Travel Insurance Basics: What It Covers and How to Choose

Travel insurance is protection against unexpected events abroad, and the practical answer is simple: buy a policy as soon as you book your trip, make sure it covers your whole itinerary, your activities and your medical history, and read the exclusions before you pay. Official guidance from the UK Foreign, Commonwealth & Development Office (FCDO) says you should take out appropriate travel insurance before you go, and that without it you could be liable for emergency expenses such as medical treatment that may cost thousands of pounds.

Who this affects

Anyone travelling internationally should buy appropriate cover before departure. This includes short trips: Canadian guidance says that if you plan to travel outside Canada, even for a day in the United States, you should buy trip interruption and travel health insurance before you leave. The same principle applies to UK travellers and others: the FCDO says if you travel internationally you should buy appropriate travel insurance before you go, covering existing physical or mental health conditions and any activities you will be doing while away.

It matters most if you have a medical condition, are doing adventure activities, are cruising, or are travelling to a destination where official advice warns against travel. If you travel to a destination where the FCDO advises against all but essential travel or all travel, your insurance may be invalidated.

What policies usually cover

Policies vary, but official guidance lists the core things to check. Your travel insurance should cover:

• The full length of your trip, including any maximum trip length or annual limit on time spent outside your home country.
• Emergency treatment in state or private hospitals, including hospital bills.
• Emergency transport such as an ambulance, which is often charged separately, and emergency travel home on medical grounds.
• Pre-existing medical conditions that you have declared.
• All activities you may undertake, such as sports or adventure tourism; some activities need specialist insurance or an add-on.
• All places you intend to visit, even in transit, in case anyone needs emergency treatment in a transit country.
• Repatriation costs if you or a family member die abroad.
• Getting home after medical treatment if you cannot use your original ticket.
• Reasonable costs for a family member or friend to stay with you, or travel out to accompany you home if required.

Canadian guidance adds three things a travel health policy should always cover: medical evacuation to Canada or to the nearest place with medical care, including a medical escort; pre-existing medical conditions, with a written agreement and a stability clause; and repatriation in case of death, including preparation and return of remains and local cremation or burial outside Canada.

Trip interruption insurance is different from medical travel insurance. It reimburses the unused portion of a trip if you must return early due to an unforeseen incident. Trip cancellation cover applies only when you cancel before the trip starts.

What is usually excluded

Check how or whether a policy covers these common exclusions:

• Alcohol and drugs. Most travel insurance policies do not cover events that happen after you have drunk excessive alcohol or taken recreational drugs or other substances.
• High-risk destinations. Many policies will not cover travel to a high-risk destination where the FCDO advises against all but essential travel or all travel. Canadian guidance says many policies will not cover you if you travel to regions where the Government of Canada has issued an advisory to avoid all non-essential travel or avoid all travel.
• Mental health conditions. You must declare mental health conditions or risk invalidating your policy. Some policies may exclude treatment related to a pre-existing mental health condition.
• Age restrictions, particularly for annual policies.
• Routine and non-emergency care. Travel health insurance rarely covers routine health checkups, non-emergency care or cosmetic surgery, and it may not cover mental health disorders.
• Certain activities. Check whether the plan excludes mountaineering, skiing, scuba diving or extreme sports.
• Airline or travel agent failure. Typically this is not covered. ATOL is a consumer protection scheme for air holidays and flights, managed by the Civil Aviation Authority. Choose an ATOL-protected holiday or a policy that includes airline or supplier failure cover.

How to choose a policy: step by step

1. Buy early. The FCDO says to buy travel insurance as soon as possible after booking your trip.
2. List your needs. Write down your destinations, transit countries, dates, planned activities and all medical conditions, including those under investigation.
3. Declare everything. You must declare all pre-existing medical conditions when buying travel insurance, and update the list before each trip abroad if you already have cover. Ask the provider to explain the definition, limitations and restrictions on pre-existing conditions, tests and treatments. Get a written agreement that your condition is covered, including a stability clause and, ideally, a compassion clause and a change-of-health clause.
4. Check the trip length and regions. Make sure the policy covers the entire duration of your holiday and all countries you transit through. If you are travelling to the US and/or Canada on a worldwide policy, check you are covered. Some policies limit how long you can be abroad; exceeding it may invalidate the policy.
5. Check medical evacuation. Confirm that medical evacuation is included. Evacuations can cost thousands of pounds, especially on adventure trips.
6. Check the activities. If you plan to quad-bike, ski or do water sports, you may need specific cover. Before hiring a vehicle, check the small print, including engine-size limits and licence requirements. Many policies expect you to hold the correct licence for the vehicle you intend to drive abroad.
7. Ask about payment and support. Ask whether the plan pays bills or provides cash advances up front, whether there is a deductible, whether cover is continuous for your stay and after return, and whether there is a 24-hour emergency contact number with English or translation services.
8. Carry the details. Take a paper copy of your policy, including the policy number and the insurer's emergency 24-hour telephone number, and share the details with travel companions and friends or family at home.

Costs and timing

Costs depend on your age, health, destinations, trip length and activities, and the source texts do not give a single price. What the sources do give is the scale of the risk. Official examples of costs without insurance include £25,000+ for a broken leg in Spain, £80,000+ for a quad bike accident in Greece, and £150,000+ for a stomach bug or infection treated in a US hospital, in each case possibly including medical evacuation or repatriation.

Timing matters in two ways. Buy as soon as possible after booking, and check that the policy covers the whole trip, including transit countries. If you are going on a cruise, check the operator's booking conditions, because cruises generally require an additional level of cover as it is more difficult to get to hospital for treatment.

Exceptions and special cases

• Serious medical conditions. You may need a specialist insurance provider or policy. The British Insurance Brokers' Association has a Travel Medical Directory listing specialist providers who cover serious medical conditions.
• GHIC and EHIC. A UK Global Health Insurance Card or European Health Insurance Card allows you to access state-provided medically necessary healthcare within the EU, Switzerland and some other countries on the same terms as residents. They are not alternatives to travel insurance: they do not cover private medical healthcare costs, repatriation or additional costs such as mountain rescue in ski resorts. Some insurers may waive an excess on medical treatment if you use an EHIC or GHIC; check your policy terms.
• Living or working abroad. Travel insurance is not intended for living outside your home country for an extended period or permanently. If you live abroad or plan to, consider your insurance needs; local laws may require medical insurance, and you may need proof of it for a visa application.
• Studying abroad. If you study or plan to study outside Canada, contact your educational institution or program administrator for advice on the coverage you need.
• Claims paperwork. Get a detailed report and invoice from your doctor or hospital before leaving the country where you received treatment, and submit original receipts. Keep copies.

What is not yet confirmed

This guide does not confirm prices, policy terms or insurer-specific rules, because these change and are set by individual insurers. The FCDO guidance was last updated on 2 August 2024, and the Canadian guidance does not give a confirmed modification date. Always check the current policy wording and the official travel advice for your destination before booking and before buying insurance.

Before you travel, check the official travel advice for your destination and sign up for alerts, because advice can change. For personal advice on your own health situation, speak to a doctor, pharmacist or travel clinic, ideally weeks before you travel.