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Travel insurance: what you actually need and what to skip

The queue at a small clinic in Chiang Mai’s Nimmanhaemin neighbourhood moves slowly. Outside, motorbikes stack up on the soi. Inside, a traveller from Berlin sits with a plastic bag of ice on her ankle, waiting to find out if it’s broken. She didn’t think she needed the upgrade to the policy with emergency evacuation cover — she was only going for two weeks, and it was just a temple step. The X-ray costs 1,800 Thai baht (about €48). The orthopaedic consultation costs 3,500. The flight change to get home early costs more than the entire insurance policy would have.

Travel insurance is one of the most genuinely misunderstood corners of trip planning — not because it’s complicated, but because most people shop for it the way they shop for phone cases: quickly, at the last minute, grabbing whatever is cheapest. The result is either serious under-coverage or money spent on add-ons that duplicate protection they already have.

This guide is about what coverage actually matters, what’s largely redundant, how to read a policy without a law degree, and what changes depending on your trip type.

The one coverage you cannot afford to skip: medical and evacuation

Emergency medical coverage is the non-negotiable core of any travel insurance policy. Everything else is negotiable. This is not.

Healthcare costs vary enormously by country, and not always in the direction you’d expect. The United States is the starkest example: a single night in a US hospital can run $5,000–$15,000 before treatment. But even countries with excellent and affordable local healthcare — Thailand, India, Vietnam — have a separate tier of private international hospitals used by expats and insured travellers, and those hospitals bill accordingly. You are unlikely to end up in a rural public ward if you are seriously unwell; you will be taken somewhere that can treat you, which means somewhere that charges a great deal.

Emergency medical evacuation is the line item many travellers delete to save €20 on the premium. Don’t. If you become seriously ill in a location without a specialist hospital — rural Uganda, the highlands of Bolivia, a remote island in eastern Indonesia — evacuation by air ambulance can cost $50,000–$200,000. This is not a figure most people have sitting in a current account. For anyone planning a trip that involves altitude, remote terrain, or adventure activities, evacuation cover is as essential as the flight itself.

What to look for:
– Minimum €/£/$500,000 in emergency medical cover for most destinations; $1 million+ if travelling to the USA
– Emergency evacuation and repatriation included (not as an optional add-on)
– 24-hour emergency assistance line with a number that works internationally
– Pre-existing conditions declared and either covered or consciously excluded

Trip cancellation and interruption: useful, but understand the limits

Trip cancellation cover reimburses non-refundable costs if you can’t travel for a covered reason — illness, bereavement, jury duty, redundancy (depending on your policy). Trip interruption cover applies if you have to cut a trip short for the same categories of reasons.

This coverage is most valuable when your trip involves significant prepaid, non-refundable costs: a multi-week overland route with pre-booked accommodation, an expensive guided trek, a long-haul flight to a single destination. For a flexible backpacking trip where most bookings can be cancelled 24–48 hours in advance, the value is lower.

The critical phrase in every cancellation policy is “covered reason”. Cancelling because you changed your mind, because a travel advisory was issued (but not an evacuation order), or because your connection fell through due to airline fault — these are typically not covered under standard cancellation clauses. Read the list of covered reasons before you buy, not after.

“Cancel for any reason” (CFAR) upgrades exist and will cover those gaps, but they typically reimburse 50–75% of your costs, not 100%, and they add 30–50% to the premium. For most trips, they’re not worth it unless you have a specific, concrete reason to expect you might cancel.

Baggage and personal belongings: the most overvalued line on the policy

Baggage cover is included in almost every travel insurance policy and is, for most people, the least useful part of it.

Here’s why: the payout limits per item are low — often £/€200–300 per item — and the claims process requires police reports, receipts, and evidence that would try the patience of a documentary filmmaker. Airlines have their own liability under the Montreal Convention for bags lost or damaged in transit (currently around $1,700 USD for international flights), and many credit cards include travel insurance that covers baggage as a benefit.

Expensive electronics — laptop, camera, drone — are often either excluded or require a separate “valuables” rider that pushes the premium up considerably. If your camera kit is worth £3,000, a standalone specialist camera insurance policy will almost always cover it more comprehensively and cheaply than a travel insurance add-on.

Where baggage cover earns its place: If you’re travelling without a credit card that includes travel benefits, and you’re carrying meaningful valuables without a specialist policy, the standard baggage cover at least provides a floor. Just don’t expect it to replace anything of real value.

Adventure activities and sports: know exactly what your policy covers

Standard travel insurance policies define “adventure activities” differently, and what one insurer includes another excludes. This is where people get caught out.

Hiking on marked trails: usually covered. Trekking above 4,000 metres: sometimes covered, sometimes not, sometimes available as an add-on. Scuba diving: covered by many policies up to 30 metres, excluded at depth or for solo diving. Motorbike rental: often excluded entirely, or only covered if you hold a valid licence for that class of vehicle in your home country.

If your trip involves any of the following, check your policy document explicitly before you travel — not the summary page, the actual policy wording:

• Trekking above 3,000–4,000m (relevant for the Everest Base Camp approach or Andean routes)
• Scuba diving or free diving
• Motorbike or moped rental (relevant across large parts of Southeast Asia and Bali)
• White water rafting, paragliding, or via ferrata
• Skiing or snowboarding off-piste

Specialist adventure insurers — World Nomads and True Traveller are two commonly used options — generally include a wider range of activities at standard price than mainstream insurers. The UK Foreign, Commonwealth & Development Office regularly updates destination-specific advice that affects what cover you may need for particular regions.

What you probably already have: avoiding double coverage

Before you buy any add-on, check what you already hold.

Credit card travel insurance is included with many premium and mid-tier cards. Coverage varies significantly — some include medical, cancellation, and baggage; others only baggage or flight delay. Read the benefits booklet that came with your card, not the marketing summary. Key questions: Does it include medical evacuation? What’s the cap on medical cover? Does it require you to have booked the trip on that card?

Reciprocal healthcare agreements exist between many countries. UK citizens travelling within countries that still have reciprocal agreements with the NHS can access state-provided emergency care. EU citizens carry a European Health Insurance Card (EHIC or GHIC) that provides access to state healthcare in EU member states. Neither of these replaces travel insurance — they cover state-level emergency treatment, not evacuation, repatriation, or the costs of a private hospital — but they do reduce your medical exposure in those regions.

Home contents insurance sometimes extends to cover personal possessions abroad. Check the policy.

How to actually read a policy before buying

The summary page of a travel insurance policy is marketing. The policy document — the Schedule of Benefits and the Exclusions section — is the contract.

Three things to read before you commit:

1. The exclusions list. This is where claims get denied. Look specifically for: pre-existing condition exclusions, alcohol-related incident exclusions (more broadly written than you might expect), and activity exclusions relevant to your trip.

2. The claims procedure. For medical claims, most policies require you to contact the assistance line before receiving treatment where possible, not after. Failing to do this is one of the most common grounds for a reduced payout or rejection.

3. The per-item limit on valuables. If you’re carrying a camera or laptop, find this figure. It is almost always lower than you expect.

Lonely Planet’s travel insurance guide covers some of these nuances in a format useful for first-time buyers.

Coverage by trip type: a practical framework

The right policy depends heavily on what kind of trip you’re taking. A weekend in Lisbon has different risk exposure than three months cycling through Sri Lanka or a gorilla trekking permit in Uganda (where the trek itself involves steep, muddy terrain in remote forest — more physically demanding than most people anticipate; see our gorilla trekking Uganda vs Rwanda comparison for the full picture on what that trek involves).

Short urban trip (1–2 weeks, low-risk destination): Medical and evacuation are still essential. Cancellation is worth including if you have significant prepaid costs. Baggage add-ons are largely optional if you carry a credit card with benefits.

Multi-week trip, mixed urban and outdoor: Medical, evacuation, and adventure activity cover if trekking or renting transport. Check that your policy covers the specific activities planned.

Long-term or multi-country travel (3+ months): Annual multi-trip policies become cost-effective above roughly 45–60 days of travel per year. For trips longer than 30 days, check whether your policy has a single-trip duration limit — many standard policies cap out at 30 or 45 days. Specialist long-stay or backpacker policies exist for this.

Travel to the USA, Canada, or Australia: Prioritise the highest medical coverage limit you can afford. A standard policy’s medical limit that is adequate for Southeast Asia may be dangerously low for a US hospital admission.

The Bottom Line

• Emergency medical and evacuation cover is the only part of a travel insurance policy that is truly non-negotiable. Everything else depends on your specific trip. Get the highest medical limit you can afford, especially for North America and remote destinations.

• Read the exclusions before you buy. The summary page sells the policy; the exclusions document defines it. Pre-existing conditions, adventure activities, and alcohol-related incidents are the three most common claim denial grounds — check all three before you travel.

• Check what you already have. Credit card travel benefits, reciprocal healthcare agreements, and home contents insurance may cover some of what you’d otherwise pay for. Avoid buying duplicate coverage for the same risk.

• Adventure activities require explicit confirmation of coverage. Motorbike rental, diving, trekking above 4,000m — these are excluded from many standard policies. If your trip includes any of them, verify the policy wording specifically, not just the activity list summary.

• For trips longer than 30 days or involving genuinely remote terrain, a specialist policy — backpacker, long-stay, or adventure-specific — will serve you better than a standard short-trip product. The premium difference is usually small; the coverage difference can be significant.

Keep reading: How to save money for a long term trip