Why it's different for America
The UK's GHIC/EHIC does not apply in the USA. There is no reciprocal healthcare agreement. You are a private patient from the moment you walk in.
Real numbers, for scale: an ambulance ride is around $1,000–$2,000. A visit to an emergency room for something minor starts around $1,500. A broken leg with surgery runs well into five figures. An air ambulance home is a six-figure event.
This is not a scare story — it's the actual pricing structure of American healthcare, and it's the reason USA travel insurance costs more than European.
What to check
Medical cover: look for at least £5 million, plus repatriation. Most decent policies do this by default.
Pre-existing conditions: declare everything. Asthma, blood pressure tablets, a knee you had scoped in 2019, anything you've seen a GP about recently. An undeclared condition doesn't just void that claim — insurers routinely void the entire policy, including the unrelated lost-luggage claim. Declaring usually costs less than people fear.
Cancellation cover: this is why you buy early. It's active from the day you buy, so buying on the day you book the flights protects the whole outlay. Buying the week before you fly protects almost nothing.
Gadget and valuables cover: check the single-item limit. It's often £300, which doesn't cover a phone. If you're travelling with cameras or laptops, list them separately.
Car hire excess: many annual policies include it. If yours does, don't buy it twice at the rental desk.
Theme park specifics: check that the policy doesn't exclude "activities at height" in a way a roller coaster could fall under. Most are fine; it takes one minute to confirm.
Practical
- Annual multi-trip policies including the USA are often barely more than a single-trip for a two-week holiday. If you travel more than once a year, do the maths.
- If you have a packaged bank account with travel insurance, check the USA is included and check the age limits — many exclude over-65s or charge extra.
- Save the policy number and the 24-hour emergency line to your phone, and to one other person's. Not in an email you'll need signal to find.
- If something does happen, call the insurer's emergency line before treatment wherever possible. Many policies require pre-authorisation for anything non-emergency.
Compare with someone who handles medical declarations properly — Staysure is the usual recommendation for that.