Travel Insurance for Europe from Canada

You don’t need travel insurance to get into Europe. You do need it to avoid paying a European hospital out of your own pocket, and to avoid the far larger bill of getting yourself home if something serious happens.

That’s the honest summary. OHIP pays nothing outside Canada, European public health systems are for their own residents, and the idea that “health care is cheap over there” is only half true. Routine care often is. Intensive care, surgery and a medical flight to Ottawa are not.

This guide is for Ontarians planning a European trip of any shape: a two-week rail loop, a family reunion in Portugal, a ski week in the Alps, a river cruise, or a long spring visiting grandchildren in London.

Do Canadians need travel insurance to enter Europe?

For tourism, no. Canadian passport holders can visit the Schengen area (most of the EU plus Switzerland, Norway, Iceland and Liechtenstein) without a visa for up to 90 days in any 180-day period. The well-known Schengen insurance requirement, a minimum of €30,000 in medical coverage, applies to travellers who must apply for a Schengen visa. Canadians visiting as tourists are exempt from that requirement.

Two administrative changes are worth knowing about:

• The EU has been rolling out an Entry/Exit System that registers non-EU travellers electronically at the border, with its ETIAS travel authorisation for visa-exempt visitors scheduled to follow. Neither requires proof of insurance. Check the official EU website for the current status before you fly, since launch dates have shifted.
• The United Kingdom is outside Schengen and now requires Canadians to hold an Electronic Travel Authorisation (ETA) before boarding. No insurance requirement, but you can’t board without it.

Longer stays are different. Student visas, working-holiday permits and residence permits in many European countries do require proof of health insurance meeting the country’s rules. If that’s your situation, read our guide to travel insurance for students abroad and confirm the exact requirement with the consulate.

What OHIP pays for in Europe: nothing

Ontario ended its out-of-country traveller program on January 1, 2020. Since then OHIP has paid nothing toward emergency physician or hospital care outside Canada, apart from narrow prior-approval programs for planned treatment. Our article on whether OHIP covers travel walks through the details.

Europe adds a second wrinkle. Some Canadians assume that because European countries have universal public health care, a visitor will be treated for free. Not for non-residents. The European Health Insurance Card (EHIC) that lets an Italian get care in Spain is only for residents of the EU, EEA and Switzerland, and Ontario has no reciprocal health agreement with any European country. You will be treated as a private, paying patient.

What medical care actually costs in Europe

This is where Europe genuinely differs from the United States, and it’s why premiums for Europe are generally lower than for U.S. trips.

Everyday care is usually affordable. A doctor’s visit, a prescription for an infection, or a few stitches in an emergency department will typically cost a fraction of the U.S. equivalent. Many travellers pay on a credit card and claim it back afterward.

Hospital admissions are not cheap. A multi-day admission for pneumonia, a broken hip after a fall on cobblestones, or a cardiac event can produce a bill in the tens of thousands of dollars, especially in private hospitals and higher-cost countries such as Switzerland, Norway and the UK. Public hospitals in many countries also bill non-residents at full rates.

Getting home is the big one. If you’re hospitalised and can’t fly commercially, the options are a medical escort on a scheduled flight, a stretcher on a scheduled flight, or a dedicated air ambulance. A transatlantic air ambulance can reach well into six figures. It’s the single biggest reason to insure a European trip properly, and no amount of “cheap European health care” reduces it.

Travel insurance for Europe: what to include

A good policy for a European trip usually combines emergency medical coverage with some non-medical protection. Here’s what matters and why it matters specifically in Europe.

Coverage	Why it matters for Europe
Emergency medical (commonly $1 million to $10 million)	Hospital, physician, diagnostics and emergency prescriptions; the high limit is really there for the repatriation flight
Medical repatriation and air ambulance	The transatlantic flight home is the largest potential cost of the trip
24/7 assistance line	Finds an appropriate hospital, guarantees payment and handles language barriers
Trip cancellation	European trips are often prepaid months ahead: flights, tours, rail passes, river cruises, villa rentals
Trip interruption	Pays to get you home early and reimburses the unused portion of the trip
Baggage and personal effects	Theft from luggage, trains and cafés is a real risk in major European cities
Travel delay	Strikes and weather disrupt European flights and rail more often than many Canadians expect

The pre-existing condition stability clause applies to all of it. Most plans cover a condition only if it has been stable, with no changes in symptoms, treatment or medication, for a set period before departure, commonly 90 to 180 days. If you take regular medication, read our guide to travel insurance with pre-existing conditions before you buy.

Multi-country trips, trains and rental cars

Most European trips cross borders. Canadian travel medical plans are priced by destination category, not by country, so a trip through France, Italy, Austria and the UK needs one policy, and you don’t need to list every stop.

Two exceptions to watch:

• U.S. stopovers. If your itinerary includes a night or more in the United States on the way there or back, say so. Many plans have a separate, higher price for trips that include the U.S., and an emergency in a U.S. airport hotel is a U.S. claim.
• Trip length. Annual multi-trip plans cap each trip at a set number of days, often 15, 30 or 60. A six-week grand tour may need a single-trip policy or a top-up. Our comparison of annual vs. single-trip travel insurance explains how to choose.

Rental cars. Travel medical insurance doesn’t cover damage to a rental car. That’s handled by the rental company’s collision damage waiver, by some credit cards, or occasionally by a rider on a package plan. Some cards exclude certain countries or vehicle types, so check before you decline the waiver.

Flight disruptions. Flights departing an EU airport, and flights into the EU on an EU carrier, fall under the EU’s passenger rights rules, which can require the airline to compensate you for long delays and cancellations within its control. That’s separate from, and in addition to, the delay and interruption benefits in your policy. Keep every receipt and boarding pass.

Skiing, hiking and other European activities

A surprising number of European claims involve activities, and activity exclusions are where travellers get caught.

• Downhill skiing and snowboarding on marked runs are covered by most standard plans. Off-piste skiing, heli-skiing and ski touring frequently are not, or need a sports rider.
• Mountain rescue in the Alps can involve a helicopter, and in some countries the rescue itself is billed separately from hospital care. Make sure the plan covers emergency evacuation from the mountain, not just transport between hospitals.
• Hiking and via ferrata are usually fine at ordinary altitudes, but some plans exclude trekking above a set elevation or climbing that requires ropes.
• Scooters and motorcycles. Many plans exclude injuries while operating a motorcycle or scooter, or cover them only if you hold a valid licence for that vehicle and wear a helmet. That Vespa in Rome may not be covered.
• Alcohol. Injuries that occur while intoxicated are commonly excluded.

If any of these are on your itinerary, tell your broker. Some insurers include a broader activity list than others, usually for little extra.

Older travellers and longer European stays

Europe is a favourite for retirees, and retirees are the group most affected by two things: age-based pricing and stability periods.

Premiums rise steadily with age and step up more sharply after 70, when most insurers also introduce a medical questionnaire. The questionnaire is binding; a wrong answer can void the policy. Our guide to travel insurance for seniors covers how to answer it accurately.

For longer stays, remember that OHIP eligibility requires you to be physically present in Ontario for at least 153 days in any 12-month period. A three-month spring in Portugal is fine; a longer absence may need advance approval from ServiceOntario. Eligibility keeps your coverage at home. It still pays nothing in Europe.

What travel insurance for Europe costs

The following are illustrative ranges only, for emergency medical coverage on a 14-day trip to Europe (no U.S. travel), for a healthy traveller with no medical questionnaire issues. Your rate depends on age, health, trip length, deductible and insurer, and prices change.

Traveller	Indicative cost, 14 days, medical only
Healthy adult, age 30–39	Roughly $35–$70
Healthy adult, age 50–59	Roughly $55–$110
Healthy adult, age 65–69	Roughly $90–$200
Healthy adult, age 75–79	Roughly $180–$400
Family of four, parents in their 40s	Roughly $80–$160

Adding trip cancellation, interruption and baggage typically costs several percent of the insured trip cost, often in the range of 4% to 8%, and rises with age. For a $10,000 prepaid European tour, budget a few hundred dollars for an all-in package, against the deposit you’d lose if a family emergency stopped you from travelling. Our article on how much travel insurance costs in Canada goes deeper on what moves the price.

How to avoid a denied claim on a European trip

Most travel claim disputes come down to a handful of avoidable mistakes:

1. Call the assistance line before non-emergency treatment. In a true emergency, get care first and call as soon as you can. Otherwise the insurer will direct you to a hospital it can pay directly, which also spares you a language problem at the billing desk.
2. Keep every document. Itemised bills, prescriptions, discharge notes and receipts. Ask for an itemised invoice before you leave the hospital.
3. Report theft to the police. Baggage and personal effects claims almost always require a police report from the country where the theft happened. Get it the same day.
4. Answer the medical questionnaire completely. Check medication names and dates with your pharmacy rather than relying on memory.
5. Buy before you leave Ontario. Most plans can’t be purchased or extended once you’re abroad, and cancellation coverage only protects you if it’s bought before the event you need to cancel for.

How Hayes can help

We compare travel insurance from Canada’s major travel insurers and match the plan to your itinerary: the countries you’re visiting, how long you’re away, what you’re doing while you’re there and what you’ve prepaid. If you have a health condition, we’ll tell you which plans will cover it under their stability rules and which won’t. Our advice is free; the insurer pays us.

Heading to Europe? Get a free travel insurance quote in about two minutes, or contact us if you’d rather talk your trip through first.