Travel insurance is one of those products people either buy reflexively or skip entirely. Both are wrong. The right answer is "it depends on what you cannot afford to lose." Here is how to decide, and what the policy actually does when you need to claim.
What a standard policy covers
Four main categories, in roughly the order they matter:
- Emergency medical - hospital, ambulance, evacuation home if needed. This is the headline benefit and the reason to buy outside your home health system. A medical evacuation from a remote destination can run USD 50,000-200,000.
- Trip cancellation and curtailment - non-refundable costs back if you cannot travel or have to come home early for a covered reason (illness, bereavement, work emergency on some policies).
- Baggage and personal effects - cover for lost, stolen, or damaged bags above the airline\'s liability cap (see our baggage guide for the airline side).
- Travel delay and missed connection - meals, overnight accommodation, alternative transport when a delay tips a trip over a threshold (often 6-12 hours).
When you probably do not need it
Short trips inside reciprocal healthcare systems (EHIC/GHIC within Europe, Medicare in Australia for some nationalities), fully-refundable bookings, and trips paid for on a premium credit card that already bundles cover. If your worst case is "I lose a few hundred dollars and reschedule," a policy is overhead. Insurance is for the tail risk, not the average case.
When you absolutely do
Long trips (more than two or three weeks). Adventure activities - hiking above a certain altitude, scuba, motorbike, ski touring. Travellers over 65 (medical costs jump). Pre-existing conditions, declared honestly to the insurer. Trips with expensive non-refundable bookings (cruise, safari, multi-stop itineraries). Travel to remote regions with limited healthcare infrastructure. In all these cases the premium is small compared to the loss exposure.
Credit card travel insurance - the gap most people miss
Premium cards (Amex Platinum, Chase Sapphire Reserve, Barclaycard Avios Plus, and equivalents) include surprisingly broad coverage - trip cancellation, delay, baggage, sometimes primary medical. But the coverage applies only when the trip is paid on that card, and the policy limits are lower than standalone insurance. Two questions decide if you need a standalone policy: does my card cover medical evacuation? (Most do not, even premium cards.) Are the per-incident caps high enough for my destination\'s healthcare costs? US healthcare alone usually requires a top-up.
Pre-existing conditions and exclusions
The two ways a claim gets denied. Pre-existing conditions: if you have a known medical condition you did not declare, the insurer will deny medical claims related to it. Declare honestly - the premium goes up a little, but the claim gets paid. Exclusions: read them before you buy. Common ones include alcohol-related incidents, unlicensed activities (motorbike without an internationally-valid licence), high-risk activities not on the standard list, and travel to areas your government advises against. If you plan to do anything outside the typical tourist menu, look for a policy that explicitly lists your activity.
Single-trip vs annual multi-trip
If you take more than two leisure trips a year, an annual multi-trip policy is almost always cheaper than several single-trip ones. The trade-off: each trip is capped (typically 30-90 days), and you cannot extend a single trip mid-journey on an annual policy. For nomads and long-stay travellers, a dedicated long-term policy (SafetyWing, World Nomads, Genki) fits better than annual multi-trip.
Frequently asked
Do I really need travel insurance?
For short, cheap, refundable trips inside countries with reciprocal healthcare - probably not. For long trips, expensive non-refundable bookings, adventure activities, or any travel outside your home medical system, yes. The question is not "is it worth it on average" but "can I absorb the worst case." A medical evacuation from a remote area can cost six figures.
Does my credit card already include travel insurance?
Many premium cards include limited coverage - trip cancellation, delay, lost baggage, sometimes basic medical - but only when you pay for the trip on that card. Read the benefits guide (not the marketing page). Coverage limits, exclusions, and the requirement to use that card for the booking trip people up most often.
What does travel insurance not cover?
Pre-existing conditions you did not declare; adventure activities outside the standard list (scuba below a certain depth, motorbike riding without a licence valid in the country, off-piste skiing); claims arising from alcohol or drugs; cancellations due to government travel advisories you booked despite; and acts of war or civil unrest in many policies. Always read the exclusions before buying.
When should I buy travel insurance?
For trip cancellation cover, on the day you book the trip - many policies only cover events that arise after purchase, so a flu the day before departure on a policy bought two weeks earlier may not be covered if it was contracted before purchase. For medical-only coverage, any time before departure is fine. Annual multi-trip policies are usually cheaper than several single-trip policies if you travel more than twice a year.
Read related: baggage rules and the airline liability cap, visa basics, or start a flight search.
