plans from random websites—they’ll deny claims for pre-existing conditions or minor things like a sprained ankle.

Specific US risks that make insurance essential:

• Medical bills: A broken bone in a rural area could cost $5k+ before you get to a hospital. Even with insurance, you’ll pay deductibles. Get coverage that covers 100% of medical costs after your deductible.
• Natural disasters: Wildfires, hurricanes, or floods can cancel flights or make your hotel uninhabitable. Standard cancellation coverage covers this. Don’t assume your credit card does—it rarely does.
• Car accidents: If you rent a car and get in a crash, medical bills pile up fast. Your rental car insurance might not cover medical costs. Insurance that includes emergency medical transport is key.
• Crime: Pickpocketing or theft in cities like NYC or LA happens. Baggage coverage is usually a waste (see above), but medical coverage covers injuries from assaults.

EU/EHIC? Forget it. EHIC is only for EU countries. The US isn’t in the EU. If you’re an EU citizen, your EHIC won’t cover you here. You still need US-specific travel insurance. No exceptions.

Here’s what to actually pay for:

• Medical coverage + evacuation (mandatory). Get a plan that covers pre-existing conditions if you have them—some require you to buy within 15 days of booking.
• Cancellation coverage ONLY if you have non-refundable deposits. Skip it if you’re just booking a hotel with a flexible refund policy.

What’s a total rip-off?

• Extra "adventure" coverage for hiking or skiing—most standard policies cover it.
• Baggage delay or "trip interruption" for minor issues (like a missed flight).
• Premiums for coverage you already have (e.g., credit card medical coverage, which is often limited).

Bottom line: Pay $30-$50 for a solid medical/evacuation plan. It’s cheaper than one ER bill. Skip the extras unless you’ve got specific non-refundable costs. Don’t rely on credit cards—they’re usually useless for medical emergencies in the US. And never, ever skip evacuation coverage. If you get stranded in a snowstorm in Colorado or a hurricane in Florida, you’ll thank yourself you had it. Don’t be the person who tries to pay $10k out of pocket for a broken leg. Get the coverage that matters. That’s the only insurance worth your money.