Travel insurance: when you need it and what it should cover
Travel insurance is one of those things that looks like a waste of money until the day you need it. These are the situations where it genuinely matters.
Within the European Union
The European Health Insurance Card gives you access to a country's public healthcare on the same terms as its residents. That covers a lot, but not everything: not private care, not repatriation, not mountain rescue, and where co-payments are standard, you pay them too. It's a good floor, not full cover.
Outside the European Union
Here insurance stops being optional in practice. In the United States an emergency room visit can cost thousands and an admission tens of thousands. And in many countries the good care is private and paid up front. A week's insurance costs 20 to 50 euros. The maths does itself.
What to check in the cover
What matters isn't the price but three figures: the medical expenses limit (look for at least 100,000 euros outside Europe, more for the United States), whether medical repatriation is included, and whether trip cancellation is covered. The rest, like baggage delay, is nice but rarely decisive.
Cancellation cover
The one most people ignore and the one most used. It covers having to cancel because of illness, a death in the family or certain work reasons. It only makes sense bought close to when you book, not the week before travelling. And check the list of covered reasons, because it's a closed list: if yours isn't on it, you don't get paid.
What's usually excluded
Pre-existing conditions, unless declared and covered separately. Risk sports, including some that don't look like it such as diving, off-piste skiing or hiking above a certain altitude. And incidents involving alcohol or drugs. Read that section — it's short, and it's where the surprises live.
Check whether you already have cover
Many credit cards include travel insurance if you paid for the tickets with that card. It's usually limited, but it may be enough for a short European trip. Call your bank before buying anything else: a five-minute call can save the whole cost.
When I wouldn't buy it
A weekend in a European city, with a European Health Insurance Card, no risky plans and a cheap trip you wouldn't mind losing. In that case insurance adds little. In pretty much everything else, I would buy it.
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