United States Travel Health Guide for International Travelers
A physician-reviewed health and safety guide for international visitors traveling to the United States of America
The United States welcomes over 75 million international visitors annually and is one of the most popular travel destinations in the world. The US has world-class healthcare, excellent infrastructure, and no tropical disease risk in most areas. However, healthcare is extremely expensive without insurance. Travel health insurance is strongly recommended for all international visitors. Gun violence, natural disasters, and road safety are the primary safety considerations.
United States of America
Capital: Washington, D.C. | Region: North America | Language: English
Before You Travel to the United States
The United States spans a vast continent with incredibly diverse climates, landscapes, and cultures — from tropical Hawaii and Alaska's arctic to the deserts of the Southwest and the cities of the East Coast. Health preparation depends heavily on your itinerary and activities. The most important preparation is securing comprehensive travel health insurance, as US healthcare costs are among the highest in the world.
Travel Health Insurance — Critical
US healthcare is extremely expensive. A single emergency room visit can cost $3,000-$10,000+. An ambulance ride averages $1,200. A hospital stay can exceed $10,000 per day. Without insurance, even minor injuries can result in catastrophic bills. Purchase comprehensive travel health insurance before arrival.
Routine Vaccinations
Ensure routine vaccinations are up to date before travel: MMR (measles outbreaks occur in the US), Tdap, seasonal influenza, COVID-19, and varicella. No special or tropical vaccines are required for US travel.
Entry Requirements
Most visitors need a valid passport and either a visa or approved ESTA (Electronic System for Travel Authorization) for Visa Waiver Program countries. Apply for ESTA at esta.cbp.dhs.gov at least 72 hours before travel. Biometric screening at entry.
Medications & Prescriptions
Bring sufficient prescription medications in original packaging with your doctor's letter. Some medications legal elsewhere may be controlled in the US. Pharmacies (CVS, Walgreens, Walmart) are ubiquitous but prescriptions from foreign doctors are generally not honored. Over-the-counter medications are widely available.
Water & Food Safety
Tap water is safe to drink throughout the United States and is regulated by the EPA. Food safety standards are high with FDA oversight. Restaurants are regularly inspected. Food allergies should be communicated — restaurants are accustomed to accommodating dietary needs.
Currency & Payments
US Dollar (USD). Credit and debit cards are accepted virtually everywhere — many businesses are cashless. Contactless payment (Apple Pay, Google Pay) is widespread. Tipping is customary: 18-20% at restaurants, $1-2 per drink at bars, $2-5 per night for hotel housekeeping.
Healthcare System in the United States
Emergency Departments (ER)
Emergency rooms are legally required to treat all patients regardless of ability to pay (EMTALA law). However, you will be billed — often thousands of dollars. ER visits average $2,200-$3,200 for minor issues and can exceed $20,000+ for complex cases. Use for genuine emergencies only.
Urgent Care Centers
For non-life-threatening issues (minor injuries, infections, flu), urgent care centers are faster and far cheaper than ERs — typically $150-$600. Available in most cities without appointment. Examples: MinuteClinic (CVS), MedExpress, CityMD. Many accept walk-ins and insurance.
Pharmacies
CVS, Walgreens, and Walmart pharmacies are found in virtually every town. Open late or 24 hours. Wide range of OTC medications. Prescription medications require a US-licensed physician's prescription. Pharmacy staff can advise on OTC alternatives.
Telehealth
Virtual doctor visits are widely available through apps like Teladoc, MDLIVE, and Amwell. Convenient for minor illnesses, prescription refills, and medical advice. Typically $50-$100 per visit. Available 24/7 in most states.
Dental & Vision
Dental emergencies can be treated at emergency dental clinics in major cities. Costs are high — a simple filling can cost $200-$600. Vision care is available at optometrists (LensCrafters, Walmart Vision). Travel insurance rarely covers routine dental or vision care.
Understanding US Medical Billing
You may receive separate bills from the hospital, doctors, lab, radiology, and anesthesiology — all for one visit. Request an itemized bill. Ask about cash-pay discounts (often 30-50% less). Keep all receipts for insurance claims. Many hospitals have financial counselors who can help.
Use urgent care instead of the ER for non-emergencies. Ask for cash-pay or self-pay rates upfront. Use GoodRx (app/website) for prescription medication discounts. Purchase travel insurance that covers outpatient care, not just hospitalization. Download the insurance company's app for provider networks and pre-authorization.
Emergency Numbers
Dialing 911 connects you to local emergency dispatch anywhere in the US. You can call or text 911. The service is free. Dispatchers can send police, fire, and ambulance. Be aware that ambulance transport is not free — it typically costs $400-$2,500+ and may not be fully covered by insurance. If the situation is not life-threatening, consider using a taxi or rideshare to reach urgent care.
Recommended Vaccines for US Travel
No special or tropical vaccinations are required for travel to the United States. Ensure the following routine vaccinations are current:
MMR Vaccine (Measles, Mumps, Rubella)
Measles outbreaks occur periodically in the US, particularly in communities with low vaccination rates. Ensure 2 doses of MMR vaccine are complete before travel.
Ensure tetanus booster is current (within 10 years). Pertussis (whooping cough) cases are rising in the US.
Influenza & COVID-19
US flu season runs October-March. Get vaccinated before travel during these months. Ensure COVID-19 vaccinations and boosters are current. Both vaccines are widely available at pharmacies.
Ensure Hepatitis B vaccination series is complete. Recommended as part of routine immunization worldwide.
Health Risks by Region
Southwest & Desert States (AZ, NV, NM, TX)
Extreme heat exceeding 45C (113F) in summer. Heat stroke is a genuine danger. Stay hydrated, carry water, avoid midday exertion. Rattlesnakes and scorpions are present. UV radiation is intense — use SPF 50+.
Mountain West (CO, UT, WY, MT)
Altitude sickness is common above 2,500m (8,000ft). Ascend gradually. Denver sits at 1,600m. Ski resorts and hiking trails reach 3,000-4,000m. Symptoms: headache, nausea, fatigue. Bear encounters possible in wilderness — carry bear spray.
Gulf Coast & Southeast (FL, LA, TX, GA)
Hurricane season runs June-November. High humidity and heat. Mosquito-borne illnesses (West Nile virus, Eastern Equine Encephalitis) are present. Alligators are common in Florida and Louisiana — avoid swimming in freshwater.
Northeast & Midwest (NY, MA, IL, MN)
Lyme disease is prevalent — transmitted by deer ticks in wooded/grassy areas. Use insect repellent and check for ticks after outdoor activities. Harsh winters with blizzards and extreme cold in northern states.
Hawaii
Strong ocean currents and rip tides cause multiple drownings annually. Swim at lifeguarded beaches only. Jellyfish are seasonal. Volcanic hazards on Big Island. Intense UV — sunburn happens quickly. Leptospirosis risk in freshwater streams.
Alaska
Extreme cold, remote wilderness, and limited medical access outside Anchorage and Fairbanks. Bear encounters are common — carry bear spray and know protocols. Hypothermia risk year-round near glaciers. Medical evacuation may be needed from remote areas.
Safety Risks in the United States
Road Safety
Road accidents are the leading cause of injury death for travelers. Americans drive on the right. Speed limits vary by state (65-85 mph on highways). Seatbelts are mandatory. Never drink and drive — DUI laws are strict. Download navigation apps (Google Maps, Waze). Be cautious of large trucks on highways.
Gun Violence
The US has higher rates of gun violence than other developed nations. Mass shooting events, while statistically rare for any individual, do occur. Be aware of exits in public venues. If you hear gunshots: Run, Hide, Fight (in that order). Most gun violence is concentrated in specific urban areas.
Crime
Petty crime (pickpocketing, car break-ins) occurs in tourist areas. Avoid leaving valuables visible in vehicles. Use hotel safes. Be cautious in unfamiliar neighborhoods at night. Use rideshare apps (Uber, Lyft) rather than walking alone at night.
Natural Disasters
Hurricanes (Southeast/Gulf, Jun-Nov), tornadoes (Midwest/South, spring), earthquakes (California, Pacific NW), wildfires (Western states, summer/fall), blizzards (Northeast/Midwest, winter). Monitor weather alerts. Download the FEMA app for emergency notifications.
Outdoor & Wildlife
National parks are stunning but can be dangerous. Hiking deaths occur annually from falls, heat, and dehydration. Carry water, tell someone your plans, and stay on marked trails. Wildlife includes bears, mountain lions, rattlesnakes, and alligators depending on region.
Drug Laws
Drug laws vary significantly by state. Cannabis is legal in some states but remains federally illegal. Do not transport cannabis across state lines or into federal property (national parks, airports). Fentanyl-laced drugs are a major risk — never accept substances from strangers.
If stopped by police, remain calm, keep hands visible, and follow instructions. Do not reach for documents until asked. You have the right to remain silent and the right to an attorney. Carry identification at all times. If arrested, ask to contact your country's embassy or consulate immediately.
Other Health Considerations
Transmitted by deer ticks, primarily in the Northeast and upper Midwest (May-September). Use DEET repellent in wooded areas, wear long clothing, and check for ticks daily. Early symptoms include a bull's-eye rash and flu-like illness. Treatable with antibiotics if caught early.
West Nile Virus
Mosquito-borne virus present in most states during summer months. Most infections are asymptomatic. Severe cases can cause encephalitis. Use insect repellent during evening hours, especially near standing water.
Valley Fever (Coccidioidomycosis)
Fungal infection acquired by inhaling spores in desert soil, primarily in Arizona, California, Nevada, New Mexico, and Texas. Risk increases during dust storms and construction. Symptoms resemble flu or pneumonia.
Altitude Sickness
Affects visitors at elevations above 2,500m. Common in Colorado (Denver, ski resorts), Utah, Wyoming, and other mountain states. Symptoms: headache, nausea, shortness of breath. Acclimatize gradually, stay hydrated, avoid alcohol for 24 hours after arrival at altitude.
Foodborne Illness
While food safety standards are high, outbreaks of salmonella, E. coli, and norovirus do occur. Follow standard food safety practices. Norovirus spreads easily on cruise ships — wash hands frequently.
Mental Health Resources
Dial 988 for the Suicide & Crisis Lifeline (24/7, multilingual). Crisis Text Line: text HOME to 741741. Emergency psychiatric care is available at hospital emergency departments. Many telehealth platforms offer mental health support.
Practical Health & Safety Tips
Essential Apps
911 works from any phone (even without service). Download: FEMA (disaster alerts), GoodRx (pharmacy discounts), Uber/Lyft (transport), Google Maps (navigation). Your embassy's app may also be useful.
Sun Protection
UV radiation is strong throughout much of the US, especially at altitude and in southern states. Use SPF 30+ sunscreen, reapply every 2 hours, and wear hats and sunglasses. Skin cancer is the most common cancer in the US.
Accessibility
The US has strong disability access laws (ADA). Most public buildings, transport, and attractions are wheelchair accessible. Service animals are permitted in all public spaces. Request accessibility accommodations in advance.
Your Embassy in the US
Pre-Departure Checklist
- Purchase comprehensive travel health insurance — this is the single most important preparation
- Ensure routine vaccinations are current: MMR, Tdap, Flu, COVID-19, Hepatitis B
- Apply for ESTA or visa well in advance at esta.cbp.dhs.gov
- Bring prescription medications in original packaging with doctor's letter
- Save your embassy's US contact number
- Register with your country's foreign ministry travel notification system
- Download FEMA app for emergency alerts
- Emergency number: 911 (police, fire, ambulance — free from any phone)
- Bring credit/debit cards — the US is largely cashless; carry some USD for tips
- Pack sunscreen, and weather-appropriate clothing for your destination
- If hiking or visiting national parks: carry water, tell someone your plans, stay on trails
- Understand tipping culture: 18-20% at restaurants, $1-2 per drink, $2-5 hotel housekeeping
- If driving: drive on the right, wear seatbelts, never drink and drive
