Insurance

Insurance for Nepal fails on exclusions rather than on price. The three that catch people are altitude caps, motorcycle exclusions and helicopter rescue, and all three are routine parts of ordinary life here - a trek, a scooter, a mountain evacuation. Read the policy wording for those three specifically before comparing anything else.

Travel cover or expatriate cover

	Travel policy	Expatriate health policy
Designed for	Trips of weeks or months	Living somewhere for a year or more
Routine care	Usually excluded	Included
Pre-existing conditions	Commonly excluded	Often covered, with underwriting
Evacuation	Usually included, check the cap	Usually included
Cost	Low	Considerably higher

If you are here for a season, a travel policy is right. If you are living here, a travel policy renewed repeatedly is the wrong instrument - it is not built for routine care and it tends not to cover the things that accumulate over a year.

The altitude question

Many standard travel policies cap cover at an altitude below where common Nepali trekking routes go. Everest Base Camp, the Annapurna passes and most of the well-known itineraries sit high enough that a default policy may simply not apply.

Find the altitude limit as a number, in the wording, before you buy. If it is below where you are going, buy the upgrade or a specialist trekking policy. "Adventure sports cover" is not a reliable proxy - get the metres.

Helicopter rescue

A mountain evacuation is effective, available and extremely expensive to fund privately. Any policy for a trek should explicitly cover helicopter rescue at the altitude you will reach.

There is a complication worth knowing about. Fraudulent and unnecessary evacuations have been documented in Nepal, billed to insurers, with some operators and clinics implicated. Insurers responded by tightening requirements, which means two things for you: use a reputable trekking operator, and where the situation allows, have the evacuation authorised through your insurer's assistance line rather than agreed on the mountain. Genuine emergencies are paid; undocumented ones are increasingly challenged.

Travel covers trekking preparation more broadly.

Motorcycles

A great many foreign residents ride a scooter daily, and a great many policies exclude motorcycling entirely, or exclude it above a certain engine size, or exclude it unless you hold a licence valid for that category in the country you are riding in.

That last clause is where an unconverted foreign licence becomes expensive. Transportation covers licence conversion, which is the fix.

Local insurance

Nepali insurers offer health, accident, vehicle and property policies, and premiums are low. Two are worth knowing about:

• Third-party vehicle insurance is compulsory if you own a vehicle here. Comprehensive cover is optional and sensible given road conditions.
• Household and contents cover is available and cheap, and worth considering given that most rented flats come with basic locks.

A local policy is not a substitute for international health cover, because it will not fund treatment abroad or evacuation. Treat them as separate layers.

Employer cover

If you are employed by a Nepali company, you may be enrolled in the Social Security Fund, which provides medical and accident benefits, and some employers add private group cover. Establish exactly what it includes before relying on it - group policies vary enormously and often exclude the things you specifically came to Nepal to do.

Jobs covers employment terms and what to confirm in writing.

What to check, in order

1. The altitude limit, as a number
2. Whether motorcycling is excluded, and under what conditions
3. Whether helicopter rescue is covered and up to what sum
4. Whether the insurer pays the hospital or reimburses you
5. The medical evacuation limit
6. Whether pre-existing conditions are covered
7. The excess, and what it applies to per claim

Get the answers from the policy wording or the insurer in writing. Comparison sites summarise, and the summary is where these exclusions disappear.

Making a claim

Claims fail on paperwork more often than on policy terms. From the first appointment, collect and keep:

• The itemised hospital bill, not a summary receipt
• The doctor's notes and diagnosis, in English where possible
• Prescriptions and pharmacy receipts
• The police report, for anything involving a vehicle or a third party
• Dates and reference numbers of every call to the assistance line

Photograph everything as you go. Paper receipts fade, get lost in transit and are impossible to reconstruct from abroad months later.

Notify the insurer early, even if you are unsure whether you will claim. Most policies require notification within a defined window, and a late notification is an easy reason to decline.

Where this goes wrong

• Buying on price. The cheap policy is cheap because of what it excludes.
• Assuming trekking is covered. Check the altitude in metres.
• Riding a scooter on an excluded policy. The most common uninsured activity among foreign residents here.
• Renewing a travel policy for years. It is not designed for routine care.
• No evacuation cover. The single line item that can be financially catastrophic.

Where to go next

Healthcare covers using the system once something happens, and emergency covers what to do in the moment.

The four questions to ask your insurer

Ask these as questions, and get the answers in writing, because the policy summary will not contain them.

What is the altitude limit, as a number in metres, and does trekking above it void the policy? Is helicopter evacuation covered, and up to what sum? Is medical evacuation to another country covered, and who authorises it? Do you pay the hospital directly or reimburse me, and what is the notification window?

If an answer is vague, treat that as the answer. These are the four points on which claims in Nepal actually fail, and all four are knowable before you fly.