Travel Insurance for the USA: What to Check Before You Fly

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Two friends and I once spent a winter camping and snowboarding in the Colorado mountains. We showered in glacier rivers and one night the heater ran out of gas at minus 13 degrees. It was one of the best trips of my life, and I wrote about it in seven crazy adventures I would never have had as an office worker. It was also the trip where I thought hardest about insurance, because an accident in the USA costs more than an accident almost anywhere else.

Here is what travel insurance for the USA needs to cover, and where the limits hide.

Why the USA is different

There is no public safety net for visitors. The UK government travel advice for the USA says medical treatment is expensive, there are no special arrangements for British visitors, and some hospitals ask non US residents for a deposit on admission. UK prescriptions are not valid there either, so you need a US doctor to get pharmacy medicine.

The FCDO foreign travel insurance guidance gives an example: a stomach bug treated in a US hospital, with possible medical evacuation, can cost more than £150,000. Not a car crash. A stomach bug.

Five things to check in your policy

1. Is the USA included at all? Many policies price the USA and Canada separately or exclude them. Worldwide often means worldwide except the USA, so read the area of cover.
2. The medical limit. A limit that feels generous in Thailand can run out in an American intensive care unit. Look for at least €1 million.
3. Emergency room excess. Some policies add a separate charge for each emergency room or urgent care visit in the USA. Know the number before you need it.
4. Direct billing. Can the insurer pay the hospital directly? If not, you may be asked for a deposit you cannot afford. The UK advice is to send the hospital’s request for funds to your insurer first and only pay if they tell you to.
5. Winter sports and road trips. Skiing in Colorado or Utah has its own conditions. My guide to travel insurance for snowboarding covers what to look for.

How Genki Traveler handles the USA and Canada

I use Genki for my own cover. Under the current Genki Traveler conditions, the USA and Canada work like this:

• You choose a region when you sign up. The worldwide region covers every country in full. The cheaper region, worldwide limited in Canada and the USA, only covers emergencies that start within 7 days of arriving in those two countries.
• You can switch region with a future date in the member centre, so you can upgrade for the months you spend in North America. If you pick the full worldwide region you keep it for at least one month.
• In the USA you pay the first €100 of each emergency room or urgent care visit yourself. That is separate from the usual €50 deductible per case, and it does not apply if the visit ends in a hospital admission.
• Hospital stays are managed and paid directly by the 24 hour emergency assistance, so there is no deposit to find. Have the hospital call them before admission.
• Cover is up to €1 million, and prices depend on your age, start date and region.

Genki does not publish one price, so check the price of Genki Traveler with the worldwide region for your own age before you book.

When you need care in the USA

• Call 911 for a real emergency, then your insurer’s assistance line once you are stable.
• For anything that is not an emergency, call before you pay. Urgent care centres are cheaper than emergency rooms for small problems.
• Ask for an itemised bill. US hospital bills are often negotiable and often wrong.
• Keep every document. My guide on how to claim on travel insurance explains what the insurer will ask for.

Do not skip it

A road trip through Utah or a season in the Rockies is worth every mile. Just do not do it on a policy that quietly stops at the border. If this is the start of a longer trip, read my gap year travel insurance guide, and for the full picture see my guide to insurance for digital nomads.

Photo by Hélène Blanquet on Unsplash.