Do you need travel insurance for the USA?

Of all the destinations an Ontarian might visit, the United States is the one where travel insurance matters most. The reason is simple: US healthcare is the most expensive in the world, and OHIP will not pick up the bill. Even a short cross-border trip carries real financial risk without coverage.

Why the USA is the highest-stakes destination

American hospitals charge more than almost anywhere else. An emergency room visit, a few days as an inpatient, surgery, or an air ambulance can each generate bills running into five or six figures. These are not worst-case exaggerations; they are ordinary US prices. Because the cost base is so high, the USA is the single most important place to carry adequate emergency medical coverage.

What OHIP actually covers

Many travellers assume their provincial plan follows them south. It does not. Most out-of-country OHIP coverage ended in 2020, and even before that it reimbursed only a small fraction of foreign costs. Critically, OHIP never pays a foreign hospital up front — you would be billed directly and left to seek any minimal reimbursement afterward. Against US prices, that gap is enormous, and it is exactly what travel insurance is built to close.

What to look for in US coverage

When insuring a trip to the USA, focus on:

• A plan that includes the USA. Choose worldwide-including-USA coverage, or a plan priced for US travel, rather than an excluding-USA plan.
• A sufficient coverage amount. US bills are high, so the emergency medical limit should reflect that reality.
• Clear pre-existing condition terms. Understand any stability period so a disclosed condition stays covered.
• 24/7 assistance. Round-the-clock help matters when navigating an unfamiliar, costly health system.

Age and health

There is no age limit on emergency medical coverage. Travellers under 60 answer no medical questions. Travellers 60 and over complete a medical questionnaire that sets the premium, not eligibility — so older travellers and those with managed conditions can always be covered. Because US care is expensive, this coverage is especially valuable for older travellers heading south.

Even short trips count

It is tempting to skip insurance for a day trip or a weekend across the border, but US prices do not scale down for short visits. An accident or sudden illness on a single-day shopping run can produce the same bill as one on a long holiday. A short-trip or single-trip plan is inexpensive for a day or weekend and is far cheaper than one uninsured emergency room visit.

Common US trips Ontarians make

The need applies across the full range of cross-border travel. A weekend shopping trip to Buffalo, a Florida winter stay, a business trip to New York, a family visit, a road trip or a US cruise departure all carry the same underlying risk, because US medical prices do not change with your reason for visiting. Snowbirds spending months in the US sunbelt face the longest exposure and should pay particular attention to their coverage amount and, if 60 or over, to completing the medical questionnaire accurately. Whatever the trip, the principle holds: in the USA, OHIP will not help and the bill is yours unless you are insured.

See your options

Travel insurance for the USA is not a formality — it is the difference between a manageable premium and a potentially ruinous hospital bill. The cost depends on your age, trip length, coverage amount and health, so the only way to see your real price is to compare your options with a quote before you cross the border.