Travel Insurance for USA from Germany: ESTA Visitor Guide

If you live in Germany and travel to the USA, you need a private travel medical policy, because German statutory health insurance generally does not pay for treatment there and many German travel policies cap each trip at six or eight weeks. For longer or higher risk trips, compare US visitor plans that cover your full stay with a high maximum. German residents can compare IMG's Patriot plans and Visitors Care on Ombrela; Trawick Safe Travels plans exclude German residents, and WorldTrips Atlas plans cannot be bought while you are in Germany.

Key facts at a glance

• Under section 18 of the German Social Code Book V, statutory funds pay for treatment outside the EU and EEA only in narrow exceptions, and the USA is not covered by the EHIC.
• Section 18 lets a fund pay up to six weeks a year of urgent treatment abroad, only if private cover is unavailable due to age or illness and the fund confirmed this beforehand.
• Annual German travel policies cover each trip only up to six or eight weeks, depending on the contract, according to the Verbraucherzentrale.
• An approved ESTA allows stays of up to 90 days per visit and is valid for two years, as the Auswärtiges Amt notes.
• The ESTA fee rose to $40 on September 30, 2025 under Public Law 119-21, according to the Federal Register.
• No health insurance is required to get an ESTA or to enter the US under the Visa Waiver Program.

Does German health insurance cover a trip to the USA?

For most people with statutory insurance (GKV), no. Outside the EU, the EEA and countries with a social insurance agreement covering health care, you generally pay for treatment yourself. Germany has no such health care agreement with the United States, and your European Health Insurance Card is not accepted there. This is general information, not legal advice; your fund can confirm your own position.

The exception in section 18 of the Social Code Book V is narrow: a statutory fund can pay for up to six weeks per calendar year of treatment that was immediately necessary abroad, but only if you could not get private cover because of age or a pre-existing condition and your fund confirmed this before you left. Even then, the fund pays only what the treatment would cost in Germany. Medical repatriation is not part of statutory benefits at all, the Verbraucherzentrale notes.

If you have private full cover (PKV), read your tariff's rules on stays abroad. Worldwide cover and time limits vary by tariff, so check both before you rely on it.

Why is my Auslandsreisekrankenversicherung not always enough?

A German annual travel policy is excellent value for short holidays, but it is designed around trip limits. The Verbraucherzentrale notes that annual contracts cover each trip only up to six or eight weeks, depending on the policy. A three month visit to family on an ESTA can exceed that limit.

Check three things in your policy wording: whether the USA is inside the area of cover or needs a separate tariff, what happens to cover once a trip passes the limit, and whether repatriation is paid when it is medically reasonable or only when it is medically necessary. The Verbraucherzentrale recommends policies that pay for a medically reasonable return. If your policy passes all three checks and your stay fits inside its limit, you may not need a US visitor plan at all.

Do I need travel insurance for ESTA?

No. The ESTA application and the Visa Waiver Program rules do not ask for proof of health insurance. Our guide do I need travel insurance for ESTA covers this in detail. The Auswärtiges Amt still advises every traveler to confirm cover that includes a medical flight home, and warns that without it, treatment and hospital costs are yours to pay.

Plan the ESTA itself early. It requires an electronic passport, allows up to 90 days per visit, and stays valid for two years or until your passport expires. The fee rose to $40 on September 30, 2025, and the law requires annual inflation adjustments, so check the current fee on the official ESTA site before you pay.

Which US visitor plans can German residents buy?

The plan catalog Ombrela uses is specific here. German residents can buy IMG's Patriot Lite, Patriot Plus and Patriot Platinum, which use the UnitedHealthcare PPO network, and IMG's Visitors Care, a limited plan that pays fixed amounts per service. Our comparison of Patriot America Lite vs Plus explains the differences between the first two.

Two families of plans are off the table. Trawick's Safe Travels plans list Germany among excluded home countries, and WorldTrips' Atlas plans cannot be sold to anyone physically located in Germany at the time of purchase. If a comparison site shows you those plans, check eligibility before paying.

Two details matter if you already hold a German policy. Patriot coverage begins once you have left your home country, so it does not cover anything at home before departure. And IMG's certificate pays in excess of other coverage, so if your German policy also responds, IMG may ask for its decision first.

How high should your policy maximum be for US costs?

US hospital charges can be very high, and a single admission can exhaust a low limit. Use the medical cost estimator to test a few scenarios for the cities you will visit, then pick a maximum that covers a hospital stay, not just a doctor's visit.

Age changes what is possible. IMG's certificates for Patriot Lite and Plus offer up to $1,000,000 through age 69, but only $50,000 or $100,000 from 70 to 79 and $10,000 from 80. Visitors Care pays fixed amounts per service, which may not match US bills. If you are 70 or older, compare those limits with a German long stay tariff (Langzeit Auslandskrankenversicherung) as well; Ombrela does not sell those, but they may fit better.

How should you pack prescriptions for a US trip?

CBP advises visitors to carry medication in its original container with the doctor's instructions on it, or to bring a copy of the prescription or a doctor's letter, and to bring no more than a 90 day supply. The medication must be legally prescribable in the United States. The Auswärtiges Amt suggests getting your doctor's confirmation in English. Pack medicines in your carry on, not in checked luggage.

Download our free USA Trip Medical Checklist for Travelers from Germany below. It turns these steps into a printable list, from checking your German policy to saving assistance numbers before you board.

How to get covered

Premiums depend on age, trip length, maximum and deductible. Enter Germany as your home country on the visitor insurance quote page and you will see only plans you are eligible to buy.

Frequently Asked Questions

Does the European Health Insurance Card work in the USA?

No. The EHIC works in EU and EEA countries and a few others with agreements. In countries without a health care agreement, such as the United States, statutory insurance generally does not pay, apart from the narrow six week exception in section 18 of the Social Code Book V. You need a private travel medical policy that covers the whole stay.

Is my German annual travel policy enough for a two month US trip?

It depends on the wording. The Verbraucherzentrale notes annual policies cover each trip for six or eight weeks, depending on the contract, so a two month trip may already exceed a six week limit. Check the maximum trip length, whether the USA is included, and whether cover continues after the limit, before relying on it.

Can I buy US visitor insurance after I arrive?

Some plans allow it; the catalog lists Patriot plans as purchasable after arrival. Coverage begins on the effective date, so any illness that started earlier is not covered, and conditions from before the policy fall under the pre-existing condition rules. Buying in Germany before you fly keeps the whole journey covered.

How long can I stay in the USA on an ESTA?

Up to 90 days per visit under the Visa Waiver Program, for tourism or business. The ESTA remains valid for two years or until your passport expires, whichever comes first. Longer stays need a visa. Match your insurance to the actual length of each visit.

Check your German policy first, then compare the US visitor plans you are eligible for on the visitor insurance page and choose a maximum that fits US hospital costs.