Travel Insurance for USA from Canada

If you insure one trip in your life, make it a trip to the United States. That’s not marketing; it follows from two facts. OHIP pays nothing for emergency care outside Canada, having ended its small out-of-country reimbursement program at the start of 2020. And American healthcare is priced higher than anywhere else in the world, so the gap OHIP leaves is at its widest exactly where Ontarians travel most.

For a Canadian visitor, that combination means a twisted ankle in Orlando, a chest-pain scare in Myrtle Beach, or a child’s ear infection in Lake Placid produces a bill that is entirely yours unless a travel medical policy picks it up. The good news is that U.S. coverage is straightforward to buy and, for most travellers, inexpensive relative to the trip.

This guide is written for the ways Ontarians actually go south: a week in Florida with the kids, a hockey tournament in Syracuse, a weekend of shopping in Watertown, a golf trip to Arizona, a business conference in Chicago, and a five-month snowbird winter. It covers what U.S. emergencies really cost, what a good plan must include, the traps specific to the U.S., entry and length-of-stay rules, and what you can expect to pay.

What healthcare in the United States costs a visitor

We don’t need invented figures to make the point. American hospitals set their own list prices, which are the ones charged to uninsured foreigners, and those prices are dramatically higher than the cost of equivalent care in Canada. Some markers that hold across the country:

• An emergency room visit for something minor is commonly billed in the low thousands of dollars once the facility fee, physician fee and any imaging are added.
• A hospital admission for a few nights is commonly in the tens of thousands.
• Surgery, intensive care, or a cardiac procedure can run well into six figures.
• Ground ambulance is billed separately, often in the low thousands; air ambulance back to Canada can cost more than a new car.
• Prescriptions filled in the U.S. during an emergency are priced at U.S. retail, which for some drugs is several times the Canadian price.

There’s also a practical wrinkle. U.S. emergency departments must stabilise anyone with an emergency condition, but once you’re stable, hospitals generally want proof of insurance or a payment guarantee before admitting or operating. Without a travel insurer’s assistance line to provide that guarantee, you may be asked for a credit card deposit or transferred to a public facility.

Our article on what OHIP does not cover sets out the provincial side of this; for the U.S., the short version is that OHIP pays nothing.

What U.S. claims usually look like

People imagine travel insurance claims as dramatic accidents. Most U.S. claims from Canadian travellers are ordinary medical events that happen to occur across the border:

• Falls and fractures: a slip on a hotel pool deck, a wrist broken on a ski hill in Vermont, a hip fracture in a Florida condo
• Cardiac and stroke symptoms: chest pain that turns out to be nothing still means an ER work-up; chest pain that turns out to be something means a catheterisation lab
• Infections and illness: pneumonia, kidney infections, severe flu, a bad reaction to food
• Children’s urgent care: ear infections, croup, a cut needing stitches, a suspected concussion at a sports tournament
• Sports and recreation injuries: golf-cart accidents, boating, cycling, theme-park incidents
• Dental emergencies: a cracked tooth or an abscess; most plans include a modest emergency dental benefit

None of these require bad luck of an unusual kind. They require being human for a week somewhere expensive.

What a good U.S. travel medical plan includes

Not every plan is equal for the United States. Look for these features when comparing.

Feature	Why it matters in the U.S.
Medical limit in the millions	U.S. bills can exhaust a low limit quickly; most Canadian plans offer several million per trip
24/7 assistance line with direct billing	The assistance company guarantees payment so the hospital admits and treats you without a deposit
Air ambulance and repatriation	Getting you home to an Ontario hospital once stable is often cheaper for the insurer and better for you
Return of vehicle	If you drove down and can’t drive back, the plan pays to bring the car home
Family transportation	Flies a family member to your bedside if you’re hospitalised alone
Emergency dental	A modest benefit for pain relief or injury to natural teeth
Prescription drugs during the emergency	Covers medications related to the covered event
Stability period you can meet	Commonly 90–180 days; pick the plan whose period fits your health, not the cheapest
Explicit U.S. coverage	Some plans are priced “worldwide excluding the U.S.”; make sure yours includes it

The assistance line is the feature people undervalue until they need it. Call it before treatment whenever possible. Many policies reduce benefits if you don’t, and the assistance company will direct you to a hospital in its network, arrange payment, and, if you’re admitted, monitor your care and plan the trip home.

Coverage traps specific to the United States

U.S. pricing. Insurers price U.S. trips higher than trips elsewhere, and some plans exclude the U.S. by default at a lower premium. If you’re buying an annual plan for Europe and Mexico but might do a weekend in Buffalo, make sure the U.S. is included.

Pre-existing conditions. The stability period is the leading cause of denied claims anywhere, and in the U.S. the amounts at stake make it worse. A blood pressure or diabetes medication change in the months before departure can void coverage for anything related. Our guide to travel insurance with pre-existing conditions explains how to choose a plan that fits your health.

Credit card caps. Card medical coverage often caps trips at a short number of days and shortens further at 65. Fine for a long weekend in New York; not for a month in Florida. Our article on credit card travel insurance shows how to check your certificate and when a top-up is needed.

Alcohol and impairment. Most plans exclude claims arising from intoxication. A fall after a long evening at a Nashville bar can be contested.

High-risk activities. Motorcycle riding, scuba diving beyond a set depth, mountaineering, and some contact sports are excluded or require a rider on many plans. Ski patrol rescue is usually fine; heli-skiing usually isn’t.

Trips already in progress. Buy before you cross. Most plans cannot be purchased once you’ve left Ontario, and those that can impose a waiting period.

Calling too late. Check whether your plan reduces benefits if you don’t contact the assistance line within a set time of seeking treatment. Save the number in your phone before you leave.

Ottawa-area day trips and frequent crossings

Ottawa sits an hour or so from the border at Cornwall, Prescott and Ogdensburg, and many families cross regularly for shopping in Watertown or Syracuse, tournaments and camps in upstate New York, skiing at Lake Placid or Whiteface, or a weekend in Burlington, Vermont. Every one of those crossings has zero OHIP coverage.

For frequent crossers, an annual multi-trip plan is the practical answer. One premium covers unlimited trips up to a set length (often 15 or 30 days each), so a spontaneous Saturday across the bridge is insured without a purchase every time. Our comparison of annual vs. single-trip travel insurance shows where the break-even sits; for most people who cross more than twice a year, the annual plan wins.

Entry rules, length of stay, and the 212-day question

Three separate rules apply to Canadians visiting the U.S., and they get muddled together.

Entry. Canadian citizens generally need a valid passport, or an accepted alternative such as a NEXUS card at land and sea crossings. U.S. requirements, including registration rules for longer stays, have changed in recent years, so check the Government of Canada travel advice page for the United States before you go, particularly for a long visit. We don’t reproduce specifics here because they change.

Keeping OHIP. To stay eligible you must be physically present in Ontario for at least 153 days in any 12-month period, which allows up to 212 days away. Eligibility is not coverage: a snowbird who stays under 212 days still has no OHIP coverage in Florida. Our guide to whether OHIP covers travel has the details.

U.S. tax residency. Separately, the U.S. counts days of presence across a rolling period to determine whether a visitor is treated as a U.S. resident for tax purposes. Many snowbirds file an annual form to claim a closer connection to Canada. This is general information, not tax advice; if you spend months in the U.S. each year, confirm your position with an accountant who handles cross-border matters.

For long winters, our snowbird travel insurance guide covers long-stay plans, top-ups, and the stability-period issues that dominate at that stage.

What U.S. travel insurance costs

The following are illustrative ranges for a healthy traveller, single-trip emergency medical including the U.S., no deductible. They are not quotes; your price depends on exact age, health answers, insurer and plan limits.

Traveller	7 days	14 days	30 days
Healthy adult, 35	$20–$45	$40–$70	$70–$130
Healthy adult, 55	$35–$75	$65–$130	$130–$260
Healthy adult, 70	$80–$160	$150–$300	$300–$600
Family of four, parents 40, kids under 18	$50–$110	$90–$190	$170–$350

Trip cancellation for the prepaid, non-refundable portion adds roughly 4–10% of the insured trip cost. Our full breakdown of travel insurance cost in Canada covers annual plans, snowbird plans and the levers that lower the price, such as deductibles.

Before you cross: a short checklist

• Policy bought, with the U.S. explicitly included
• Every traveller named on the policy, including the kids
• Medical questionnaire answered completely, and no medication changes since
• Assistance line number saved in your phone and written on a card in your wallet
• Policy number and insurer name shared with your travelling companion
• Passport or NEXUS card, and current entry rules checked
• Your regular prescriptions packed in original containers, with enough for the trip plus a buffer

How Hayes can help

We’re an independent brokerage in Ottawa, and U.S. trips are the most common travel coverage we arrange. We compare travel insurance from Canada’s major travel insurers and match the plan to the trip: a single-trip policy for the Florida week, an annual plan for the family that crosses at Prescott every month, a long-stay plan with the right stability period for the snowbird winter. If you have a health condition, we’ll tell you plainly which insurers will cover it.

Our advice is free; insurers pay us. Get a U.S. travel insurance quote in about two minutes, or contact us before your next trip south.