Guide to traveling to the United States: visa, health and insurance
The United States requires a different entry check depending on each traveler's passport: some nationalities can apply for the Visa Waiver Program (ESTA) and enter without a visa for up to 90 days, while many others need to apply for a tourist visa (B1/B2) with an appointment and consular interview. There's no single requirement for all travelers: it depends exclusively on the passport presented at immigration.
Beyond the immigration process, what surprises many visitors is the real cost of healthcare: an emergency room visit without insurance can exceed USD 1,200, and a night of hospitalization can go beyond USD 10,000. That's why travel insurance is treated almost as a de facto requirement, even if it isn't always demanded when your passport is stamped.
Washington D.C. is the political capital, but the entry points most used by visitors are New York, Miami, Los Angeles and Orlando. The US dollar (USD) is the only official currency, and cards are accepted almost everywhere, even for small purchases.
Visa and health for travelers
Visa: Many nationalities need to apply for a tourist visa (B1/B2) with a consular interview; some qualify for the Visa Waiver Program (ESTA), which allows short stays without a visa. Check the exact requirement for your passport at the corresponding embassy or consulate.
Health & travel insurance: Medical care is of very high quality but also among the most expensive in the world: a night of hospitalization can exceed USD 10,000 without insurance. Having travel insurance with solid medical coverage is nearly essential.
ESTA or B1/B2 visa: how to know which applies to you
The ESTA is an electronic permit (not a visa) available only for passports from countries with a visa-waiver agreement; it's applied for online, has a low cost and is valid for two years or until the passport expires, for stays of up to 90 days per trip.
If your passport isn't on that list of countries, you need a B1/B2 visa: it's applied for with form DS-160, a consular fee is paid, and an in-person interview is scheduled at the corresponding embassy or consulate. Wait times for the appointment vary widely by country and time of year, so it's worth starting the process several months in advance.
Medical costs in the US and the role of travel insurance
The US hospital network is among the best in the world in technology and specialists, but also among the most expensive for anyone paying out of pocket. The table below shows reference cost ranges without insurance.
Plans like Assist-365's Elite Cover or Million Cover, with coverage of up to USD 500,000 or USD 1,000,000, are designed precisely for destinations with high medical costs like this one. The code MEDALLOADV2023 applies a discount when you quote directly.
Climate and best times to travel by region
The country is huge and the climate changes radically between regions: the northeast has very cold winters and hot summers, the southwest is desert-like almost year-round, and Florida and the southern US have hurricane season between June and November. It's worth checking the specific climate of your destination before packing.
Transport and getting around the country
Outside a few cities with good public transport (New York, Chicago, San Francisco, Washington D.C.), getting around the country usually requires a rental car or domestic flights, given how large the distances between major cities are.
Safety, tipping and other practical customs
Tipping (15-20% at restaurants) is considered part of service workers' income and isn't optional in practice. As for safety, main tourist areas are safe during the day, but it's worth researching which neighborhoods to avoid at night in each specific city.
Travel checklist for United States
Quick list based on this guide's real data (not generic) before traveling to United States.
- Check the visa requirement for United States based on your passport: Many nationalities need to apply for a tourist visa (B1/B2) with a consular interview; some qualify for the Visa Waiver Program (ESTA), which allows short stays without a visa. Check the exact requirement for your passport at the corresponding embassy or consulate.
- Passport valid for at least 6 months from the entry date
- Travel medical insurance arranged, keeping this in mind: Medical care is of very high quality but also among the most expensive in the world: a night of hospitalization can exceed USD 10,000 without insurance. Having travel insurance with solid medical coverage is nearly essential.
- Save United States's emergency number: 911, along with your insurer's contact
- Cash or a no-fee card in US dollar (USD)
- Physical and digital copies of passport, insurance and bookings
- Required or recommended vaccines up to date for the region
- eSIM or international data plan active on arrival
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Average medical costs without insurance in the US (reference)
| Service | Approximate cost (USD) |
|---|---|
| Emergency room visit | 1,200 - 3,000 |
| Ambulance transport | 900 - 2,500 |
| Night of hospitalization | 10,000 - 20,000+ |
| Air medical repatriation | 20,000 - 100,000+ |
Frequently Asked Questions
Do I need the ESTA or a B1/B2 visa to enter the United States?
It depends on your passport: only countries with a visa-waiver agreement can use the ESTA; everyone else needs to apply for a B1/B2 visa with a consular interview.
What happens if I get sick in the US without travel insurance?
Hospitals treat emergencies, but the bill is the patient's responsibility and can reach tens of thousands of dollars for a brief hospitalization.
What's the emergency number in the United States?
911 works throughout the country for police, fire and ambulance services.
Can the ESTA be used to work or study in the US?
No. The ESTA only authorizes tourism, short business trips or transit; studying or working requires a different, specific visa.
Can you pay for almost everything with a card in the US?
Yes, cards are accepted at the vast majority of businesses, but it's worth carrying some cash for tips and transport in smaller cities.
