CompareAll Business InsuranceCompare Business InsuranceOverseas Visitor CoverAll LoansCompare Loans
Travel insurance for the USA is about one thing above all: medical costs. Smartraveller says US hospital standards are similar to Australia's but medical costs are significantly higher, that a doctor's visit for a minor issue can cost thousands of dollars, and that there is no reciprocal health care agreement, so Medicare will not help. Buy a policy with the highest overseas medical limit you can get, ideally unlimited, and make sure the region includes the Americas.
The US is also where region settings trip people up. A policy priced for Asia or Europe does not cover a stopover in Los Angeles or a week in Hawaii, and those are exactly the places where an uninsured hospital stay is least survivable.
By Better Rate Mate Editorial Team ยท Last reviewed
As at 28 September 2026, Smartraveller's advice for the United States (page updated 26 September 2026) is to exercise normal safety precautions, with no higher regional levels. Level 1 means the security situation is comparable to a large Australian city. It does not change the cost of medical care, which is the risk that matters most for insurance.
There is no public system you can fall back on as a visitor. Smartraveller notes you may be asked for proof of insurance or ability to pay before treatment, and the cost of an emergency admission, surgery or an air ambulance can exceed what most households could pay. Its advice for the US is that your insurance should cover pre-existing conditions, all planned activities and medical evacuation.
Many comprehensive policies offer unlimited overseas medical cover; others set a dollar cap or a time limit on ongoing treatment. For the US, choose unlimited where you can, and check any time limit and the sub-limits for dental and for evacuation.
| Risk | Why it matters in the US | What to check in the PDS |
|---|---|---|
| Hospital and emergency care | No reciprocal agreement and very high costs | Unlimited or high medical limit; any time cap on treatment |
| Medical evacuation | Getting you home on a stretcher or with a medical escort is expensive | Evacuation included in the medical benefit and approval rules |
| Pre-existing conditions | An undeclared condition can make a US hospital bill yours | Every condition declared and accepted in writing |
| Stopovers and side trips | Any time in the US needs an Americas region | Region covers every country, including transit |
| Driving and hire cars | Licence rules vary by state and rental company | Rental vehicle excess cover and licence conditions |
| Hurricanes and wildfires | Can cancel flights, cruises and accommodation | Known-event rule and cancellation reasons |
Insurers price the Americas separately because of US medical costs. Your policy's region has to include every country you visit, including stopovers and transits, so a flight to Europe or Mexico through a US airport, a US port on a cruise, or a detour to Hawaii all need the Americas included. On an annual multi-trip policy, set the region for the most expensive destination you might visit during the year.
Australians can usually visit the US for tourism or business for less than 90 days under the Visa Waiver Program with an approved ESTA (Electronic System for Travel Authorization). Smartraveller notes approval can take up to 72 hours, an ESTA is valid for 2 years for multiple entries on the same passport, and a Visa Waiver Program stay generally cannot be extended beyond 90 days. Apply only through the official US Government site.
Travel to Cuba since 12 January 2021, or to Iran and certain other listed countries since 1 March 2011, makes you ineligible for the Visa Waiver Program, so you would need a visa. Smartraveller also notes that officials may inspect your devices, and that foreign nationals aged 14 or over staying more than 30 days must register.
Some US states accept an Australian licence for a limited time, while others, and some rental companies, require an International Driving Permit. Smartraveller advises getting an IDP before you leave Australia, and warns that driving without a required IDP can void your travel and vehicle insurance. Carry your physical licence, as digital licences are not widely accepted. To ride a motorcycle you need a motorcycle licence or IDP, and you should check your policy covers motorbikes, quad bikes, e-bikes and e-scooters before you hire one.
Smartraveller lists hurricanes, tornadoes, wildfires, earthquakes and winter storms among US hazards, with hurricane risk running from May to November. Smartraveller's US page, updated 26 September 2026, notes that after Hurricane Lowell the Hawaii Tourism Authority urged travellers to postpone trips to Kauai: exactly the kind of event that becomes a known event for any policy bought afterwards. Buy cover when you book so cancellation cover is in place before the weather turns.
Many Australians join cruises in the US, to Alaska, the Caribbean or Mexico. Smartraveller's advice is to choose a policy that covers you for cruising and any activities you do on shore. That usually means adding a cruise option and checking the region covers every port of call.
It is not an entry requirement, but travelling without it is a serious financial risk. There is no reciprocal health care agreement, Medicare does not cover you, and Smartraveller says a doctor's visit for a minor issue can cost thousands of dollars.
As much as you can get. Many comprehensive policies offer unlimited overseas medical cover, which is the safest choice for the US. If a policy caps medical cover, check the cap, any time limit on treatment and the evacuation terms.
Yes. The policy's region must cover every country you visit, including transits and stopovers, so time in the US usually means choosing a region that includes the Americas.
Australians visiting for less than 90 days under the Visa Waiver Program need an approved ESTA before travel. It can take up to 72 hours to approve and is valid for 2 years on the same passport. Some past travel, such as to Cuba or Iran, makes you ineligible.
Some states and rental companies require one. Smartraveller advises getting an IDP before leaving Australia, and warns that driving without one where it is required can void your travel and vehicle insurance.
