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Travel insurance for USA

The famous cliché of America is that it's big. And it is. Across its six time zones are examples of virtually every type of geography on earth, from the baked deserts of Nevada to the mountains of Colorado. There's something for everyone.

Many are attracted to its warm welcomes and iconic metropolises. Whether you’re sampling wine in Napa Valley, beer in Boston or trekking through canyon country, read our guide to medical care, getting around and the importance of travel insurance in the USA.

Grand Canyon at sunset

Medical care for Brits in the USA

America’s healthcare is some of the most sophisticated in the world, however it is also notoriously expensive and privatised. This means that having good medical travel insurance is an imperative. Without it, you are unlikely to receive treatment or, if you do, it could run to tens of thousands of dollars.

You may be asked to pay an amount up-front by a hospital or treatment centre as a gesture of good faith. If this happens, contact your travel insurer to find out whether this is something they will cover. It’s important to make sure you have available funds for healthcare emergencies in addition to your holiday insurance policy to be on the safe side.

The emergency service number in the USA is 911. There are few diseases associated with travel in the USA, however it’s important to follow the Foreign, Commonwealth and Development Office (FCDO) advice on health and travel in the USA to make sure you know whether there are risks local to where you’re going and can take all necessary precautions.

Protect what matters when you go with good travel insurance

Travel risks in the USA

The travel risks associated with the USA are the kind common to visiting any country. Be vigilant against theft, pickpocketing, burglary from home or car and other street crimes. If you are going to be in unfamiliar areas, always travel in groups and try not to walk alone at night in areas where crimes are more prevalent.

It’s unusual for crime to target tourists, particularly when outside of large cities. There are greater concerns about the risks of crime in states that border Mexico due to the illegal drug trade, however this too is unlikely to specifically target tourists.

Regional considerations

The laws of the USA vary by state, and it’s important to understand how they differ depending on where you will be visiting. Some have strict alcohol laws, such as Utah, while others such as California have very strict laws about smoking and littering. Fireworks are legal in some states and illegal in others, so carrying anything that could cause controversy across state borders is very unwise. This can include things you might normally consider safe, such as beer and wine.

The USA is a land of contrast, including culturally. Some areas are very religiously conservative while others are highly liberal and cosmopolitan. Even within states, cultural norms can vary by area. It’s important to research the locality you’re visiting to avoid any faux pas.

Despite that, the USA is famously a cultural melting-pot and you are likely to find people from all walks of life in most areas.


The Electronic System for Travel Authorisation is an automatic visa waiver programme designed for people from participating countries who are visiting the USA for leisure or business for up to 90 days. It needs to be completed online and is often instant, however it can take as long as 72 hours.

Make sure you have allowed time to get your ESTA, as the process can take longer if your application is rejected. In that situation, you will need to apply for a Non-Immigrant Visa and this can involve trips to the US Embassy, which is by appointment and may take a long time. It’s always a good idea to apply for your ESTA in plenty of time to allow for this eventuality.

Getting around

It may have been your lifelong dream to rent an open-top car and cruise down Route 66. Indeed, with much of the USA being so spread out, driving is often one of your only transport options. But have a mind to driving laws. These vary by state and may have different requirements. For instance, in some parts of America, having a valid UK driving licence is sufficient to rent a car and drive, however others will require you to have an International Driving Permit. For the sake of safety, it may be a good idea to apply for an IDP if you plan on driving in the USA.

Speed limits are set by state and even local municipality. They can vary significantly between built up areas and motorways, so make sure you know what the maximum (and, in some cases, minimum) speed limits for the areas you’ll be driving in are. You may find that there are different speed limits depending on time of day and weather type. Importantly, it is common for the maximum speed limit to be lower than in the UK, with some areas such as Washington D.C. having a maximum speed of 55mph. Be aware of what the maximum is for the road you’re travelling on.

Remember that your travel insurance may not cover many aspects of car rental, and this will need to be done by having a separate insurance policy. It is likely that this insurance will come as part of your rental agreement, but it is always wise to make sure.

For long distance travel, flying is one of the most common ways of getting around in the USA and is more popular than trains. However, people have reasons besides speed for seeing the USA by rail, and there are some combination tickets (rail and air) available. America’s spellbinding geography can be taken in wonderfully if you take the Amtrak, however it could be more expensive than air travel.

Public transport in cities differs depending on where you are, with some systems more up-to-date than others. Some large cities such as Los Angeles are renowned for having very limited public transport, so research before you go to see whether you need to make arrangements like renting a car.

Other travel considerations

Remember that alcohol in drinks is often (but not always) measured by its weight rather than its percentage volume, which is different to the UK. The alcohol-by-weight is also expressed as a percentage, though – so a beer that reads 3.2% alcohol by weight is in fact slightly over 4% alcohol by volume. Remember that if you're involved in an incident while under the influence of alcohol your travel insurance policy may not cover you.

Is travel insurance compulsory for the USA?

While travel insurance is a compulsory requirement for visiting some countries and territories, the USA is not one of them. But that doesn’t mean it’s not worth taking out. Just consider what an unexpected incident while you were there could end up costing you if you weren’t’ covered.

For one thing, the United States is one of the most expensive countries in the world for healthcare. And while it may seem unlikely you’ll need to call on its medical services on your visit, you could be looking at a hefty bill if you do.

With travel insurance in place before you go, it’s one less thing to think about. You’ll have the reassurance not only that any emergency medical expenses and repatriation (transport home) are covered if you need them but also that other protection’s in place too.

Good quality travel insurance should cover trip cancellation and delays in some circumstances, replacement of lost or damaged belongings, and even access to emergency assistance if you need to call on it while you’re exploring Stateside.

How much travel insurance do I need for the USA?

It’s important that your travel insurance for America provides good medical cover, enough to pay for any healthcare treatment you may need if you fall ill or are injured while there. Don’t underestimate how much treatment can cost there. From getting stitches to a ride in an ambulance, it soon mounts up.

The level of cover you choose should be sufficient to reimburse you for the holiday if it’s cancelled for one of the reasons set out in the policy wording. Make sure it will also reimburse you for the cost of lost, damaged or stolen belongings – so work out their value and keep the receipts handy if you have them.

Remember, for some activities or types of holiday you may need additional or specialist cover. For instance, winter sports cover for skiing, snowboarding, etc, sports travel insurance or cruise cover. You may need additional gadget cover for the devices you take on your trip. And you should make sure you have the level of coronavirus cover you need. Some insurers enable you to add more covid-19 cover to your policy.

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