Travel Insurance 101 for American Travelers
Understand what travel insurance covers, when to buy it, and how to compare policies for trips outside the United States.
Why travel insurance matters
Most U.S. health plans and Medicare policies provide little to no coverage overseas. A dedicated travel insurance policy fills the gap by covering emergency medical costs, trip cancellations, and evacuation expenses that can easily reach six figures.
The reality for American travelers
- Medicare doesn't cover you abroad (except limited coverage in Canada/Mexico near the border)
- Medicaid has zero international coverage
- Private insurance may cover emergencies but rarely medical evacuation
- Medical evacuation from Europe: $50,000–$100,000
- Medical evacuation from Asia-Pacific: $100,000–$250,000+
- Emergency surgery abroad: $20,000–$150,000 out-of-pocket
Real example: A 62-year-old American suffered a stroke while on a river cruise in Germany. Total costs: $87,000 for hospitalization + $142,000 for air ambulance to the U.S. Medicare paid $0.
JetSet Protect tracks more than 50 global insurers, highlighting the clauses that matter to American travelers:
- How quickly you must purchase a plan to qualify for pre-existing condition waivers
- Which providers support high trip values (luxury cruises, bucket-list safaris, multi-country tours)
- What limits you need for medical evacuation from popular regions like Europe, Southeast Asia, and South America
- Cancel For Any Reason (CFAR) options for maximum flexibility
Key coverage types
| Coverage type | What it protects | Minimum recommended limit |
|---|---|---|
| Emergency medical | Hospitalization, doctor visits, prescriptions | $100,000 |
| Medical evacuation | Air ambulance, repatriation | $250,000 (Asia-Pacific: $500,000) |
| Trip cancellation | Non-refundable deposits, flights, tours | 100% of trip cost |
| Baggage | Lost, stolen, delayed luggage | $1,000+ |
Tip: If you're traveling with expensive gear (cameras, skis, scuba equipment), confirm the per-item limit and consider scheduling high-value items separately.
When to purchase travel insurance
You can buy travel insurance up to the day before departure, but purchasing early unlocks critical benefits:
- Pre-existing condition waivers — most providers require purchase within 14–21 days of your first trip payment.
- Cancel For Any Reason (CFAR) — typically must be added within 14 days and reimburses 50–75% of prepaid costs.
- Supplier default protection — covers situations where a cruise line or tour operator ceases operations.
How to compare travel insurance plans
- Start with your itinerary: destination, total trip cost, travel dates, and any special activities (skiing, scuba, trekking).
- Check your existing coverage: credit cards may include secondary trip interruption, but almost never cover medical evacuation.
- Use the TravelShield comparison tool: filter by trip type, budget, and activity to shortlist 3–5 providers.
- Read the policy schedule: pay attention to exclusions, claim filing deadlines, and documentation requirements.
Recommended providers for Americans
| Provider | Why we recommend it | Ideal traveler |
|---|---|---|
| Allianz Travel | High cancellation limits, CFAR option, strong concierge | Luxury trips, families |
| World Nomads | Buy/extend on the road, 200+ covered sports | Adventure travelers, gap years |
| GeoBlue | Blue Cross Blue Shield network abroad | Seniors, chronic conditions |
| battleface | Covers remote destinations and higher-risk activities | Expedition and adventure travel |
Common mistakes Americans make
1. Assuming credit card coverage is enough
Credit cards typically offer secondary coverage (pays only after your primary insurance) and rarely include:
- Medical expenses or evacuation
- Pre-existing conditions
- High-risk activities (skiing, scuba diving)
- Trip cancellation for illness
Bottom line: Credit card benefits are a backup, not a replacement for comprehensive travel insurance.
2. Waiting too long to buy
Many Americans purchase travel insurance just days before departure, missing out on:
- Pre-existing condition waivers (must buy within 14–21 days of first trip payment)
- Cancel For Any Reason coverage (must add within 14 days)
- Maximum trip cancellation benefits
3. Under-insuring medical evacuation
A common mistake is choosing $50,000 medical evacuation coverage. For remote destinations or Asia-Pacific travel, you need $250,000–$500,000 minimum.
4. Not reading exclusions
Many Americans are shocked to learn their policy excludes:
- Adventure sports without a rider
- Travel to State Department Level 3/4 destinations
- Injuries related to alcohol
- Pre-existing conditions (without a waiver)
What your credit card actually covers
| Credit card benefit | What's covered | What's NOT covered |
|---|---|---|
| Trip cancellation/interruption | Covered reasons (illness, death, severe weather) | Medical expenses, evacuation, "cancel for any reason" |
| Baggage delay | Essential items if bags delayed 6+ hours | Lost baggage, high-value items, electronics |
| Travel accident insurance | Death/dismemberment on common carrier | Medical treatment, evacuation, non-carrier accidents |
| Rental car coverage | Collision damage waiver | Liability, injury, some vehicle types (vans, luxury cars) |
Key insight: Premium travel credit cards (Chase Sapphire Reserve, AmEx Platinum) offer better benefits than standard cards, but still lack comprehensive medical and evacuation coverage.
Understanding State Department travel advisories
The U.S. State Department issues travel advisories on a 4-level scale. Most travel insurance excludes coverage for Level 3 and Level 4 destinations unless you purchase before the advisory is issued.
- Level 1 (Exercise Normal Precautions): Full coverage
- Level 2 (Exercise Increased Caution): Usually covered
- Level 3 (Reconsider Travel): Often excluded or requires special rider
- Level 4 (Do Not Travel): Almost always excluded
Check current advisories at travel.state.gov before purchasing insurance.
How much does travel insurance cost?
For American travelers, expect to pay:
- 4–8% of trip cost for comprehensive coverage (trip cancellation + medical)
- 8–12% if you add Cancel For Any Reason (CFAR)
- $200–400 for annual multi-trip plans (good for frequent travelers)
Cost examples:
- $3,000 European vacation (7 days): $150–$240
- $8,000 cruise to Alaska (10 days): $480–$960 (with CFAR)
- $500 weekend trip to Mexico: $25–$40
Frequently asked questions
Do I need travel insurance for domestic trips? Trip cancellation coverage can be valuable for non-refundable domestic trips, but medical coverage isn't necessary since your U.S. health insurance applies. Consider "cancel for any reason" for expensive domestic trips.
What if I have a pre-existing condition? Purchase travel insurance within 14–21 days of your first trip payment (varies by provider) and meet other requirements (insure full trip cost, be medically able to travel) to waive pre-existing condition exclusions.
Can I buy travel insurance after I've already departed? Some providers like World Nomads allow you to purchase or extend coverage while already traveling, but you'll face waiting periods and limited coverage for the first few days.
Does travel insurance cover COVID-19? Most policies now cover COVID-19 like any other illness for medical expenses and trip cancellation (if you test positive before departure). Check if pandemic-related border closures are covered.
What's the difference between trip cancellation and trip interruption?
- Trip cancellation: Reimburses prepaid, non-refundable costs if you cancel before departure
- Trip interruption: Reimburses unused portion + extra costs to return home if you must cut your trip short
How do I file a claim? Contact your insurer immediately when an incident occurs. Save all receipts, medical records, police reports, and documentation. Most claims must be filed within 20–90 days of returning home.
Next steps
- Use the Comparison Tool to filter providers by your destination, trip type, and budget
- Review our Niche Travel Guides for specialized coverage (cruises, adventure sports, digital nomads, seniors)
- Check Insurance Requirements by Destination to see if your destination mandates coverage
- Read Real Claim Scenarios to understand how policies perform when you need them
Still deciding? Head to the comparison tool and start building a tailored shortlist in under five minutes.