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Travel insurance is one of the areas where US and EU policies differ significantly in pricing, coverage defaults, mandatory inclusions, and what is actually useful because of the underlying healthcare systems.
| Aspect | United States (US-issued policies) | European Union (EU/EEA-issued policies) | Key Practical Differences & Winner |
|---|---|---|---|
| Average Annual/Multi-trip Cost (family of 4, worldwide cover) | $400 – $1,200+ (Allianz, Travel Guard, World Nomads, IMG, etc.) | €120 – €450 (Allianz, AXA, Europ Assistance, ERV, HanseMerkur, etc.) | EU much cheaper (often 60-70% less for similar cover) |
| Average Single Trip Cost (2 weeks worldwide excl. USA) | $80 – $250 per person | €25 – €90 per person | EU wins on price |
| Medical Coverage Default | $50,000 – $1,000,000+ (very high limits are normal and heavily marketed) | €30,000 – €500,000 (lower limits common because public healthcare exists almost everywhere) | US over-insures medical; EU realistic |
| Why the medical difference matters | US citizens have no reciprocal health rights almost anywhere → need private-level medical cover + evacuation | EHIC/GHIC (for EU/UK citizens) + reciprocal agreements in many countries (Australia, etc.) → medical is often free or cheap at point of use | EU citizens need far less medical coverage when traveling → can buy cheaper policies |
| Repatriation / Evacuation | Always $500k–$1M+, heavily emphasized | €100k–€1M+, but less marketing hype because public systems often cover basic repatriation | Similar in practice |
| Trip Cancellation / Curtailment | Very generous ($5k–$50k per person), “cancel for any reason” (CFAR) add-on common (extra 40-50%) | Usually €2k–€15k per person; CFAR rare and expensive or unavailable | US far superior for expensive trips |
| Baggage / Personal Effects | $1,000 – $3,000 per person | €500 – €2,500 per person | US higher limits |
| COVID / Pandemic Coverage | Still explicitly listed by many providers (medical, quarantine, cancellation) | Mostly dropped or treated as any illness (2024–2025) | US more explicit |
| Pre-existing Medical Conditions | Strict 60–180 day look-back; waiver if bought within 14–21 days of initial trip deposit | Often 6–12 month look-back; some insurers (e.g., UK/Post Office) cover many conditions automatically | US more flexible with early-purchase waivers |
| Policy Validity / Territorial | Worldwide excluding or including USA/Canada as options (USA is the most expensive zone) | Worldwide excluding or including USA/Caribbean (same pricing logic, but lower baseline) | Same structure, EU cheaper even with USA included |
| Cross-border validity inside Europe | US policies work fine in Europe, but you pay US prices | EU policies automatically valid across all 27 EU + EEA + Switzerland (no extra charge) | EU wins for Europeans |
| Sports & Activities | Very detailed tiers (skiing, scuba, trekking >4,000m often extra) | Similar tiers, but winter sports often included in annual policies | Comparable |
| Age Limits | Many policies stop or load heavily at 70–80 | Annual policies routinely cover up to 85–99 with little or no loading (especially Germany, NL, UK) | EU much senior-friendly |
| Best Providers 2025 | Allianz, Travel Guard (AIG), World Nomads, IMG (iTravelInsured), Travelex, Berkshire Hathaway | Allianz, AXA Assistance, Europ Assistance, ERV (Germany), HanseMerkur, ADAC (Germany), CoverWise (Italy/UK) | Same big names, but local EU brands cheaper |
Quick Verdict (2025)
| Traveler Profile | Better Choice |
|---|---|
| US citizen traveling anywhere | Buy a US policy (you need the high medical limits & CFAR options) |
| EU/UK citizen traveling worldwide incl. USA | Buy an EU policy → same or better coverage for 50-70% less money |
| EU/UK citizen only traveling in Europe | Often just rely on EHIC/GHIC + credit-card insurance; top-up only if needed |
| Digital nomad / long-term travel (3-12 months) | World Nomads (Australian but popular globally) or SafetyWing (subscription model) often beat traditional policies from both regions |
If you tell me:
- Your nationality/residence
- Destinations (especially if USA/Canada included)
- Trip length & activities
- Age & any medical conditions
- Budget
I can give you exact 2025 quotes or the best current providers for your situation.
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