Travel Insurance for Europe: Who Needs It and What to Buy

Travel insurance for Europe is mandatory only if you need a Schengen visa. In that case your policy must provide at least EUR 30,000 of emergency medical and repatriation cover, be valid in all 29 Schengen countries, and run for your entire stay. If you travel visa free, as US citizens do on short trips, insurance is optional, but your US health plan and Medicare usually pay little or nothing abroad, so a travel medical policy is still worth carrying.

Key facts at a glance

• Article 15 of the EU Visa Code (Regulation 810/2009) requires Schengen visa applicants to hold travel medical insurance with a minimum coverage of EUR 30,000, valid throughout the Schengen area for the whole intended stay or transit.
• Under the same article, the policy has to cover urgent medical attention, emergency hospital treatment, repatriation for medical reasons and death.
• The European Commission says you can apply no earlier than 6 months and no later than 15 days before your trip, and lists the visa fee as EUR 90 for adults and EUR 45 for children aged 6 to 12.
• The Schengen area has 29 countries. Bulgaria and Romania became full members on 1 January 2025. Ireland is in the EU but outside Schengen, Cyprus was still completing its accession as of 1 October 2026, and the United Kingdom is in neither.
• Medicare.gov states that Medicare usually does not cover health care outside the United States, apart from a few narrow exceptions.
• According to GOV.UK, most visa exempt visitors to the United Kingdom, including US citizens, now need an Electronic Travel Authorisation, which costs GBP 20.

Do you need travel insurance for Europe?

It depends on your passport, not on where you live. If your nationality is visa exempt for the Schengen area, as US, Canadian, Australian and Japanese passports are, nobody at the consulate or the border will ask for an insurance certificate for a short visit of up to 90 days in any 180 day period.

If your nationality requires a Schengen visa, insurance is a formal part of the application. The consulate will not treat your file as complete without a certificate that meets the Visa Code rules, and a policy that falls short is one of the more avoidable reasons for a refusal. Our guide to Schengen insurance mistakes covers the common ones.

Either way, the practical argument is the same. European hospitals treat emergencies first and bill afterwards, and visitors who are not insured in an EU country are billed as private patients. The European Health Insurance Card only works for people insured in an EU or EEA country or Switzerland, so it does not help US residents.

Who needs Schengen compliant insurance if they live in the USA?

Many people living in the United States travel on passports that need a Schengen visa: Indian, Chinese, Filipino and many other nationals on H-1B, F-1 or L-1 status, and green card holders who have not naturalized. A US visa or green card does not exempt you. You apply at the consulate of the country where you will spend the most time, normally the one with jurisdiction over your US address, and you include an insurance certificate.

We have separate guides for H-1B holders, F-1 students and green card holders, and the visa insurance requirements tool shows the rule for your nationality and destination.

What must a Schengen insurance policy include?

The Visa Code sets the floor, and consulates check it line by line. Your certificate should show:

• A medical maximum of at least EUR 30,000. US dollar policies are generally accepted when the limit clearly exceeds that amount, so many applicants choose a maximum of USD 50,000 or higher to leave a margin for exchange rates.
• Coverage in every Schengen member state, not only the country you are visiting first.
• Dates that match the full trip on your itinerary. For a multiple entry visa, the Visa Code asks for cover for the first intended visit and a signed statement that you will insure later trips.
• Emergency medical treatment, hospitalization and repatriation, including repatriation of remains.
• Your name exactly as it appears in your passport.

Among the plans you can compare on Ombrela, the WorldTrips Atlas International plan details state that applicants buying for Schengen visa purposes should select a zero dollar deductible. That is a sensible default on any plan, because a consulate may question a certificate that leaves you paying the first part of a claim.

How do healthcare and insurance rules differ by country?

The EUR 30,000 rule is the same everywhere, but consulates and health systems are not identical. Each country's consulate in the US has its own appointment system, document checklist and preferences about how the certificate is worded, and the way a visitor is billed differs too.

• France: public hospitals bill visitors who are not insured in France or the EU directly. See Schengen insurance for a France visa.
• Germany: the German missions ask for proof of cover valid in all Schengen states for the full stay. See Schengen insurance for a Germany visa.
• Italy: emergency rooms use a triage code system, and cases judged not urgent can carry a charge. See Italy.
• Spain: popular with long stay visitors, and private clinics in resort areas usually expect payment or an insurer's confirmation. See Spain.
• Switzerland: in Schengen but not in the EU, and widely regarded as one of the more expensive places in Europe to receive care, so a higher policy maximum is worth considering. See Switzerland.
• Netherlands, Austria, Portugal and Greece: see the guides for the Netherlands, Austria, Portugal and Greece. Island and alpine itineraries make the evacuation benefit more relevant.

We do not quote treatment prices by country here, because hospitals set private patient rates individually. What matters for your decision is that a serious admission or an air ambulance flight home can exceed the EUR 30,000 minimum, which is why many travelers choose a higher limit than the visa requires.

Does one policy cover the UK, Ireland and other stops outside Schengen?

A Schengen visa and Schengen wording on a certificate do not extend to the United Kingdom or Ireland, which run their own border and visa systems. Neither country requires visitors to hold insurance for a short tourist stay. In England, GOV.UK guidance states that accident and emergency department treatment is free to everyone, but overseas visitors who are not exempt are charged 150 percent of the NHS cost for other hospital care, including care after admission.

The travel medical plans sold for Schengen purposes are usually worldwide policies that exclude only the United States and a short list of restricted destinations. The Atlas International and Patriot International plans in Ombrela's catalog work this way, so a single policy can cover London, Dublin and Paris on one trip. Check that your dates include the days outside Schengen, and remember that the UK now asks most visa exempt visitors for an Electronic Travel Authorisation before boarding.

Do ETIAS and the new border checks change the insurance rules?

No. The EU's Entry/Exit System, which registers the fingerprints and facial image of non EU visitors at the border, became fully operational on 10 April 2026 according to the European Commission, and the EU's guidance describes ETIAS as an online travel authorization for visa exempt travelers with a fee of EUR 20. The EU's published schedule points to the last quarter of 2026, with the exact date to be announced ahead of launch, so check the official EU travel site before you book.

Neither system adds an insurance requirement. ETIAS is a security screening, not a visa, and travelers who need a Schengen visa do not apply for it at all.

How much does travel insurance for Europe cost?

Premiums depend on your age, the number of days, the policy maximum and the deductible. Travel medical plans for Europe are priced per day and are generally a small part of a trip budget for younger travelers, rising with age. Plans that add trip interruption, trip delay or lost luggage benefits cost more than medical only plans. Live quotes are the only reliable way to see the price for your dates.

Be aware of eligibility limits. According to the plan catalog, Trawick's Safe Travels International plans are not available to residents of the United States, and the IMG and WorldTrips plans exclude residents or citizens of a short list of countries and cannot be purchased from some US states, including New York. The quote form filters these out for you.

To keep the paperwork straight, download our free Europe Trip Insurance Checklist below. It walks through whether you need a visa, the cover a consulate expects, notes for stops outside Schengen, and what your certificate must show before your appointment.

How to get covered

Enter your travel dates, age and country of residence on the Schengen insurance quote page to compare plans that meet the EUR 30,000 requirement. Choose a zero deductible, confirm the dates match your itinerary, and download the visa letter after purchase to include in your application.

Frequently Asked Questions

Is travel insurance mandatory for Europe?

It is mandatory only for travelers who need a Schengen visa. Article 15 of the EU Visa Code requires those applicants to show travel medical insurance with at least EUR 30,000 of cover, valid across the Schengen area for the whole stay. Visa exempt travelers, including US citizens on short visits, are not required to carry insurance, although it is strongly advisable.

Does my US health insurance work in Europe?

Often not in any practical way. Medicare.gov states that Medicare usually does not cover care outside the United States, and many employer and marketplace plans treat foreign care as out of network or limit it to emergencies that you pay for first and claim later. Ask your insurer in writing before you rely on it, and note that domestic plans rarely include medical evacuation.

Can I use one insurance policy for several European countries?

Yes. A Schengen compliant policy must be valid in all 29 Schengen countries by definition, and the travel medical plans sold for this purpose are typically worldwide policies that exclude the United States. That means the same policy can also cover stops in the United Kingdom or Ireland, provided your coverage dates include those days.

When should I buy insurance for a Schengen visa application?

Buy it before your consulate or visa center appointment, because the certificate is part of the application file. The European Commission says applications can be lodged from 6 months to 15 days before travel. Choose a plan that can be cancelled or have its dates changed if your visa is delayed or refused, and check the refund conditions and any cancellation fee.

Whether a consulate requires it or you simply want to avoid a private hospital bill abroad, compare Schengen compliant plans on Ombrela and have your certificate ready before you travel.