Important notice: travelling to the United States without insurance is a serious financial risk. Medical invoices can be legally pursued for years and affect your situation on future trips to the country. Always take out a product with a high medical cap and explicit coverage for USA/Canada.
1. Typical USA traveller profile
Trips to the United States fall into several profiles: big city tour (New York, San Francisco, Los Angeles), national parks (West Coast with Yosemite/Grand Canyon/Yellowstone), theme parks in Florida (Orlando/Miami families), business travel (one week on east/west coast) and studies (academic year, university exchange).
2. Healthcare costs in the USA: why it is so expensive
The USA has the most expensive healthcare system in the world. Without insurance, real prices for a foreign traveller can be:
- Emergency consultation without admission: 500 - 3,000 USD
- Ambulance: 500 - 3,000 USD just for the transfer
- X-ray / CT / MRI: 500 - 5,000 USD
- Standard hospital night: 3,000 - 8,000 USD
- ICU night: 5,000 - 15,000 USD
- Complex surgical intervention: 50,000 - 250,000 USD
- Heart attack or serious accident with prolonged hospitalisation: 200,000 - 1,000,000+ USD
- Medical repatriation with medical team: 50,000 - 150,000 EUR
American hospitals bill by item (itemized billing): every aspirin, every saline bag, every doctor visit is billed separately. Without insurance you will receive invoices for weeks.
3. Common risks
- Accidents in national parks: hiking, altitude, dehydration in remote areas. Evacuation from national parks can be by helicopter (very expensive).
- Traffic accidents: car hire is very common. Check whether your card covers CDW/LDW or take out full insurance from home.
- Altitude incidents: Denver, western parks, Colorado. Altitude sickness possible.
- Heatstroke: Death Valley, Las Vegas, Arizona in summer.
- Hurricanes: East coast, Gulf of Mexico, Florida between June and November.
- Theft and assault: generally low but higher in specific areas of big cities. Caution with strangers and valuables.
4. Which IATI product fits best
| Profile | Recommended IATI product | Minimum medical coverage |
|---|---|---|
| New York / Miami tour 1-2 weeks | IATI Estrella (worldwide + USA) | 500,000 EUR — 1,000,000 EUR |
| West Coast + national parks | IATI Estrella (high cap) | 1,000,000 EUR |
| Family to Orlando (Disney) | IATI Familia (USA) | 500,000 EUR per insured person |
| Academic year / Erasmus USA | IATI Estudios (USA scope) | 1,000,000 EUR + univ. requirements |
5. Common claim scenarios
Fracture in Central Park, New York
Ambulance to reference hospital. Contact IATI 24/7 helpline for direct billing. Short admission, minor surgery, discharge the next day. Keep all invoices (they arrive over weeks). Cost without insurance: 15,000-40,000 USD.
Skiing accident in Colorado
Requires product with explicit ski extension. Without it, exclusion likely. Evacuation from resort, reference hospital, possible surgery. Cost without insurance: 30,000-100,000 USD.
Heart attack in Las Vegas
Life-threatening emergency → go to the hospital and notify the helpline afterwards. ICU admission, catheterisation, prolonged hospitalisation. Real cost without insurance: 100,000-500,000 USD. This is where a high cap (1,000,000 EUR) makes the difference between being covered or not.
Flight cancelled by hurricane in Miami
Weather-caused coverage is standard. Keep official airline communications, accommodation and meals if applicable. Alternative repatriation per policy.
Mobile phone theft in San Francisco
Police report compulsory. Without an official report there is no reimbursement. Keep a copy of the report + phone invoice if you have it.
6. Before travelling to the USA: checklist
- Minimum medical cap 500,000 EUR, ideally 1,000,000 EUR.
- Verify that the certificate says "worldwide scope including USA/Canada" explicitly.
- Save the 24/7 assistance number + certificate in digital format.
- Download the IATI app if available.
- Check whether your bank card supplements car hire coverage (CDW/LDW).
- Emergency card with personal medical data (allergies, medication).
- Emergency contact at home and consulate details (Embassy in Washington + regional consulates).
- Valid ESTA before travelling.
- If you plan to ski, take out the winter sports extension.
Frequently asked questions
Is insurance compulsory for the USA?
No, but it is probably the destination where it is most critical. Hospital costs without insurance can exceed 500,000 USD.
What medical cap is recommended?
Minimum 500,000 EUR, ideally 1,000,000 EUR. A heart attack or serious accident can easily exceed 500,000 USD.
Do standard products cover the USA?
Yes if you take out worldwide scope. Verify that the certificate says so explicitly and that the cap is high.
How does direct billing work in US hospitals?
Contact the 24/7 helpline before going. Network of partner hospitals. Keep ALL invoices: they arrive over weeks.
Does it cover Caribbean cruises from the USA?
Usually requires a specific cruise product or extension. Check before boarding.
See also
- IATI Estrella vs Mochilero vs Backpacker comparison
- How much an IATI insurance costs in 2026
- Documentation needed to claim from IATI
- Complaints to IATI: complete guide
Have you used your IATI insurance in the United States? Your real experience with hospitals, billing or repatriation is especially valuable given the size of the costs.
Disclaimer: this guide is indicative and reflects public information as of September 2026. Exact coverage, exclusions and caps may vary. Healthcare prices mentioned are indicative ranges based on public sources. Always check the particular conditions in force on the official IATI website before purchasing. This content does not constitute medical, healthcare or commercial advice.