Travel insurance for the USA

Travel insurance for a US trip usually pays for treatment, hospital fees and emergency transport, according to Japan's foreign ministry. One federal survey of US residents puts mean payments for an emergency room visit at $1,315 in 2023. We found no US government figure for what a hospital charges a foreign visitor.

A search for travel insurance USA often starts with one question: is it required? The answer below is general consumer information, not advice on what to buy. We name no insurer and quote no premium, and your own policy wording decides what you hold. We blurred the number plates in the cover photograph. We read the figures below on 3 November 2026 on eCFR, the Federal Register, CMS, AHRQ, HHS, GOV.UK, Canada's travel.gc.ca, Germany's Foreign Office and Japan's foreign ministry.

Do a B-1/B-2 visa or an ESTA require travel insurance?

No regulation we read requires travel insurance for a B-1/B-2 visa or for ESTA. The travel.state.gov, cbp.gov and uscis.gov sites all refused our reads on 3 November 2026. This answer rests on the regulations alone, and your consulate has the last word.

• B-1/B-2 visa, 22 CFR 41.31: the officer must be satisfied of intent to leave, permission to enter a foreign country afterwards, and "adequate financial arrangements" for the visit. The section never names insurance.
• ESTA, 8 CFR part 217: the words insurance, health and medical appear nowhere in the part. We could not read the questions on the ESTA form itself.
• J-1 exchange visitors, 22 CFR 62.14: sponsors must require insurance that covers sickness or accidents. J-1 is the one case where we found insurance mandatory.

No source we read ties "adequate financial arrangements" to insurance or to medical costs. We cannot say how an officer weighs cover in an interview. The rest of each application is in our guides to US visas for tourists and ESTA explained.

Did the 2026 public-charge rule add a condition on cover for visitors?

The DHS public-charge rule published on 20 July 2026 sets no visitor insurance requirement in what we read. The rule took effect on 18 September 2026 and rescinds the 2022 regulations. Its preamble says the ground applies to visa applicants, immigrant and nonimmigrant, and to nonimmigrants seeking admission at a port of entry. The text does not use the terms B-2, ESTA or Visa Waiver.

Private health insurance does appear in the preamble, as one factor. For a person whose condition could be managed, DHS says it "would consider" private health insurance or other means to pay. That is part of a public-charge judgement, not a stated condition of a visitor visa.

We could not read the State Department's 2026 notice "Preventing Public Benefits Reliance", because travel.state.gov refused us.

A Federal Register search found no presidential document of 2025 or 2026 on health insurance for visa applicants. Older claims that the USA demands health cover may trace to Proclamation 9945 of 2019. That proclamation applied only to immigrant visas and was revoked on 14 May 2021.

What must a hospital emergency department do under EMTALA?

A hospital emergency department covered by EMTALA must screen you, then stabilise or transfer you, whatever your citizenship or ability to pay. Congress passed the law in 1986. CMS, the federal health agency, says it binds any emergency department that receives Medicare funds, "which includes most U.S. hospitals". Canada's advice says "all hospitals", but we follow the narrower CMS wording.

CMS lists three duties:

• An appropriate medical screening exam.
• Treatment until the emergency condition is stabilised, meaning it "is unlikely to get materially worse". That is not the same as cured.
• An appropriate transfer to another hospital, where the hospital cannot stabilise you or you ask for one.

Citizenship cannot be a ground for refusal. The CMS list covers insurance status, ability to pay, national origin and more, and adds "If you aren't a U.S. citizen".

Payment questions cannot hold up care. Under 42 CFR 489.24 a hospital "may not delay" the screening exam or treatment to ask about your method of payment or insurance status. Nor may it seek approval from your insurer before the exam and the start of treatment. CMS says staff can ask about insurance at check-in if that causes no delay.

EMTALA does not make care free. The CMS pages we read are silent on billing. Canada's travel advice is not: "Clients will, however, be charged for all services rendered." No page we read says whether a freestanding urgent-care clinic falls under the law.

What do emergency-room figures in US data measure?

US emergency-room figures measure different things, and none of them is a price quoted to a visitor. Read each row alone, since the years, payers and meanings all differ.

The spread inside one source is wide. Peterson-KFF reports a quarter of visits at $970 or less and another quarter at $3,043 or more. HCUP's self-pay and no-charge row for 2021, $610, is also a hospital cost and not a cash price.

What do foreign governments tell travellers about American hospital bills?

Foreign ministries in the UK, Canada, Germany and Japan all tell their citizens that US medical treatment is expensive. Only the UK and Japan print a sum for a hospital stay.

The £150,000+ sum is the UK government's own illustration, not a measured average. The same table shows "£25,000+" for a broken leg in Spain. Neither that sum nor the Japanese range is a guide to a policy limit, and we do not suggest one.

Will a GHIC, EHIC, home health plan or credit card pay a US hospital?

National health cards and home plans give a US visitor little on the pages we read, and we found no regulator figure for credit-card cover.

Germany and Australia stay unconfirmed. Germany's Foreign Office tells travellers to ask their insurer. It does not say what state health insurance pays in the USA. No Australian government page answered us, so we say nothing about Australian cover.

Credit-card cover stays unmeasured, because the UK and Australian regulator pages refused our reads. Canada's consumer office says a card may offer medical and baggage cover. Japan's foreign ministry says limits, services and conditions differ by card. Get your card's terms in writing, including its limits on treatment and evacuation.

What do ambulances and medical helicopters charge?

Ambulance charges have no official price we could find for a visitor. The 2024 report of the federal committee on ground ambulance billing gives no dollar price for an uninsured patient. It did hear that about 30 percent of 911 responses end without transport, and that some ambulances charge "assessment fees" even then.

Ground ambulance sits outside the No Surprises Act. CMS says "ground ambulance services aren't covered by billing protections", though state law can differ. Air ambulance is inside the Act for people with covered insurance. The UK Foreign Office warns that emergency transport "is often charged separately", so check how your policy treats it. Japan's foreign ministry says an ambulance is paid in most areas and that you cannot choose the receiving hospital.

Air ambulance figures reach us second-hand, from a September 2021 brief by HHS's policy office ASPE. It quotes the Government Accountability Office: the median price charged in 2017 was $36,400 for a helicopter transport and $40,600 for a fixed-wing one. We could not read the GAO report itself. These are 2017 charges rather than payments, for privately insured patients, and not a price for a visitor.

Evacuation is a separate line to look for in your wording. Canada tells hikers to buy cover that includes helicopter rescue and medical evacuation. ASPE says patients typically have no choice of air ambulance provider. The park's safety page puts Dry Tortugas National Park over 68 miles of open sea from the nearest hospital. Emergency medical help at Haleakalā National Park is at least an hour away.

Can the No Surprises Act or a good-faith estimate protect a foreign policyholder?

Protection for a visitor holding only a foreign policy could not be confirmed under either rule, so we imply nothing either way. CMS says the Act applies to people in the United States "who use most types of private health insurance". Its list names employer plans, the Marketplace and individual-market coverage. The words foreign, visitor and travel insurance do not appear on that page.

Good-faith estimates are owed to uninsured and self-pay patients, but not in an emergency. CMS says "You won't get an estimate during emergency care." Patients usually get one when they schedule care at least 3 business days ahead, or when they ask.

The rule, 45 CFR 149.610, defines an uninsured person by the benefits they hold and has no citizenship term. A foreign travel policy is not among the plan types it lists, and the text does not say how such a holder counts.

Planned care has one more public route: hospitals must post their discounted cash price and standard charges for at least 300 shoppable services. Ask your insurer in writing before relying on any of this.

Which exclusions and undeclared conditions can void a travel claim?

Undeclared medical conditions can cost you the whole cover: the UK Foreign Office says "failing to declare something may invalidate your travel insurance". The list below is a government's, not any policy's terms, so read your own wording against it.

• Existing conditions: declare conditions and pending treatment or tests. Canada's Financial Consumer Agency says a policy may not cover conditions you had before applying; we read that page through an extraction tool.
• Mental health: the Foreign Office says some policies may exclude treatment related to a pre-existing condition.
• Alcohol: the Foreign Office says most policies do not cover events after excessive drinking.
• Sports and vehicles: bungee jumping, jet skiing, winter sports and skydiving are not usually in standard policies, and quad bikes or mopeds are not usually covered.
• Destinations: many policies will not cover places where the Foreign Office advises against travel.
• Other points to check: terrorism, natural disasters, civil unrest, age limits, trip length and cruises.

The UK regulator and MoneyHelper pages refused our reads, so their wording is unread here. No source we read says whether a policy pays for treatment that is the purpose of the trip, so ask before relying on it.

Where does rental-car liability fit beside medical cover?

Rental-car liability is a separate question from your own medical bills. The UK Foreign Office says to check what you are covered for with the hire company.

California is one example only. Its DMV lists $30,000 for injury or death to one person, $60,000 to more than one, and $15,000 for property damage. Those limits are the state's insurance requirement, not what a rental company's included cover pays. Germany's Foreign Office says rental cars usually carry liability cover up to a set amount, and that punitive damages cannot be insured.

Damage to the car itself is another line, and the company rules are in our guide to renting a car in the USA.

What should you do first when you reach a US hospital?

Emergency help comes first at a US hospital, and your insurer comes straight after. These steps come from government pages, and none is medical advice.

1. Call 911 in an emergency. The UK Foreign Office says "Dial 911 and ask for an ambulance." Our phone and eSIM guide for the USA covers 911 from a foreign phone.
2. Expect the most serious cases to go first. Japan's foreign ministry says mild cases may wait several hours in an ER. It points non-urgent care to walk-in and urgent care clinics.
3. Contact your insurer or assistance company quickly, as the UK Foreign Office advises.
4. Send any deposit request to your insurer first. The Foreign Office says some hospitals ask non-US residents for a deposit on admission. It says to pay only if your insurer advises it. No page we read reconciles that with the EMTALA bar on delaying the exam, so do not assume how the two meet.
5. Ask for the financial assistance policy. CMS says nonprofit hospitals "must give financial assistance to eligible patients". Neither CMS nor the IRS says who is eligible, and neither mentions foreign visitors.
6. Get prescriptions locally. The Foreign Office says UK prescriptions are not valid in the US. It says you need one from an urgent care facility, emergency room or doctor.

A hospital that refuses the screening exam can be reported. CMS says "Anyone can file an EMTALA complaint", and complaints go to the State Survey Agency.