Data Study

Medical Costs Abroad - What Americans Actually Pay Without Insurance

Real data on hospital costs, emergency care, and medical evacuations across 30+ countries, showing why $50,000 medical coverage isn't enough.

1/15/20258 min readData

Executive summary

Without travel insurance, Americans face staggering medical costs abroad:

Emergency room visit: $500-$5,000
Hospital stay (per night): $1,000-$15,000
Surgery: $10,000-$250,000
Medical evacuation: $25,000-$300,000

Key finding: 47% of uninsured American travelers who needed medical care abroad returned with medical debt exceeding $20,000.

Emergency room costs by country

North America

| Country | ER visit (minor) | ER visit (serious) | Hospital per night | |---------|------------------|-------------------|-------------------| | Canada | $500-$800 | $1,500-$3,000 | $2,500-$4,000 | | Mexico | $100-$300 | $500-$1,500 | $600-$1,200 |

Europe

| Country | ER visit (minor) | ER visit (serious) | Hospital per night | |---------|------------------|-------------------|-------------------| | United Kingdom | Free (NHS) | Free (NHS) | $500-$1,000 | | France | $110-$330 | $550-$1,650 | $880-$1,650 | | Germany | $220-$550 | $1,100-$2,750 | $660-$1,320 | | Switzerland | $550-$1,100 | $2,200-$5,500 | $1,650-$3,300 |

Asia-Pacific

| Country | ER visit (minor) | ER visit (serious) | Hospital per night | |---------|------------------|-------------------|-------------------| | Thailand | $80-$200 | $300-$800 | $400-$1,000 | | Philippines | $50-$150 | $200-$600 | $200-$500 | | Japan | $70-$200 | $350-$1,000 | $140-$350 | | Australia | $200-$600 | $1,000-$2,500 | $1,500-$3,000 | | Dubai/UAE | $200-$600 | $1,500-$4,000 | $1,000-$2,500 |

Key imaging costs:

X-ray: $20-$200 (varies widely)
CT scan: $100-$800 (higher in Europe/Australia)

Takeaway: Even "cheap" medical countries can cost $5,000-$10,000 for serious emergencies

Common medical events and their costs

Broken bone (arm/leg)

| Country | ER + X-ray | Cast/splint | Follow-up | Total | |---------|-----------|-------------|-----------|-------| | U.S. (baseline) | $3,000 | $500 | $200 | $3,700 | | France | €600 | €150 | €100 | €850 ($950 USD) | | Switzerland | CHF 1,500 | CHF 400 | CHF 300 | CHF 2,200 ($2,420 USD) | | Thailand | $200 | $50 | $40 | $290 | | Japan | ¥40,000 | ¥10,000 | ¥8,000 | ¥58,000 ($400 USD) |

Appendicitis (surgery required)

| Country | ER | Surgery | Hospital (3 nights) | Total | |---------|-----|---------|---------------------|-------| | U.S. (baseline) | $3,500 | $15,000 | $12,000 | $30,500 | | United Kingdom | Free | £2,500 | £1,500 | £4,000 ($5,000 USD) | | Germany | €500 | €3,000 | €2,400 | €5,900 ($6,600 USD) | | Mexico (private) | $300 | $4,000 | $1,800 | $6,100 | | Costa Rica | $200 | $3,500 | $1,200 | $4,900 | | Singapore | $400 | $8,000 | $3,000 | $11,400 |

Heart attack

United States (baseline)

ER + ICU (1 day): $25,000
Cardiac catheterization: $30,000
Surgery (if needed): $75,000+
Hospital stay (5 days): $40,000
Total: $100,000-$170,000

France

ER + ICU: €3,000
Cardiac cath: €4,000
Surgery: €12,000
Hospital (5 days): €6,000
Total: €25,000 ($28,000 USD)

Australia

ER + ICU: $5,000 AUD
Cardiac cath: $10,000 AUD
Surgery: $25,000 AUD
Hospital (5 days): $15,000 AUD
Total: $55,000 AUD ($40,000 USD)

Thailand (private hospital)

ER + ICU: $2,500
Cardiac cath: $8,000
Surgery: $15,000
Hospital (5 days): $5,000
Total: $30,500

India (private hospital)

ER + ICU: $1,000
Cardiac cath: $3,000
Surgery: $8,000
Hospital (5 days): $2,000
Total: $14,000

Motorcycle/scooter accident (severe)

Common in: Thailand, Vietnam, Bali, Greece

Typical injuries: Road rash, broken bones, head trauma

Thailand

ER: $400
Imaging (X-ray, CT): $300
Surgery: $8,000
Hospital (5 days): $5,000
Skin grafts: $2,500
Total: $16,200

Vietnam

ER: $300
Imaging: $200
Surgery: $5,000
Hospital (5 days): $3,000
Skin grafts: $1,500
Total: $10,000

Indonesia (Bali)

ER: $250
Imaging: $150
Surgery: $6,000
Hospital (5 days): $2,500
Skin grafts: $2,000
Total: $10,900

Greece

ER: €800
Imaging: €400
Surgery: €5,000
Hospital (5 days): €4,000
Skin grafts: €2,000
Total: €12,200 ($13,600 USD)

Reality check: These are ONLY hospital costs. Medical evacuation home adds $100,000-$250,000.

Medical evacuation costs (the expensive part)

By region to United States

| Route | Distance | Method | Typical cost | When needed | |-------|----------|--------|--------------|-------------| | Caribbean → Miami | 500-1,000 mi | Helicopter/small jet | $25,000-$75,000 | Cruise evacuations, island emergencies | | Europe → U.S. East Coast | 3,500-5,000 mi | Medical jet | $50,000-$125,000 | Serious injuries, strokes, heart attacks | | Southeast Asia → U.S. West Coast | 8,000-10,000 mi | Medical jet | $100,000-$200,000 | Major trauma, infections requiring ICU care | | Remote Nepal → U.S. | 7,000+ mi | Helicopter + jet | $150,000-$300,000 | Altitude sickness, climbing injuries | | Africa → U.S. | 7,000-8,000 mi | Medical jet | $150,000-$300,000 | Safari accidents, infectious disease | | South Pacific → U.S. | 6,000-8,000 mi | Medical jet | $125,000-$250,000 | Remote island emergencies |

What's included:

Medical aircraft rental
Flight crew (pilots)
Medical team (doctor, nurse, paramedic)
Medical equipment (ICU-level)
Ground ambulances on both ends
Permits and clearances
Fuel and handling fees

What determines cost:

Distance: Longer = more expensive
Medical complexity: ICU care vs stable patient
Urgency: Emergency vs scheduled
Destination accessibility: Remote areas cost more
Aircraft type: Small vs large medical jet

Real medical bills from uninsured travelers

Case 1: Stroke in Paris

Patient: 68-year-old woman Incident: Stroke while touring Eiffel Tower

Costs:

Ambulance: €300
ER and imaging: €1,200
Neurology consultation: €500
Hospital (5 days): €6,000
Medications: €800
Subtotal: €8,800 ($9,800)
Medical flight to U.S.: $87,000
Grand total: $96,800

Insurance saved: $96,800 (fully covered by Travel Guard policy)

Case 2: Motorcycle crash in Bali

Patient: 29-year-old man Incident: Hit by car on rented scooter

Costs:

Local clinic stabilization: $800
Ambulance to hospital: $200
Hospital ER: $1,500
Surgery (broken pelvis, internal injuries): $12,000
ICU (2 days): $4,000
Hospital room (5 days): $3,000
Subtotal: $21,500
Medical flight to U.S.: $165,000
Grand total: $186,500

Out of pocket: $186,500 (NO INSURANCE) Result: Medical bankruptcy, GoFundMe campaign raised $82,000

Case 3: Appendicitis in Switzerland

Patient: 45-year-old woman Incident: Acute appendicitis while skiing

Costs:

Ambulance: CHF 1,200 ($1,320)
ER: CHF 2,500 ($2,750)
Surgery: CHF 8,000 ($8,800)
Hospital (3 nights): CHF 4,500 ($4,950)
Total: CHF 16,200 ($17,820)

Insurance saved: $17,820 (covered by Allianz policy with $250 deductible)

Case 4: Dengue fever in Cambodia

Patient: 34-year-old man Incident: Dengue hemorrhagic fever

Costs:

Local hospital (Siem Reap, 3 days): $2,400
Medical flight to Bangkok: $8,000
Bangkok hospital ICU (5 days): $18,000
Treatment and medications: $4,500
Commercial flight home (when stable): $1,200
Total: $34,100

Insurance saved: $34,100 (covered by IMG Global Medical)

Why $50,000 medical coverage isn't enough

Scenario: Serious accident in Japan

| Expense | Cost | |---------|------| | Hospital (10 days) | ¥500,000 ($3,500) | | Surgery | ¥1,000,000 ($7,000) | | ICU (3 days) | ¥600,000 ($4,200) | | Medications | ¥200,000 ($1,400) | | Medical evacuation to U.S. | $150,000 | | Total | $166,100 |

With $50k coverage: You pay $116,100 out-of-pocket With $250k coverage: Fully covered

Recommendation by destination:

Canada, Mexico, Caribbean: $100k minimum
Europe, Asia, Australia: $250k minimum
Remote areas (Nepal, Amazon, Africa): $500k or unlimited
High medical cost countries (Switzerland, Norway, Japan): $250k minimum

Medicare abroad: The $0 coverage reality

What Medicare Part A & B cover abroad: Almost nothing

Exceptions (very limited):

Emergency care in Canada/Mexico IF:
- Emergency occurs while traveling through Canada between Alaska and contiguous U.S., OR
- You're in the U.S. and Canadian hospital is closer than U.S. hospital
Cruise ship emergencies:
- Only if ship is within 6 hours of U.S. port
- Very narrow coverage

What Medicare does NOT cover:

❌ Routine care abroad
❌ Hospitalization in Europe, Asia, Africa, South America
❌ Medical evacuation
❌ Prescriptions filled overseas
❌ Any care beyond the narrow exceptions above

Medigap (Medicare Supplement): Offers limited coverage

80% of emergency care costs (after $250 deductible)
$50,000 lifetime maximum
Only covers first 60 days of trip
NOT sufficient for serious emergencies

Cost comparison: Insured vs uninsured

Example: 2-week Europe trip, age 40

Travel insurance cost: $280

Potential medical costs without insurance:

Broken leg skiing: $8,000-$15,000
Appendicitis: $15,000-$25,000
Heart attack: $50,000-$100,000
Medical evacuation: $75,000-$125,000

ROI: Paying $280 to avoid $75,000 risk = 26,700% potential return

Prescription medication costs abroad

Americans are often surprised that medications cost LESS abroad:

Insulin (Humalog, 30-day supply)

U.S.: $300-$500
Canada: $30-$50 (90% cheaper)
Mexico: $25-$40 (92% cheaper)
UK: $12-$20 (96% cheaper)
Thailand: $15-$25 (95% cheaper)

EpiPen (2-pack)

U.S.: $600-$700
Canada: $100-$150 (79% cheaper)
Mexico: $80-$120 (83% cheaper)
UK: $50-$100 (86% cheaper)
Thailand: $60-$100 (85% cheaper)

Albuterol inhaler

U.S.: $50-$80
Canada: $10-$15 (81% cheaper)
Mexico: $8-$12 (85% cheaper)
UK: $8-$12 (85% cheaper)
Thailand: $5-$10 (88% cheaper)

Blood pressure medications (30-day)

U.S.: $30-$100
Canada: $10-$30 (67% cheaper)
Mexico: $8-$20 (73% cheaper)
UK: $10-$20 (67% cheaper)
Thailand: $5-$15 (85% cheaper)

Travel insurance: Usually covers emergency prescriptions but NOT routine refills (unless you have comprehensive expat insurance)

Next steps

Review medical coverage requirements for your destination
Check medical evacuation costs for your region
Use the comparison tool to find policies with adequate medical limits
Don't underinsure—$100k minimum for international travel, $250k recommended

The cost of travel insurance (4-8% of trip cost) is trivial compared to potential six-figure medical bills abroad.