What your travel insurance must cover to trek in Nepal: the altitude limit in the wording, helicopter evacuation, pre-existing conditions, Lukla and Jomsom delays, rescue fraud, and the details we need from you before you start.
14 min read
For trekking in Nepal you need a travel insurance policy that covers trekking up to the highest altitude on your itinerary, emergency medical treatment, and helicopter evacuation from that altitude. On our treks that is a condition of booking, set out in our terms and conditions. An ordinary holiday policy usually is not enough, because many stop covering walking at 2,000 to 3,000 m.
The altitude in your policy wording is the detail that catches people out. A policy capped at 4,000 m covers Poon Hill but not Annapurna Base Camp at 4,130 m, and nowhere near Kala Patthar at 5,545 m. Read the wording, not the sales page.
There is a checklist of policy wording at the end.
Yes, in practice. Every reputable trekking company in Nepal asks for it, and on our treks it is a condition of booking. Your policy must cover trekking to the highest altitude on your trip, medical treatment and emergency evacuation. Without it, a helicopter out of the mountains and a few days in a Kathmandu hospital land on your own credit card.
The reason is simple geography. Above Namche Bazaar, or anywhere on routes like Manaslu, Kanchenjunga or Dolpo, there is no road. If someone develops severe altitude sickness or breaks an ankle, the choices are being carried down for a day or more, or a helicopter. Your guide will start descent on foot first if that is safe, but when a helicopter is the right call, it needs to be called quickly, and that means an insurer who will pay.
We have not found any official government rule that makes proof of insurance a condition for ordinary trekking permits. Some trekking blogs say it is now mandatory, but none cite a law or a Department of Immigration or Nepal Tourism Board notice. What checkpoint staff actually check is your permit and passport.
The background is the Integrated Tourism Bill. The National Assembly passed it in February 2026 with tighter mountaineering rules and insurance provisions, and in August 2026 it was still before a House of Representatives committee, with stakeholders asking for insurance and fake-rescue controls to be added. Until it becomes law and the rules are published, insurance for trekkers is required by companies like us, not by the permit office. If that changes, we will tell you when you book.
Your policy must cover trekking up to the highest point you will reach, not the highest place you sleep. For Everest Base Camp that is Kala Patthar at 5,545 m, so you need cover to 6,000 m. Insurers usually sell altitude in bands, commonly up to 3,000 m, 4,000 m, 4,500 m or 6,000 m.
Each of our trip pages lists the evacuation altitude your policy needs. Here are the figures from our current treks:
Cover needed up to | Our treks |
|---|---|
3,000 m | Ghandruk Village, Australian Camp and Dhampus, Chisapani and Nagarkot |
3,500 m | |
4,000 m |
Because many of Nepal's most popular treks go above 4,000 m, and a policy capped there will not pay for anything that happens higher up. Annapurna Base Camp is 4,130 m, Thorong La 5,416 m, Larkya La 5,106 m and Gorak Shep 5,164 m. A 4,000 m cap quietly leaves all of them uncovered.
Some policies go further and treat any trekking above the limit as outside cover for the whole activity. Read how your policy words it. If in doubt, buy the 6,000 m band: the price difference is usually small compared with the cost of a helicopter.
Watch for three other phrases in the activity section:
"Hiking" versus "trekking": some policies cover hiking on marked trails only, or define trekking narrowly.
"Mountaineering" or "use of ropes and ice axes": our treks are not mountaineering, but on a snowy Thorong La or Kang La your guide may hand out microspikes. Check that simple traction is not treated as climbing equipment.
"Guided" or "organised by a commercial operator": some policies only cover high trekking with a licensed guide through a registered company. All our treks meet that.
Good trekking policies do, but only if helicopter or air evacuation is named in the wording, from the altitude you are trekking at, and only when it is medically necessary. A helicopter because you are tired, or because a flight is delayed, is not a medical evacuation, and the insurer will not pay for it.
A helicopter rescue in Nepal costs several thousand US dollars. Figures quoted in 2026 range from roughly USD 3,000 from the lower Annapurna valleys to well over USD 10,000 from remote valleys such as Dolpo or Kanchenjunga, before any hospital bills. Hospital care in Kathmandu and, in a serious case, a medical flight home cost far more again. That is why the medical limit matters as much as the evacuation line.
Your guide assesses the problem, starts descent if it is safe, and calls our office. We contact your insurer's 24-hour assistance line with your policy number, they approve the evacuation, and the helicopter flies when weather allows. Flights only operate in daylight and reasonable visibility, so evacuations are usually early morning.
In practice, the evening is when problems show up. Your guide checks everyone's oxygen saturation and pulse at dinner. If someone's headache has worsened, they are vomiting or they cannot walk straight, the decision to descend is made there and then. If it is dark, the team walks down by headtorch where the trail allows and the helicopter is requested for first light. This is why we need your policy details before the trek, not in a panic on the night.
With direct billing, the insurer's assistance company issues a guarantee of payment to the helicopter company and hospital, so you pay nothing up front. With pay and claim, you pay first and claim it back later, which can mean thousands of dollars on a credit card in a Kathmandu hospital.
Most trekking evacuations in Nepal now need the insurer to approve the flight before it takes off. That is normal and usually quick, but only if your guide can reach the assistance line. So:
Save the 24-hour number in your phone with the country code, and give it to us.
Ask your insurer whether they pay helicopter companies and hospitals in Nepal directly.
Check the excess on evacuation claims. Some policies carry a separate, larger excess for helicopter rescue.
Carry a credit card with a decent limit anyway, in case a hospital asks for a deposit.
No. Evacuation means flying a sick or injured person whose location is known to hospital. Search and rescue means looking for someone who is missing or stuck, and many policies cover it separately, with a lower limit, or not at all. If you are trekking with a guide this is rarely needed, but read whether "search and rescue" appears in the wording.
Only if you declare them and the insurer accepts them. Undeclared conditions are one of the most common reasons claims are refused. Asthma, high blood pressure, heart problems, diabetes, epilepsy, recent surgery and pregnancy all matter at altitude, and some policies exclude high trekking with certain conditions altogether.
Declare everything, including conditions controlled by tablets. Tell the insurer the altitude you are going to. Get the acceptance in writing. Then tell us too: our terms ask you to let us know about any medical condition before booking, so your guide knows what to watch for and what is in your first-aid pouch. Our altitude sickness guide explains which symptoms matter and how we pace treks to avoid them.
Sometimes. Look for travel delay, missed departure and missed connection cover, and check what triggers a payout. Cloud regularly delays the small planes to Lukla and Jomsom by a day or more. A policy that pays for extra nights, or for a missed international flight, takes the sting out of it.
Read the details:
Travel delay often pays a small fixed sum per 12 hours of delay, or reasonable extra accommodation. Check whether it covers domestic flights within Nepal, not just your flight home.
Missed connection may pay to rebook your international flight if a delayed Lukla or Jomsom flight makes you miss it. Many policies only pay if you left a sensible gap.
Helicopter flights to beat a delay are a choice, not an emergency, so insurers rarely pay for them.
Our Everest itineraries keep a spare day in Kathmandu for Lukla delays, and our Jomsom and Muktinath trek has a spare day for the Jomsom flight. Build at least one more buffer day before your flight home on any fly-in trek. Our Lukla flights guide covers the Ramechhap departures and what happens when the weather closes in.
Yes, buy cancellation cover, and buy it as soon as you pay your deposit. It protects what you have paid if illness, injury or a family emergency stops you travelling. Cancellation cover usually starts when you buy the policy, so a policy bought the week before you fly does not help with something that happened a month earlier.
Also look for curtailment cover, which pays for the unused part of your trip and extra travel costs if you have to leave the trek early for a covered reason. Our cancellation and refund policy sets out what we refund in each case, and insurance fills the gap.
For years some helicopter companies, hospitals, agencies and guides in Nepal have billed insurers for fake or inflated rescues. The Kathmandu Post first exposed the practice in 2018. Police arrested executives from three rescue and trekking firms in early 2026, and in March 2026 a case was filed at Kathmandu District Court against 32 people.
The Kathmandu Post's reporting on the charge sheet links more than USD 19.6 million in claims to the network. The methods described include several trekkers on one charter flight billed as separate rescues, forged passenger manifests, hospital records inflated or invented, and commissions paid to agencies and guides who sent trekkers to particular helicopter companies and hospitals. A government committee also received complaints that some operators served adulterated food to make trekkers ill. Insurers have become stricter about approving evacuations in Nepal, and at least one international assistance company has threatened to stop insurance for trekkers there.
For you, the risk is not only your conscience. If your claim is caught up in a fraud investigation, it can be delayed or refused.
Never accept a helicopter you do not medically need, and make sure your insurer approves any evacuation before the flight. If someone on the trail suggests that "insurance will pay" for a flight out because you are tired, say no.
Walk down if you can. Descent fixes most altitude problems, and lower villages are where rescues are rarely needed.
Insist that your insurer's own assistance company is called, and speak to them yourself if you can.
Do not sign blank forms or hand your policy documents to a helicopter or hospital representative.
Ask for itemised bills and keep copies of everything: messages, times, the oxygen readings your guide recorded.
If anything feels wrong, call our office.
Our guides descend first and call for a helicopter only when it is medically necessary, through your insurer. For the latest on the court case, read the Kathmandu Post or the Himalayan Times rather than social media.
Expect roughly USD 100 to 250 for a month of cover that includes trekking to 6,000 m, depending on your age, where you live, the altitude band and the medical limit. Specialist adventure and trekking policies are often better value than adding extras to a basic holiday policy. Our Nepal trekking cost guide puts insurance alongside the other trip costs.
We do not recommend particular insurers, because the right policy depends on your country, age and health. Compare the wording of two or three specialist policies against the checklist below, and if your current policy almost fits, ask your insurer to confirm in writing that it covers the altitude and helicopter rescue.
Before you arrive, send us your insurer's name, your policy number and the insurer's 24-hour emergency phone number, plus a copy of the policy schedule showing the trekking altitude and helicopter evacuation. Your guide carries a copy on the trail. Without these, we cannot start the trek.
Send them by email or WhatsApp at least a week before departure, together with:
an emergency contact at home, with phone number
any medical conditions, allergies and regular medicines
your passport scan, if we have not had it for permits
Keep your own copy on your phone, and a paper copy in your daypack. Phones die in the cold. The details we need for permits are in our Nepal trekking permits guide.
Hold your policy wording against this list. If any line is missing or unclear, ask the insurer and get the answer in writing.
Activity and altitude
Trekking is covered (not only "hiking"), with or without a guide as your policy defines
Altitude limit at or above the highest point of your trek
Simple traction such as microspikes is not treated as mountaineering
No exclusion for travel to Nepal
Evacuation and medical
Helicopter or air evacuation named, from your trekking altitude
High medical expenses limit, including hospital stays in Kathmandu
Repatriation to your home country
Search and rescue, and its limit
24-hour assistance line, and whether they pay providers in Nepal directly
The excess on evacuation and medical claims
Health
All pre-existing conditions declared and accepted in writing
No age limit that excludes you from the trekking cover
Trip disruption
Cancellation cover, bought when you book
Curtailment if you leave the trek early
Travel delay and missed connection, including domestic flights in Nepal
Baggage and personal belongings, with the single-item limit
Paperwork
Policy dates cover your whole stay, including buffer days
Policy number, insurer name and emergency number sent to us
Paper and phone copies with you
Usually not. Card policies often exclude trekking or cap it at a low altitude, and many have small medical limits. Read the wording for the altitude, helicopter evacuation and medical limit, and if any of them falls short, buy a separate trekking policy.
Some insurers sell policies to travellers already abroad, often with a waiting period before cover starts. Many do not. Buy before you leave home, which also gives you cancellation cover from the day you book.
Yes. Choose a policy that runs from the day you leave home until you get back, not just the trekking days. Road accidents and stomach bugs in town are more common than mountain rescues.
Not automatically. Paragliding in particular is often excluded or needs an extra premium. If you plan to fly from Sarangkot or raft after your trek, check those activities are listed in your policy.
As high as you can reasonably get. A helicopter evacuation, several days in a private Kathmandu hospital and a medical flight home can together cost far more than the evacuation alone. Many specialist trekking policies offer limits in the hundreds of thousands of dollars or more.
Permits and rules
Which permits each Nepal trek needs in 2026, what they cost, where they are issued and checked, and what documents to bring. Includes the March 2026 solo restricted-area change, the new Upper Mustang daily fee and a permit table for every trek we run.
4,500 m | Annapurna Base Camp, Mardi Himal, Gosaikunda, Pikey Peak, Upper Mustang |
5,000 m |
5,500 m | Annapurna Circuit, Tilicho Lake, Manaslu Circuit, Nar Phu, Gokyo Lakes, Kanchenjunga, Makalu, Dhaulagiri Circuit, Lower Dolpo, Upper Dolpo |
6,000 m |
Yes. Cover must reach the highest point you walk to, and on our Everest Base Camp trek that is Kala Patthar at 5,545 m. We ask for cover to 6,000 m on that trek.
Some policies only cover high-altitude trekking organised by a registered company with a licensed guide. All our treks are fully guided by licensed guides, so that condition is met, but read your own policy if you plan any independent walking.
Your guide continues descent on foot or by mule or porter where that is safe, which is the right treatment for most altitude illness anyway. In a life-threatening case the helicopter company may fly against payment from you, and you claim later. This is why the 24-hour number and clear evacuation wording matter.