Nepal trekking insurance for Americans, and the altitude limit nobody in the US market prints

If you live in the United States, the number that decides your Nepal claim is almost never printed. Ask your insurer, in writing, for the maximum trekking altitude covered under the wording you are being sold, and do not pay until you have the reply. Of the companies that will actually sell to a US resident, exactly one publishes an altitude threshold on its public pages — and that threshold is 15,000 feet (4,600 m), which is below Everest Base Camp.

This page is the American half of a decision we get asked about every week. The other half — True Traveller, the BMC, Snowcard — is written for people who live in the UK or the EEA and cannot be bought from a US address at all. If you have been reading a British comparison and wondering why none of the names are familiar, that is why.

Who will actually sell a Nepal trekking policy to a US resident

More companies than you think, and fewer useful ones than you hope. The market splits cleanly: US-domiciled travel insurers sell you a broad policy that says almost nothing about altitude, while the specialists that publish real altitude ladders are all sold under UK or European residency rules and are closed to you. Everything below comes from each company’s own public pages, checked in August 2026. We have no commercial relationship with any of them and earn nothing whichever you pick.

Read the middle column downward and the problem states itself. Every provider that will sell to you leaves the ceiling blank, and every provider that prints one will not sell to you. That is not a scandal — US policies are built around trip cost, cancellation and medical bills rather than around a mountain — but it does mean the American buyer has to do a piece of work the British buyer does not.

Two names we deliberately have not given numbers to. battleface sells separate wordings by market, and we could not retrieve a published altitude figure for its US wording; its UK-market wording is a different contract and you should not reason from one to the other. Travelex’s plan pages would not load for us at all, so we are not printing a limit we could not read. In both cases the instruction is the same as for everyone else on the list: ask, in writing.

Global Rescue prints a number, and the number is below Base Camp

This is the single most useful fact on the page for an American trekker. Global Rescue’s standard membership covers travel up to 15,000 feet (4,600 metres). Its own High-Altitude Evacuation Package documentation says the package “should be purchased by any member planning to travel above 15,000 feet or 4,600 meters at any point during their trip, excluding airplane travel”, and describes the package as providing medical transport to members who go above that height and “require emergency transport due to injury or illness”.

Now put Nepal against it. Everest Base Camp is about 5,364m. Kala Patthar, which nearly everyone walks the following morning, is about 5,545m. The Thorong La on the Annapurna Circuit is about 5,416m. All three are comfortably over 4,600m, and the wording says at any point during their trip — one morning above the line is enough to put the whole trip outside the standard membership. If you are buying Global Rescue for a Nepal trek, you are buying the upgrade too, or you are buying the wrong thing.

Two more things worth knowing before you treat it as your only cover. Global Rescue is a membership and a service, not an insurance policy — it arranges and pays for the rescue itself rather than reimbursing you, and it does not do baggage, cancellation or trip interruption. And medical transport home applies when you are hospitalised more than 100 miles from home. For a trek it pairs well with an ordinary travel policy; it does not replace one.

Evacuation and emergency medical are two different numbers

The US market structures this differently from the British one, and the difference costs people money. A UK specialist writes one enormous medical limit and a separate, much smaller search-and-rescue limit. US plans usually write a big evacuation limit and a smaller medical limit — and evacuation is the number that gets quoted in the marketing.

Ripcord is the cleanest illustration because it publishes both: $1,000,000 for medical evacuation and repatriation of remains, and $100,000 for emergency accident and emergency sickness medical expense. Those solve different problems. The million dollars gets you off the mountain and home. The hundred thousand is what pays for intensive care in Kathmandu or Delhi if the thing that put you on the helicopter needs treating for a fortnight before you can fly.

So when a plan advertises “$500,000 medical evacuation”, ask what the emergency medical limit is, and vice versa. IMG publishes both for its iTravelInsured plans and the gap is instructive: the LX plan pairs $1,000,000 of evacuation with $500,000 of medical, while the SE plan pairs $500,000 with $250,000. Same brand, same trip, half the hospital cover. The mechanics of what a Nepal rescue actually costs and who authorises it are in our guide to helicopter rescue costs in Nepal.

Medicare stops at the border, and probably so does your plan

Medicare is the clearest case because the government publishes it plainly. Its own fact sheet states that “Medicare coverage outside the U.S. is limited” and that “in most situations, Medicare won’t pay for health care or supplies you get outside the U.S.” — where “outside the U.S.” means anywhere other than the 50 states, DC, Puerto Rico, the US Virgin Islands, Guam, American Samoa and the Northern Mariana Islands. There are three narrow exceptions, and every one of them involves a foreign hospital being physically closer to you than a US one, or a cruise ship within six hours of a US port. None of them can occur in the Khumbu.

Your employer or marketplace plan we cannot read for you, and we are not going to guess. Open your summary of benefits and search it for two things: the phrase “outside the United States” and the word “evacuation”. Whatever those two searches return is your answer. In our experience of what clients report back, the first usually finds a narrow emergency-only provision and the second finds nothing at all — but yours is yours, and the two minutes it takes to check is the cheapest research in the whole trip.

The email to send before you pay

Copy this. It is four questions, it takes ten minutes, and the replies are the only version of your cover that will matter at 3am.

• “What is the maximum trekking altitude covered under this policy?” Give them your real high point — 5,545m for Everest Base Camp with Kala Patthar, 5,416m for the Thorong La, 4,130m for Annapurna Base Camp — and ask them to confirm it in the reply.
• “Is helicopter evacuation named as a benefit, and what is its limit?” “Medical evacuation” on its own can be read as a road ambulance, and above Lukla there are no roads.
• “Will you issue a guarantee of payment directly to a Nepali helicopter operator, or do I pay and claim it back?” Operators in Nepal generally want the guarantee before the rotors turn. The answer to this question decides how fast an aircraft reaches you.
• “Is altitude sickness itself covered, or excluded above a stated height?” It is the most likely claim on a Nepal trek, and it is a separate question from the ceiling.

Then do the unglamorous part: carry the policy number and the 24-hour emergency line on paper, and give the same details to your trekking company at the pre-trip briefing. Severe altitude illness makes people confused. The person dialling will not be you.

When a cheap US policy is genuinely enough

The unprofitable part, and the reason to believe the rest of the page.

• Below 3,000m, an ordinary policy is fine. Kathmandu, Chitwan, Lumbini, Pokhara and its day walks, Sarangkot, Australian Camp — none of that needs a specialist product or a rescue membership. Do not let anyone upgrade you to an expedition tier for a week of temples and hills.
• A good premium credit card can genuinely cover a low-altitude trip. If you already pay an annual fee for real travel medical cover, use it and spend the difference on a better lodge. Above 4,000m it almost never holds: card benefits guides rarely name an altitude at all, and where they include evacuation the sub-limit is often a few thousand dollars, which is less than one helicopter flight.
• Do not buy the box at airline or booking-site checkout. It is priced for a beach holiday and capped accordingly.
• Insurance is not acclimatisation. A policy pays for the rescue. It does nothing to stop the illness, and the cheapest evacuation is the one you avoid by walking slowly and sleeping lower than you climbed — which is what our altitude sickness guide is for.
• And you do not have to book with us to ask us. If you are trekking with another company and want a second opinion on whether your policy clears your route, send us the wording. We would rather you were covered than that you were our customer.

So, the verdict. For an American on Everest Base Camp or a big pass, we would pair a mainstream US travel policy for cancellation, baggage and hospital cover with a Global Rescue membership carrying the High-Altitude Evacuation Package — because it is the only thing on the US shelf that has written down where it stops, and because it arranges the rescue rather than reimbursing it. If you would rather hold one product, Ripcord publishes both of its limits and that alone puts it ahead of most of the field. What we would not do is buy on price from a comparison site and assume that a plan which never mentions altitude has no opinion about it.

Keep reading

Trekking a lower route instead? The same logic applies at a different height — see Annapurna trek insurance for the 130 metres that quietly void an Annapurna Base Camp claim. Ready to plan the trip? Contact us and we will confirm the altitude your policy needs to clear alongside your dates, permits and guide.