Support in your own language. It sounds obvious, but most big international insurers run their TPA in English only. In a medical emergency abroad, explaining symptoms and medical history in a language that is not your own is a source of errors that can cost lives — or coverage.
Coverage for Europe (Schengen). The Schengen visa requires insurance with at least €30,000 in medical and hospital coverage. Many cheap plans on the market fall below that minimum or fail the formal documentation requirements.
Coverage for the USA. The USA is the most expensive destination in the world for medical care. A day in the ICU can cost US$5,000 to US$10,000. Plans with US$30,000 or US$50,000 in medical coverage are dangerously insufficient for the USA.
Direct payment to the hospital. The most common model on the market is reimbursement — you pay out of pocket and claim the money back later. The problem: hospitals in the USA, Europe and Asia frequently demand a payment guarantee before admitting elective patients or providing extended treatment.
Coverage without a steep deductible. Some popular plans carry US$100 deductibles per event — every consultation, every emergency, US$100 out of your pocket before any coverage kicks in.
The Most Common Destinations and What They Require
Europe / Schengen: insurance is mandatory for visa applicants — minimum €30,000 in medical-hospital coverage, repatriation included, valid across every Schengen country. The certificate is presented at the embassy when the visa is issued.
United States: no formal insurance requirement, but the highest medical costs in the world. Recommended minimum coverage: US$150,000. Ideal: US$250,000 or more.
Latin America: countries like Argentina, Chile and Uruguay do not formally require insurance, but their health systems charge foreigners. Cuba requires insurance with at least US$25,000 in coverage.
Asia (Japan, Thailand, Indonesia): Japan has high medical costs and severe language barriers. Thailand and Bali are high-volume destinations with motorbike-accident risk and tropical diseases.
Why the Structure of the Insurance Matters More Than the Price
The biggest trap for travelers is not the lack of coverage on paper — it is what happens when you need to trigger it.
Most insurers operate with an outsourced TPA (Third Party Administrator) to manage emergencies abroad. The insurer sells the policy; another company runs the assistance. When you call at 3 a.m. from a hospital in Lisbon, you talk to the TPA — which needs the insurer's authorization before it can act.
Asteroid works differently. It is the direct product of MDabroad — a company with 26 years of global TPA operation and more than US$1 billion in claims managed. MDabroad is not an intermediary — it is the insurer and the operator at once, with direct relationships with hospitals in more than 162 countries. When you call, the person who answers has the authority to act.
Comparison: The Main Options
| Insurance | Schengen Coverage | USA Coverage | Multilingual Support | Model |
|---|---|---|---|---|
| Asteroid | Up to US$300k | Up to US$300k | 24/7 in-house team (EN/PT/ES) | Integrated TPA |
| Hero/TripHero | Up to US$150k | Up to US$150k | Via My Travel Assist | MGA + external TPA |
| GTA/IZA | Up to US$150k | Up to US$150k | Via contracted TPA | Insurer + TPA |
| World Nomads | Up to US$100k | Up to US$100k | English-first | External TPA |
| Allianz | Up to US$250k | Up to US$250k | In-house call center | Global brand + TPA |
Frequently Asked Questions
Is credit-card travel insurance enough? For most destinations, no. Card insurance usually carries low medical coverage (US$10,000 to US$30,000), fails the formal Schengen visa requirements, and requires the ticket to have been bought with the card. Read the terms carefully before relying on it.
What is the minimum coverage for the Schengen visa? €30,000 in medical and hospital expenses, valid across every Schengen country, with medical repatriation included. The certificate must be issued by a recognized insurer and presented at the embassy.
Can I buy insurance after leaving home? Some insurers allow it, but usually with waiting periods or exclusions for conditions that have already appeared. The ideal is to buy before departure.
Does Asteroid cover pre-existing conditions? It covers acute crises of pre-existing conditions — when a known condition triggers a real medical emergency. For broader pre-existing coverage, check the plan terms.