The USA Guides

Travel Insurance for the USA: What You Need and Why It Matters

· 7 min read Practical
Person reviewing a travel insurance document at an airport departure lounge

Contents

  1. Why US Medical Costs Are Different
  2. Minimum Cover Requirements for the USA
  3. Recommended Providers
  4. World Nomads
  5. SafetyWing
  6. Allianz Travel Insurance
  7. IMG Global (Patriot Travel)
  8. Pre-Existing Conditions
  9. Activities Coverage
  10. Credit Card Travel Insurance
  11. Making a Claim
  12. When to Buy

Travel insurance for a US trip is not optional—it is one of the most important things you book before you leave. The USA has the most expensive healthcare system in the world, with no universal public care for foreign visitors. A single night in a US hospital can cost more than the entire cost of your trip. This guide explains exactly what cover you need and which providers deliver it.

Why US Medical Costs Are Different

Most countries have public healthcare systems that provide emergency treatment at low or no cost to uninsured visitors. The USA does not. Every procedure, every ambulance ride, every consultation generates a bill at rates that bear no relation to international norms.

Indicative costs as of 2026:

  • Urgent care visit (minor injury or illness): $150–250
  • Emergency room visit (non-critical): $1,500–5,000
  • Ambulance transport (urban): $1,200–3,500
  • CT scan: $500–3,000
  • Broken arm treatment (X-ray, cast): $2,500–7,500
  • Appendectomy: $25,000–50,000
  • Heart attack treatment and 3-night ICU stay: $100,000–300,000
  • Medical evacuation flight to home country: $50,000–200,000+

Emergency rooms are legally required to stabilise patients regardless of ability to pay (under EMTALA), but this applies to stabilisation only—not to the resulting bills, which are sent in full.

Without insurance, a serious accident or illness in the USA can generate debt that takes years to resolve. Medical bankruptcies are the leading cause of personal bankruptcy in the USA.

Minimum Cover Requirements for the USA

These are the minimum figures we recommend. If a policy falls short on any of these, look elsewhere.

  • Emergency medical treatment: minimum $500,000; preferably $1,000,000+
  • Medical evacuation (repatriation): minimum $500,000; this covers air ambulance home if local treatment is inadequate
  • 24-hour emergency assistance: a phone line that operates around the clock and can coordinate direct billing with US hospitals (so you do not have to pay upfront and claim back)
  • Trip cancellation/interruption: minimum cover equal to your non-refundable trip costs
  • Baggage and personal effects: $2,000–3,000 minimum

Do not rely on a policy purchased through a budget comparison site that offers $50,000 medical cover — this amount would not cover two nights in a US hospital.

World Nomads

World Nomads (worldnomads.com) is the most widely recommended provider for independent travellers and covers a broad range of adventure activities as standard, including hiking, kayaking, and cycling.

USA cover levels:

  • Standard Plan: medical cover up to $100,000; evacuation up to $300,000; suitable for low-risk trips only
  • Explorer Plan: medical cover up to $1,000,000; evacuation unlimited; recommended for all USA trips

Indicative pricing for a UK resident, 2-week USA trip, age 30:

  • Standard Plan: approximately £60–70
  • Explorer Plan: approximately £90–110

World Nomads covers pre-existing conditions only if declared at the time of purchase and assessed as stable. For travellers with ongoing conditions (diabetes, heart conditions, asthma), the premium will be higher or coverage declined depending on severity.

Strengths: Strong adventure activities coverage; good claims reputation; direct billing coordination with US hospitals.
Weaknesses: More expensive than budget alternatives; Standard Plan medical limit is too low for the USA without upgrade.

SafetyWing

SafetyWing (safetywing.com) operates on a subscription model billed monthly, which makes it popular with digital nomads and long-stay travellers.

Nomad Insurance plan:

  • Cost: approximately $42–56/month for travellers under 40 (as of 2026; varies by age)
  • Medical cover: up to $250,000 per period
  • Evacuation: covered
  • Deductible: $250 per policy period

The monthly subscription model is useful if you are unsure how long you will stay. You can stop the subscription when you leave the USA. However, the $250,000 medical ceiling is lower than the World Nomads Explorer Plan—it covers most scenarios but not catastrophic multi-week hospitalisations.

Strengths: Affordable; no fixed trip length; renews automatically; covers 30 days in your home country per 90-day period.
Weaknesses: Lower medical ceiling than some alternatives; pre-existing conditions excluded by default.

Allianz Travel Insurance

Allianz (allianztravelinsurance.com) is a large established insurer with strong direct billing arrangements with US hospitals.

OneTrip Prime Plan (indicative for 2-week trip, age 30):

  • Cost: approximately $100–130 for a US resident; slightly higher for international visitors via Allianz partners
  • Medical cover: $50,000 (upgrade to AllTrips Premier for $500,000 emergency medical)
  • Evacuation: $500,000
  • Trip cancellation: up to $100,000

Note: Allianz’s base plans have lower medical limits than World Nomads’ Explorer. Always check and upgrade if needed.

Strengths: Large network; good 24/7 support; widely accepted at US providers.
Weaknesses: Base plan medical limit is low; pricing can be higher for older travellers.

IMG Global (Patriot Travel)

IMG Global’s Patriot Travel Medical Insurance (imglobal.com) is designed specifically for international visitors to the USA and offers higher medical limits at competitive prices.

Patriot America Plus:

  • Medical cover: up to $1,000,000
  • Evacuation: included
  • Cost: approximately $30–60/month depending on age and deductible selected
  • Deductibles: $0, $100, $250, $500, or $1,000 per period (lower deductible = higher premium)

IMG Patriot is one of the few products designed exclusively for non-US nationals visiting the USA, with direct billing arrangements at most major US hospital networks. Worth considering for longer trips or travellers over 50.

Pre-Existing Conditions

Every provider handles pre-existing conditions differently. Key terms:

  • Excluded: The condition is not covered at all, whether the claim is related to it or not
  • Covered with declaration: You declare the condition at purchase; it is assessed and either covered (possibly at higher premium) or excluded with written notification
  • Look-back period: Many policies define pre-existing as any condition you were aware of, treated for, or had symptoms of in the 60–180 days before purchasing (varies by policy)

If you have a significant pre-existing condition—heart disease, cancer history, diabetes, COPD—read the policy wording carefully and call the insurer before purchasing. Do not assume coverage.

For travellers with complex medical histories, specialist providers such as AllClear Travel Insurance (allcleartravel.co.uk, UK-based) and Battleface (battleface.com) will quote for conditions that mainstream providers decline.

Activities Coverage

Standard travel insurance policies exclude “extreme sports” and “hazardous activities.” In the USA context, this matters for:

  • Skiing and snowboarding (excluded on many base policies — World Nomads Explorer and SafetyWing both cover this)
  • White-water rafting (Class III+ often requires adventure add-on)
  • Motorcycle riding (almost always excluded on standard policies; requires a specific add-on or specialist policy)
  • Scuba diving (covered if PADI-certified on most mainstream policies; uncertified diving often excluded)
  • Rock climbing (sometimes excluded without rope; specify when purchasing)

If your trip includes any of the above, read the activities list in your policy wording and upgrade if necessary before departure.

Credit Card Travel Insurance

Many premium credit cards include travel insurance when you book the trip using the card. Common examples:

  • Chase Sapphire Reserve: Medical evacuation up to $100,000; trip interruption up to $10,000; baggage delay $500. Medical limit is low for the USA.
  • American Express Platinum: Purchase and trip protection; limited medical ($10,000 emergency medical assistance) — not sufficient as standalone US medical cover.
  • Barclaycard Avios Plus (UK): Includes travel insurance when used to book flights; check medical limits.

Credit card cover is often inadequate for US medical expenses. Use it as a supplement (for trip cancellation and baggage), not as your primary medical insurance. If you rely on card insurance, read the certificate of insurance and note the medical limit before you go.

Making a Claim

  • Contact your insurer’s 24-hour emergency line before agreeing to any expensive treatment where possible — they can pre-authorise and arrange direct billing with the hospital
  • Keep all medical reports, receipts, ambulance records, and pharmacy receipts
  • Request itemised bills from US hospitals (standard billing bills are often inflated; hospitals routinely negotiate; your insurer’s claims team will handle this)
  • File the claim as soon as possible — most policies require notification within 30–90 days of the incident

When to Buy

Buy travel insurance as soon as you book your trip, not the day before departure. Purchasing early means any trip cancellation or amendment before departure is covered from the purchase date. Purchasing at the last minute means you are only covered from that point.