Do I need health insurance for ESTA?

No. Health or travel insurance is not a requirement for ESTA or the Visa Waiver Program. However, as there is no public health system for tourists in the USA, our editorial team strongly recommends travel insurance with medical cover.

Will a US emergency department treat me without insurance?

Under the federal EMTALA law, hospitals with an emergency department that participate in Medicare must provide a medical screening examination and stabilise an emergency condition regardless of ability to pay. This does not make treatment free – the hospital can bill you afterwards.

Is COVID-19 vaccination still required to enter the USA?

No. The vaccination requirement for non-US air travellers ended in May 2023.

ESTA INFORMATION

Doctors and Hospitals in the USA: What Visitors Need to Know

The key points first: there is no public health system for tourists in the USA, and ESTA does not require health insurance.Emergency departments must examine and stabilise you regardless of your ability to pay — but that treatment is not free. Here is what this means for your trip.

No public cover for visitors — and no insurance requirement for ESTA

The USA has no public health system that automatically covers you as a tourist. At the same time:

ESTA and the Visa Waiver Program do not require health insurance — insurance is not listed as a requirement in the official ESTA FAQ
Being allowed to enter therefore does not depend on whether you are insured
You will, however, have to pay for any treatment yourself unless an insurer covers it

Our recommendation (editorial):before you travel, take out travel insurance with medical cover that explicitly includes the USA. This is not a US Government rule or an ESTA requirement, but our strong advice — check the terms of your policy yourself.

Emergency departments: what the federal EMTALA law guarantees

The Emergency Medical Treatment & Labor Act (EMTALA), passed in 1986, is designed to ensure access to emergency care regardless of ability to pay. According to the US agency CMS, this means:

It applies to hospitals with an emergency department that participate in Medicare — not to urgent care clinics, doctors’ surgeries or pharmacies
The hospital must carry out a medical screening examination — including for women in labour
If there is an emergency, it must stabilise the patient or, if that is not possible, arrange an appropriate transfer
Screening and stabilisation must not be delayed to ask about payment or insurance
The obligation ends once no emergency is found or the patient has been stabilised or transferred

Important: EMTALA does not mean “free”. The law guarantees screening and stabilisation regardless of ability to pay. The hospital may still ask for your insurance details (as long as this does not delay the examination) and bill you for treatment afterwards. EMTALA does not cover further treatment after stabilisation.

In an emergency: 911 — and no more COVID vaccination requirement

In a medical emergency, dial 911 (police, fire, ambulance). For details, see Emergency number 911 in the USA
The COVID-19 vaccination requirement for non-US air travellers ended in May 2023
If you are bringing your own medicines, follow the rules in Taking medicines to the USA

Related information

USA travel guide

All practical topics at a glance

Emergency number 911 in the USA

911, 988, Poison Help, lost passport

Taking medicines

Prescription, original packaging, declaration

Sources and currency of information

Last reviewed: 12 October 2026. This website is an independent information service and is not an official website of the US Government.

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