Travel Insurance for the USA: Why You Need £10m+ Medical Cover

The United States has the most expensive healthcare system in the world. Travel insurance to the USA isn't a nice-to-have — it's the single most important purchase you'll make for the trip.

Why £10m is the minimum

A simple appendicitis with overnight stay in New York or LA routinely costs £40,000–£60,000. A heart attack with a few days in ICU can pass £200,000. £5m sounds like a lot — and it is, almost everywhere except the USA.

• £10–£15m medical cover — non-negotiable
• Repatriation — air ambulance from the US to the UK is £100,000+
• Direct billing arrangements — so the hospital bills your insurer, not you
• £250–£500 excess — higher excesses save money but think carefully

Ambulances are not free

A US ambulance ride averages £1,500–£2,500. Air ambulance from a remote area can be £30,000+. Always call your insurer's assistance line first if it isn't a life-threatening emergency — they'll arrange transport with billing direct to them.

Hire cars

Travel insurance covers personal liability but not driving liability. For US road trips you need:

• The hire car company's Liability Insurance Supplement (LIS) — bring it up to $1m
• Optional: car hire excess insurance from a UK provider, which is cheaper than the rental company's CDW

ESTA and visas

An ESTA is required for most UK visitors. Travel insurance does not replace it. If you're refused entry at the border, cancellation cover doesn't apply — that's an immigration matter, not an insured peril.

Hurricanes and weather

Florida and the Caribbean US states (Puerto Rico, USVI) are exposed to hurricane season (June–November). Standard cover includes natural disaster cancellation if your destination is officially evacuated, plus delay benefits if your flight is grounded.

Pre-existing conditions

Declare everything. US hospitals routinely contact insurers to confirm coverage before treating non-emergencies, and any undeclared condition will mean a refused claim.

Get a USA travel insurance quote.