Travel insurance for Antigua and Barbuda is not, as a rule, a legal condition of entry, but it is strongly worth arranging before you fly into V. C. Bird International Airport (ANU). Entry rules across the Caribbean have changed several times in recent years, and a short-lived requirement to carry insurance during the pandemic has since lapsed, so the current position is that cover is recommended rather than mandatory. Requirements can change, so it is wise to check the official Antigua and Barbuda immigration guidance close to your travel date. The stronger reason to carry insurance is medical. Antigua and Barbuda has one main hospital, the Sir Lester Bird Medical Centre in St John's, formerly known as Mount St John's Medical Centre. It is a modern teaching hospital with around 185 beds and handles most routine and emergency care on the island. What it does not have is the full range of specialist facilities found at larger Caribbean or US hospitals, so cardiac events, complex trauma, and major surgical emergencies are typically stabilised locally and then evacuated to Barbados, Puerto Rico, or Miami for definitive treatment. That evacuation step is where costs escalate. An air ambulance from the eastern Caribbean to Miami can run into tens of thousands of US dollars, entirely separate from the hospital bill itself, and local hospitals expect payment or a guarantee of payment at the time of care rather than billing a foreign health plan. A travel medical policy that includes emergency treatment, a solid medical-evacuation limit, and repatriation is what turns that exposure into a fixed, modest premium. Antigua is a sailing and watersports destination, so it is worth checking that any policy covers the activities you actually plan, including boating, diving, and, if relevant, treatment in a decompression chamber, which some standard leisure policies exclude. Trip-interruption and baggage cover are also useful during the June to November hurricane season, when a storm can disrupt flights and accommodation at short notice. If you are comparing options, a fixed per-trip policy is usually the best value for a one or two week holiday, while subscription-style cover such as SafetyWing suits longer or open-ended travel. Whichever you pick, buy it before you leave home. Most insurers will not cover a trip that has already started, and pre-existing-condition terms are stricter the longer you wait. Read the medical limit, the evacuation limit, and the activity exclusions before you rely on the policy, and keep the insurer's 24-hour assistance number to hand.
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