Updated April 2026
Cusco sits at 3,400m. Machu Picchu at 2,430m. The Inca Trail crosses passes up to 4,215m. Peru is a dream destination — and a place where altitude can kill if you do not prepare.
Is Travel Insurance Mandatory in Peru?
For most visitors: Not required by law. Many nationalities enter visa-free for up to 90 days — check the rules for your passport.
The real issue: Peru has one of the highest altitude-sickness rates of any tourist destination in the world. Hospitals in Cusco have hyperbaric chambers — and they charge dearly.
Altitude: The Main Risk
Cusco (3,400m) and surroundings
- 25-40% of visitors suffer some degree of AMS (acute mountain sickness)
- Symptoms: intense headache, nausea, insomnia, dizziness
- Severe cases (HAPE/HACE): life-threatening medical emergency
Caminho Inca e treks alternativos
- Highest pass on the classic Inca Trail: 4,215m (Warmiwañusca)
- Salkantay Pass: 4,600m
- Ausangate: up to 5,200m — technical mountaineering
O que fazer
- Arrive in Cusco before Machu Picchu (not the other way around)
- Spend 2 days in Cusco before any intense activity
- Acetazolamide (Diamox) — ask your doctor first
- Recognize HAPE/HACE symptoms and descend immediately
Medical Costs in Peru
| Procedure | Estimated Cost (USD) |
|---|---|
| Private consultation in Cusco | $60–$150 |
| Hyperbaric chamber (per session) | $150–$400 |
| Hospitalization (per day, private clinic) | $300–$800 |
| Medical evacuation Cusco → Lima | $8,000–$20,000 |
| Repatriation home | $25,000–$60,000 |
Outros Riscos
Lima
- Tráfego intenso — acidentes comuns
- Theft in Callao and parts of the historic center
Amazônia (Puerto Maldonado, Iquitos)
- Dengue, malaria (chemoprophylaxis recommended)
- Very limited medical infrastructure — evacuation to Lima needed in emergencies
Lago Titicaca (3,812m)
- Even higher altitude than Cusco — increased AMS risk
- Island communities: no local doctor
Recommended Coverage
| Coverage | Mínimo | Asteroid Recommendation |
|---|---|---|
| Medical expenses | USD 30,000 | USD 75,000 |
| Medical evacuation | USD 20,000 | USD 50,000 |
| Altitude coverage | Verificar | Included |
| Funeral repatriation | Included | Included |
Critical: confirm that your insurance does not exclude altitude as a pre-existing condition or special risk. Some cheap policies carry that exclusion. Asteroid Assistance covers AMS, HAPE and HACE.
Cenário Real
André, 35, developed HAPE on his second day in Cusco. Oxygen and hyperbaric-chamber treatment for 2 days, then evacuation to Lima for full care:
- Hyperbaric chamber (3 sessions): USD 900
- Hospitalization in Cusco (2 days): USD 1,400
- Air ambulance Cusco → Lima: USD 11,000
- Hospitalization in Lima (3 days): USD 2,100
- Passagem de retorno antecipada: USD 600
- Total: USD 16,000 — sem seguro
FAQ
1. Do you need a visa for o Peru?
No. Free entry for up to 90 days with a valid passport.
2. Should I fly straight to Cusco?
Not recommended. Most flights route through Lima — spend 1-2 nights in Lima (sea level) before flying up to Cusco. It helps acclimatization.
3. Meu seguro cobre a altitude de Machu Picchu?
Machu Picchu sits at 2,430m — lower than Cusco. The risk of severe AMS is smaller, but real. Asteroid covers altitude-related illness at any altitude.
4. Does the Inca Trail require special coverage?
Recreational trekking on the Inca Trail is covered. For Salkantay in technical conditions or Ausangate, check adventure-sports coverage.
5. Is there internet/phone signal to call for assistance?
In Cusco and Lima, yes. On the Inca Trail and in the Amazon, no. Tell the assistance team your itinerary and dates before entering zones without signal.
Why Choose Asteroid?
- Altitude covered, no exclusions
- Medical evacuation from Cusco, Titicaca and the Amazon
- 24/7 multilingual assistance
- Trekking e caminhadas incluídos
Asteroid Assistance — coverage issued by regulated insurers