Lijiang sits at roughly 2,400 meters in the foothills of Yunnan province, and that altitude alone is reason enough to carry travel insurance, before any trekking is added to the trip. The old town itself is a gentle, walkable UNESCO site, but the honest risk sits just outside it, on the trails above the gorge nearby.
Altitude here is moderate rather than extreme, enough to cause mild headaches or breathlessness in some visitors arriving directly by air. Lijiang's own hospitals handle routine altitude complaints and everyday illness well, but anything serious - a bad fall, a cardiac event, a complication needing specialist attention - is typically referred to Kunming, Yunnan's provincial capital and the region's real medical hub, several hours away by road or rail. Confirm your policy covers transfer between Chinese cities rather than assuming Lijiang's own facilities can handle a complex case.
Tiger Leaping Gorge, one of the world's deepest river canyons and the main trekking draw near Lijiang, is where the real activity risk lives: a multi-day trail along steep, narrow paths with rockfall and landslide sections, especially after rain, and long stretches with no phone signal or vehicle access. Check that your policy explicitly names trekking and covers rescue or evacuation from the trail itself, not just a standard hiking clause, since an injury deep in the gorge can mean a slow, difficult extraction.
Summer, roughly June through August, brings Yunnan's rainy season, and heavy rain raises the odds of landslides closing sections of the gorge trail or the roads leading to it - worth checking trip-delay cover if your visit falls in this window. Keep any clinic paperwork from Lijiang or Kunming, trekking-permit or guide records, and receipts for treatment or rescue costs, since claims involving the gorge trail typically need more documentation than a routine city illness. Many policies also require notice before non-emergency transfer between facilities, so check the claims process before setting out.