Planning a trip to the United States from Europe? Now that you have organized your flights and hotels and mapped out your itinerary, have you thought about health insurance? It's one of the most important things travelers overlook, and skipping it can be consequential.
Why the US Is Different
Unlike a lot of countries in Europe, the United States does not have a universal public healthcare system. There is no equivalent of the NHS, the French Sécurité Sociale, or Germany's statutory health insurance that covers foreign visitors. If you get sick or injured in the US without insurance, you will be billed directly — and those bills can be costly.
A single night in a US hospital can cost anywhere from $5,000 to $30,000. An emergency room visit for something as routine as a broken wrist can run $3,000–$7,000 before any surgery. Air ambulance transport between cities can cost over $50,000.
Does My European Health Insurance Cover Me?
In most cases, no. European national health insurance (such as the UK's NHS, Germany's Krankenkasse, or Italy's SSN) generally only covers you within your home country or, in some cases, within the EU/EEA under the European Health Insurance Card (EHIC). The EHIC does not apply in the United States.
Some private health insurance plans sold in Europe do offer worldwide coverage — check your policy documents carefully and look specifically for "USA coverage" or "North America coverage," as the US is sometimes excluded or listed separately due to the high cost of care there.
What About the ESTA / Visa Waiver Program?
Most European citizens traveling to the US for tourism or short business trips use the Visa Waiver Program (VWP) and obtain an ESTA authorization. The ESTA does not require you to have travel insurance, and US immigration does not check for it at the border. However, not having coverage is a serious risk you take entirely at your own expense.
What Travel Health Insurance Should You Get?
When shopping for travel insurance that covers the US, look for the following:
- Medical coverage of at least $100,000 — many advisors recommend $500,000 or more for US trips.
- Emergency evacuation coverage — in case you need to be airlifted or transported home.
- Pre-existing condition coverage — if you have ongoing health conditions, confirm these are included.
- 24/7 emergency assistance hotline — so you can get help finding in-network providers quickly.
- Trip cancellation/interruption — useful if you need to cut the trip short due to illness.
Recommended Providers for Europeans Visiting the US
Several travel insurance companies are well-regarded for US coverage sold to European residents:
- Allianz Travel Insurance — widely available across Europe, for solid US medical coverage.
- AXA Assistance — offers medical coverage specifically for North America.
- Europ Assistance — strong network in the US with direct billing to hospitals in many cases.
- World Nomads — popular with independent travelers, has flexible terms, and good for active trips.
Always read the fine print and declare any pre-existing conditions honestly — claims for undisclosed conditions are routinely denied.
How Much Does It Cost?
A typical short-term travel health insurance plan for a 2-week trip to the US from Europe costs roughly €30–€80 for a healthy adult under 40, depending on coverage limits and the provider. For travelers over 60, this can rise to €100–€200 or more.
Bottom Line
You are not legally required to have health insurance to visit the US, but going without it is one of the riskiest decisions a traveler can make. Medical costs in the US are among the highest in the world, and a single unexpected event — a car accident, a sudden illness, or a bad fall — can result in bills that follow you for years.
Always purchase comprehensive travel health insurance before departing for the US. It's one of the best investments you can make for any American trip.
Quick Checklist Before You Fly
- ESTA approved (if using Visa Waiver Program)
- Travel health insurance purchased with US coverage confirmed (view potential providers above)
- Policy documents saved on your phone and printed
- Emergency assistance hotline number saved in your contacts
- Pre-existing conditions declared to your insurer