How to choose international travel insurance for trips outside Europe: Europe or Worldwide cover, what changes in Africa, the case of São Tomé and Príncipe, a checklist, prices and what to do in an emergency.
Which international travel insurance should you choose for a trip outside Europe? A policy with at least €1,000,000 in medical expenses, evacuation and repatriation paid at real cost, direct payment to the hospital and 24-hour assistance. Outside Europe, the European Health Insurance Card does not apply, and in destinations such as São Tomé and Príncipe, where serious cases have to be evacuated, medical evacuation is what matters most. We are a local agency in São Tomé, which is why we ask all our travellers to come insured. The one we recommend is IATI Seguros, with 5% off through our link.
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What international travel insurance is
It is insurance that protects you during a trip outside the country where you live. It pays medical expenses if you fall ill or have an accident, organises and pays for your return home if needed, and can include cancellation, baggage and personal liability. The difference from ordinary health insurance is simple: as a rule, your health insurance or national health service will not pay for a private hospital in Zanzibar or an air ambulance from São Tomé to Lisbon.
Europe or Worldwide insurance: the difference
Almost all insurers divide their plans by zone. The price varies considerably, and choosing the wrong zone is one of the most common mistakes:
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| Europe insurance | Worldwide / international insurance | |
|---|---|---|
| Where it covers | European countries and, on some plans, the Mediterranean basin | The whole world; the USA and Canada often have their own price |
| Typical medical expenses | €100,000 to €300,000 | €1,000,000 or more |
| Price for 7 days | about €20 to €30 | about €40 to €75 |
| Who it suits | Short breaks and holidays in Europe | Africa, the Americas, Asia, long cruises |
If your trip has a stopover or any part outside Europe, choose Worldwide insurance. Europe insurance does not cover a trip to São Tomé, even if your flight leaves from Lisbon.
Travel insurance for Africa: what changes
Travelling in Africa is no more dangerous than travelling on other continents, but medical care works differently. Capitals have private clinics, but on islands and in remote areas resources are limited, and a serious case may require transport to another country. So, in insurance for Africa, prioritise:
- Medical evacuation and repatriation at real cost, without low caps.
- Medical expenses of €1,000,000 or more.
- Direct payment: many African clinics ask for payment before treating you. An insurer that guarantees payment saves you that problem.
- 24-hour assistance with experience in organising transport from Africa.
- Tropical diseases included, such as malaria and dengue. Check the terms.
Travel insurance for São Tomé and Príncipe
Is it mandatory? No. Nobody asks for your insurance at the airport. But it is strongly recommended, and we ask all our clients to have it.
We live and work in São Tomé and know how things work. The Dr. Ayres de Menezes Central Hospital in the capital and some clinics handle simple situations. For serious cases, a bad accident or an illness needing intensive care, the solution is air evacuation to Europe, and an air ambulance can cost tens of thousands of euros. Without insurance, that bill is yours.
On Príncipe Island resources are even more limited, and transport to São Tomé is by plane. If you are going to Príncipe, Rolas Islet or hiking in Obô Park, evacuation is the most important cover in your policy.
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Other health precautions for São Tomé:
- Malaria: present on the islands. Repellent, long clothing in the evening and a travel health appointment before you leave.
- Yellow fever: the vaccine is required for travellers arriving from a country with risk of transmission. For those flying directly from Portugal it is usually not required, but check at your travel health appointment.
- Sea: many beaches have no lifeguard. Always ask your guide.
For this trip, we recommend IATI Standard with medical expenses for outside Europe, or IATI Estrela if you also want cancellation. If you are doing serious trekking, such as climbing Pico de São Tomé, IATI Mochileiro includes adventure activities and rescue.
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Checklist: 7 points to check before you pay
- Right zone: Worldwide, not Europe.
- Medical expenses: €1,000,000 or more.
- Evacuation and repatriation: real cost, no low limit.
- Excess: ideally none.
- Direct payment: the insurer pays the hospital, not you.
- Activities: diving, trekking and boat trips included, if you will do them.
- Cancellation: if the trip is expensive, take it out right after booking.
Which is the best international travel insurance
The best is the one that meets the checklist at the fairest price. The insurer we recommend to our travellers is IATI Seguros. According to IATI's published terms:
- no excess on medical expenses;
- direct payment to the hospital in most cases;
- repatriation included in all plans;
- 24-hour assistance and a medical chat in the app;
- plans for outside Europe with €1,000,000 or more in medical expenses, an adventure plan and an annual policy;
- an automatic 5% discount when you buy through a partner link.
What about the alternatives? Credit card insurance usually has lower medical limits, requires the trip to be paid with the card and does not always pay the hospital directly. Among online insurers, prices are similar, but some only lower the price with an excess. For a trip to Africa, we prefer no excess and direct payment, and that is what IATI offers.
An honest note: as with any insurer, pre-existing conditions are generally excluded, and claims require you to follow the process. Always call the assistance line first and keep all documents.
How much international travel insurance costs
As a guide, for one adult, based on prices published in 2026:
- 7 days outside Europe, Standard plan with €1,000,000 medical expenses: around €40 to €45.
- 7 days, adventure plan: around €55.
- Most comprehensive plan: up to about €75 per week.
- Cancellation: extra cost, depending on the trip's value.
For an 8 to 11-day trip to São Tomé, insurance typically costs between €50 and €90 per person. You can see the exact price for your dates in the IATI quote tool, with our 5% discount already applied.
What to do in an emergency abroad
- Call the insurer's assistance line before going to a clinic, unless it is a life-threatening emergency.
- Follow their instructions: the insurer chooses the clinic and guarantees payment.
- Let your guide or agency know. On our trips, the guide goes with you and helps you talk to the clinic.
- Keep everything: medical reports, prescriptions, receipts and pharmacy slips.
- Claim back any small expenses you paid through the app.
Travel to São Tomé with a local agency
On our trips you have a São Tomé guide from the first day to the last, who knows the clinics, the roads and the people. See the private 8-day São Tomé and Príncipe tour, the 11-day trip across both islands or the 8-day trek in the cocoa forest. And before you leave, buy your IATI insurance with 5% off.
Sources: European Commission, "Healthcare cover during a temporary stay"; São Tomé and Príncipe entry requirements; IATI Seguros, published terms and plans; indicative prices from quotes published in 2026. Cover and prices may change: always check the terms in the quote before buying.
Frequently asked questions
Insurance that covers medical expenses, repatriation and, optionally, cancellation and baggage during a trip outside the country where you live, including destinations outside Europe.
One with €1,000,000 or more in medical expenses, evacuation and repatriation at real cost, no excess and direct payment to the hospital. We recommend IATI Seguros, with 5% off through our link.
It is not required for entry, but it is strongly recommended, because serious cases require medical evacuation to Europe.
No. For São Tomé, Cape Verde, Guinea-Bissau or Zanzibar you need insurance with Worldwide cover.
For 8 to 11 days, typically between €50 and €90 per person, without cancellation. See the exact price in the IATI quote tool with 5% off.
As a rule, illnesses contracted during the trip, including tropical diseases, are covered under medical expenses. Check the terms of your plan.
