Travel insurance for the USA: coverage, costs & tips

The United States is the easiest destination for Ontarians to reach and the most expensive place in the world to get sick. That combination is exactly why travel insurance matters more here than almost anywhere else.

Why U.S. medical bills are the real risk

American healthcare has no national price controls, and hospitals bill visitors at full rates. An emergency room visit, a few nights as an inpatient, or an air ambulance can each run to tens of thousands of dollars — and sometimes far more. These aren’t worst-case stories; they’re ordinary invoices in the U.S. system. Emergency medical insurance exists precisely to absorb that shock.

The OHIP gap

Many travellers assume provincial health travels with them. It doesn’t. Ontario ended most out-of-country medical coverage in 2020, so OHIP now pays very little toward care in the U.S. and never pays the hospital up front. Anything you might recover is a small reimbursement after you return — not help at the bedside. Private emergency medical insurance is what pays the hospital directly and coordinates your care.

What to look for in a plan

• Correct geography. For a U.S. trip, your plan must include the USA. A Worldwide-excluding-USA plan costs less but will not cover American care.
• A high coverage limit. Given U.S. prices, a generous emergency medical limit is the feature that matters most.
• 24/7 assistance. Around-the-clock support that can direct you to appropriate care and handle payment arrangements is invaluable in an emergency.
• Honest health declaration. Under 60, you typically answer no medical questions. At 60 and over, a Medical Questionnaire sets your premium — not your eligibility. Declare everything accurately.

What emergency medical coverage includes

Emergency medical coverage is built for a sudden, unexpected medical problem away from home: hospital and physician fees, diagnostics, emergency ambulance, prescriptions given during treatment, emergency dental, and medical evacuation or repatriation to Canada. In the U.S., where a single serious event can run to tens of thousands of dollars, the high limit and the evacuation benefit are the parts that matter most. Many plans also include telemedicine access and 24/7 assistance that can arrange payment directly with an American hospital.

It’s worth knowing what sits outside this coverage. Emergency medical is not trip cancellation, trip interruption, lost baggage or rental-car protection — those are separate coverages. If you want to protect prepaid, non-refundable costs or a rental car, add them deliberately rather than assuming your medical plan handles them.

How coverage is priced

There’s no flat rate. Premiums are built from your age, trip length, the coverage amount you choose and your health. The USA is more expensive to insure than most destinations because of those medical costs, so expect it to price higher than, say, a Caribbean trip of the same length — but the only accurate number comes from a quote with your real details.

Practical tips

• If you cross into the U.S. often, compare a multi-trip annual plan against separate single-trip policies.
• Match your coverage dates to your actual travel so you don’t over-pay.
• Keep your assistance line and policy number with you, not just at home.
• Consider telemedicine access, which can resolve minor issues without a costly clinic visit.

A U.S. trip is the one case where going uninsured can be financially catastrophic. Before you drive south or board a flight, compare your options and get a quote that includes the USA with a limit you’re comfortable with.