A medical evacuation helicopter costs $80,000–$250,000. Your Chase Sapphire Reserve covers $2,500 in medical expenses abroad. That math should terrify you — or at least make you read this article.
Travel insurance costs 4–10% of your trip price. Here's exactly when it's worth buying, when your credit card already has you covered, and when you're throwing money away.
At a Glance
Average Cost
4–10% of trip price ($40–100 for a $1,000 trip)
When You Need It
Any international trip (medical coverage)
When You Can Skip It
Domestic trips under $2,000 with a good credit card
Best Comparison Site
Squaremouth.com or InsureMyTrip.com
Biggest Mistake
Buying the airline's policy at checkout
Info Current As Of
March 28, 2026
The 60-Second Decision Tree
You don't need to read this entire article. Answer these five questions:
Domestic trip under $2,000? → Your credit card probably covers enough. Skip the policy.
International trip, any budget? → You almost certainly need medical coverage. Your US health insurance doesn't work abroad.
Trip over $5,000? → Cancellation insurance starts making mathematical sense. A $200–350 policy protects a $5,000 investment.
Adventure activities (skiing, scuba, hiking)? → Standard policies exclude these. Get one that explicitly covers your activity.
Pre-existing medical conditions? → Buy within 14–21 days of your first trip deposit to qualify for the pre-existing condition waiver.
What Your Credit Card Already Covers (And What It Doesn't)
This is the section most Americans need. Premium travel credit cards offer surprisingly strong trip protection — and dangerously weak medical coverage. Here's the breakdown:
Chase Sapphire Reserve
$550/yearVerdict: Excellent for domestic trips. Dangerously insufficient for international medical coverage.
Chase Sapphire Preferred
$95/yearVerdict: Great value for domestic. The primary rental car coverage alone saves $15–25/day. For international trips, you need supplemental medical.
Amex Platinum
$695/yearVerdict: Strong travel perks but the insurance is actually worse than Chase Sapphire. Car rental is secondary, not primary. Global Assist sounds helpful until you read the fine print — they coordinate, they don't pay.
No Premium Card?
Most basic credit cards — including standard Visa and Mastercard — offer zero travel insurance. If you don't carry a Chase Sapphire, Amex Platinum, or similar premium card, you need a standalone policy for any meaningful travel protection.
When You Absolutely Need a Standalone Policy
1. Any International Trip
US health insurance does not work abroad. Medicare covers nothing outside the country. Most employer plans exclude international care entirely. A broken leg in Paris costs $15,000. An appendectomy in Tokyo: $30,000+. Your credit card covers $2,500 max in medical expenses — that's one ER visit, not a hospitalization. A standalone medical policy for a week in Europe costs $30–60.
2. Trips Over $5,000
At 4–7% of trip cost, a $200–350 policy protects a $5,000 investment. If your airline goes bankrupt, your tour operator cancels, or you get sick the day before departure, the policy pays for itself. Under $5,000, the cost-benefit is less clear — your credit card's trip cancellation benefit usually suffices.
3. Adventure Travel
Skiing, scuba diving, bungee jumping, zip-lining, and backcountry hiking are excluded from most credit card coverage AND most basic travel insurance policies. If your trip involves anything beyond walking tours and beach lounging, you need an “adventure sports” rider — and you need to read the specific activities list before buying.
4. Cruises
Getting sick onboard a cruise ship is expensive — the ship's medical center charges premium rates, and evacuation from sea by helicopter can cost $50,000–150,000. Cruise-specific policies cover medical care, emergency evacuation to the nearest port, and missed port stops. If you're cruising internationally, this is non-negotiable.
5. Pre-Existing Conditions
Most travel insurance policies exclude pre-existing medical conditions — unless you buy within the “look-back” window, typically 14–21 days from your first trip deposit. Buy within that window and most reputable insurers will waive the exclusion. Miss it, and any claim related to your condition gets denied.
When You Can Safely Skip It
Domestic weekend trips under $500
Your credit card's trip cancellation covers the cost. Your US health insurance works domestically. The financial exposure is minimal.
Fully refundable bookings
If you can cancel the hotel and flight for free, cancellation insurance is redundant. You're already protected against the biggest risk.
Short domestic trips with no checked bags
No luggage to lose, minimal financial exposure, and your health insurance works. The risk doesn't justify the premium.
How to Buy (And How Not to Get Ripped Off)
- Never buy the airline's insurance at checkout. It's overpriced, limited in coverage, and exists because airlines know you're in buying mode and won't compare. Every time.
- Use comparison sites: Squaremouth.com and InsureMyTrip.com are both licensed, show verified reviews, and let you filter by coverage type. Five minutes here saves you from a bad policy.
- Typical cost: 4–10% of your trip cost. A $1,000 trip = $40–100. A $5,000 trip = $200–350. If a policy costs more than 10%, something's wrong.
- Consider “Cancel For Any Reason” (CFAR): Costs 40–50% more than standard but lets you cancel for literally any reason. Typically reimburses 75% of costs, not 100%. Worth it for expensive trips where your plans might change.
- Read the “covered perils” list. Not every reason for cancellation qualifies. “I changed my mind” isn't covered under standard policies. Illness, injury, jury duty, job loss — those are. Know the difference before you buy.
Frequently Asked Questions
Does my regular health insurance work internationally?
Almost never. Medicare covers nothing outside the US. Most employer-provided plans exclude international care entirely or limit it to emergencies with high out-of-pocket costs. A few PPO plans offer limited international coverage — call your insurer and ask directly before assuming you're covered. The safe assumption: you're not.
Is credit card travel insurance enough for a trip to Europe?
For trip cancellation and delays, probably yes — most premium cards offer $5,000–10,000 in cancellation coverage and $500 for delays. For medical coverage, absolutely not. The Chase Sapphire Reserve caps emergency medical at $2,500, which won't cover a single ER visit in Western Europe. A standalone medical policy for a week in Europe costs $30–60. Buy one.
What's the difference between primary and secondary coverage?
Primary means the travel insurer pays first — you file one claim and you're done. Secondary means you file with your personal insurance first (auto insurance for car rentals, health insurance for medical), and the travel insurer only covers the gap. Chase Sapphire offers PRIMARY rental car coverage, which is rare and genuinely valuable — it means you never have to involve your auto insurer or pay the rental company's $15–25/day collision waiver.
Should I buy “Cancel For Any Reason” insurance?
Only if your trip cost exceeds $3,000 and you have a plausible reason you might cancel — uncertain work schedules, health concerns, or flexible plans. CFAR typically reimburses 75% of prepaid costs, not 100%, and costs 40–50% more than standard cancellation coverage. For a $5,000 trip, that's roughly $300–500 for the policy vs $200–350 for standard.
Does travel insurance cover pandemics?
In 2026, most policies treat COVID and other infectious diseases like any other illness. If a physician orders you to quarantine, that's a covered medical expense. If you test positive and can't fly, trip interruption kicks in. But “I'm worried about getting sick” or “there's a new variant” doesn't qualify — those are reasons to buy CFAR, not standard coverage.
The short version: For domestic trips, your Chase Sapphire has you covered. For international trips, buy a standalone medical policy — $30–60 is cheap insurance against a $100,000 hospital bill. Don't buy the airline's policy at checkout. Compare on Squaremouth.com. Five minutes of research might save you from financial catastrophe.
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Disclosure: Some links in this article are affiliate links. We may earn a commission at no extra cost to you. Policy details were verified March 28, 2026 and may change — always confirm coverage with the issuer. See our full disclosure policy.