Do I need travel insurance for Europe?

Short answer: if you need a Schengen visa to enter Europe, travel insurance is legally required — at least €30,000 in medical coverage, valid across the whole Schengen area for your entire stay. If you're a US citizen traveling visa-free for under 90 days, it's not required by law. But "not required" and "not needed" are very different things.

Your US health insurance generally doesn't cover you abroad. Medicare covers nothing outside the US. A single emergency — a broken leg on a cobblestone street, an emergency evacuation from a remote area — can cost tens of thousands of dollars out of pocket. Travel insurance for Europe is cheap relative to that exposure, typically a few percent of your trip cost.

Here's how to think about it clearly.

When it's legally required: the Schengen visa rule

Under Article 15 of the EU's Schengen Visa Code, anyone who needs a Schengen visa must show proof of travel medical insurance before the visa is issued. The requirements are specific: minimum €30,000 in coverage for emergency medical treatment, hospitalization, and repatriation (including repatriation of remains), valid in all Schengen countries — not just your main destination — for the entire duration of the stay.

This applies to travelers from countries that require Schengen visas — much of Asia, Africa, and parts of Latin America and the Middle East. The Schengen area now covers 29 countries, including France, Germany, Italy, Spain, Greece, and the Netherlands; Croatia joined in 2023, and Bulgaria and Romania completed full integration in 2024-2025. Ireland remains outside Schengen with its own rules.

If this is you, don't treat the insurance as a formality. Consulates verify the certificate, and inadequate insurance is a common reason for visa delays or rejections. Get a compliant policy from a recognized insurer and make sure the certificate states the coverage amount, the Schengen-wide validity, and your name exactly as on your passport. Note that the requirement is denominated in euros — a USD-denominated policy is fine as long as the medical limit clearly meets or exceeds the €30,000 equivalent, which a $50,000 policy does with room to spare.

When it's not required: US visa-free travelers

US citizens don't need a Schengen visa for tourist stays under 90 days, and no proof of insurance is required at the border. That's not changing with ETIAS — the EU's new pre-travel authorization system expected to launch in late 2026. ETIAS is a pre-screening requirement, similar to the US ESTA, and it does not require proof of insurance. Border officials can ask about your plans, but there's no insurance mandate for visa-exempt travelers.

So legally, you're in the clear without a policy. The question becomes purely financial: can you comfortably absorb a medical emergency abroad? For most travelers, the honest answer is no, which is why travel insurance remains strongly recommended even when it's optional.

What your existing coverage actually does abroad

This is where assumptions get expensive. Medicare — Parts A and B — provides no coverage outside the United States, with only rare exceptions. If you're on Medicare and traveling to Europe, you effectively have no health coverage the moment you leave.

Employer and marketplace health plans vary. Some cover emergency care abroad and reimburse you later; many exclude international coverage entirely or cover only limited emergency stabilization. Even plans that "cover emergencies" abroad typically don't cover medical evacuation — getting you home or to an adequate facility — which alone can cost $25,000 to $100,000-plus depending on distance and medical needs.

Credit cards are the other pleasant surprise people over-rely on. Many premium travel cards include some trip protection — trip cancellation, lost baggage, sometimes emergency medical — but the medical limits are often low (tens of thousands, not hundreds), evacuation coverage may be absent, and the coverage only applies if you paid for the trip with that card. Read the actual benefits guide, not the marketing summary.

What good travel insurance covers

A solid travel insurance policy for Europe has two halves: medical and trip. The medical half covers emergency treatment, hospitalization, and medical evacuation/repatriation — this is the part that protects against catastrophe. Look for medical limits of at least $100,000 and evacuation limits of at least $250,000; the Schengen €30,000 minimum is a floor, not a target.

The trip half covers trip cancellation and interruption (reimbursing prepaid, nonrefundable costs if you have to cancel or cut the trip short for a covered reason), travel delays, missed connections, and lost or delayed baggage. If you've prepaid thousands in nonrefundable hotels, tours, or cruises, this half matters as much as the medical half.

Also check the fine print that actually gets used: pre-existing condition coverage (usually available if you buy within 14-21 days of your first trip payment), adventure activity exclusions (skiing, scuba, and similar may need a rider), and whether the policy is primary or secondary — primary pays first without involving your home insurer, which is simpler abroad.

What it costs and when to buy it

Travel insurance typically costs 4 to 10 percent of your total prepaid trip cost, depending on your age, trip length, and coverage levels. A $5,000 trip might cost $200 to $500 to insure. Medical-only policies — skipping the trip cancellation half — run cheaper and are worth considering if your bookings are refundable.

Timing matters. Buy soon after your first trip payment (first deposit or flight booking) to get the pre-existing condition waiver and to cover supplier default. You can usually buy up until the day before departure, but you lose those early-purchase benefits and the cancellation coverage for anything that happens between booking and purchase.

Annual multi-trip policies make sense if you travel internationally two or more times a year — they often cost little more than a single-trip policy and remove the per-trip decision entirely.

How to shop for the right policy

Start with a comparison marketplace rather than a single insurer's site — seeing several quotes side by side is the fastest way to learn what coverage levels cost for your specific trip. When comparing, line up the numbers that matter: emergency medical limit, evacuation limit, trip cancellation limit (usually 100 percent of insured trip cost), interruption limit, and the deductible.

Then read the exclusions before you read the marketing. Common exclusions include traveling against medical advice, incidents involving alcohol, high-risk activities without a rider, and — critically — the definition of "covered reasons" for cancellation. "Cancel for any reason" upgrades exist and typically reimburse 50 to 75 percent of trip cost; they're expensive add-ons, but for uncertain plans (a health situation that might flare up, work that might intervene), they can be worth it.

Check the insurer's claims reputation, not just the price. A cheap policy from a company known for slow or adversarial claims handling is a bad deal. Look for recent customer reviews specifically about claims, and confirm the policy includes 24-hour emergency assistance — a phone number you can call from a hospital in another country matters more than most line items.

Finally, keep your documentation accessible while traveling: the policy number, the emergency assistance number, and the claims filing instructions saved on your phone and shared with a travel companion. The best policy in the world doesn't help if nobody can find it at 2 a.m. in a foreign emergency room.

When you might reasonably skip it

Insurance is about transferring risk you can't comfortably absorb. You might reasonably skip a full policy if: your trip is short and cheap with fully refundable bookings, you have strong existing international coverage through an employer plan or premium card (verified, not assumed), you're young and healthy traveling to countries with excellent, affordable healthcare — and even then, evacuation coverage alone is worth pricing.

What's never reasonable is assuming "nothing will happen" as a strategy. Travelers get injured doing ordinary things — slipping on wet stairs, food poisoning, a twisted ankle on a hike. European hospitals will treat you, but as a non-resident you'll generally be expected to pay, sometimes upfront.

Also consider who's traveling. Older travelers face higher medical risk and higher premiums — but also higher potential bills, which is exactly when insurance earns its keep. Travelers with known conditions should prioritize the pre-existing condition waiver by buying early. And if you're traveling with kids, remember that pediatric emergencies abroad come with the same payment expectations — plus the added stress of navigating a foreign medical system while worried about your child, which is when that 24-hour assistance line proves its worth.

The calm takeaway: for visa-required travelers, it's mandatory — get a compliant €30,000-plus policy and move on. For everyone else, it's one of the cheapest forms of financial protection you can buy for a European trip. Price a policy, read what your card and health plan actually cover, and make the decision with real numbers instead of assumptions.