A travel credit card can be excellent at earning points, unlocking airport lounges and softening the cost of a delayed flight. But many Americans appear to be treating those perks as evidence of something far broader: comprehensive travel protection.

A new Squaremouth survey of 4,700 travelers found that two-thirds hold at least one travel credit card. Nine in ten said they were familiar with their card’s protections, while 55% believed they knew exactly what was covered.

Once respondents were asked about specific exclusions and limits, however, that confidence began to look misplaced.

The coverage gap

The survey suggests that cardholders are not simply overlooking small-print technicalities. Many are unaware of limitations that could leave them facing substantial costs after a cancellation or medical emergency.

Among the findings:

• 62% did not know that pre-existing medical conditions may be excluded. Many cards apply a lookback period, often covering conditions diagnosed or treated during the 60 days before the first trip payment.
• 62% were unaware that cancellation coverage is restricted to specified reasons and subject to reimbursement limits. Squaremouth says many cards cap trip cancellation benefits at $10,000 per person, while at least one widely held card limits reimbursement to $2,000.
• 55% did not realize that eligibility can depend on how the trip was paid for. Some benefits require the full fare to be charged to the eligible card. Splitting payments between cards, points and miles can complicate—or invalidate—a claim, although requirements vary by issuer and benefit.
• 48% did not know that most travel cards provide little or no emergency medical coverage abroad. Squaremouth’s card comparison found only limited medical protection, including one benefit capped at $2,500 with a $50 deductible.
• One-third believed a travel credit card could adequately replace comprehensive travel insurance.

The distinction matters. A card may perform reasonably well when luggage is delayed or a qualifying flight disruption forces an overnight hotel stay. It can be far less useful when a traveler is hospitalized overseas, needs medical evacuation or cancels an expensive itinerary for a reason not listed in the policy.

Rewards are not insurance

Airline and hotel co-branded cards were the most popular category in the survey, held by 30.2% of respondents. Chase Sapphire products followed at 23.8%, with American Express cards at 20.7%.

That ranking exposes an awkward mismatch. Co-branded cards are designed primarily to deepen loyalty to an airline or hotel group. They may offer free checked bags, status benefits or accelerated points, but often provide weaker insurance than premium general travel cards.

“Treat your credit card as a supplement to travel insurance, not a full replacement,” says Chrissy Valdez, Senior Director of Operations at Squaremouth. “Our market analyses have repeatedly shown that the majority of travel cards are built to reward travel, not to insure it. Currently, 3 out of the 4 major premium travel cards offer no Emergency Medical coverage at all, which means if you get sick overseas, you’ll likely be paying out of pocket unless you have supplemental travel insurance.”

Even premium cards should not be judged by their annual fee or marketing language. Benefits differ by card, state, payment method and claim type. The document that matters is the issuer’s current guide to benefits—not the headline promising “travel protection.”

Check before departure

Travelers do not necessarily need to duplicate every benefit their card already provides. A better approach is to identify the genuine gaps before buying additional protection.

Before departure:

• Check the card’s limits for cancellation, interruption, delays, baggage, emergency treatment and evacuation.
• Confirm whether the entire trip, only the common-carrier fare or merely part of the booking must be paid with the card.
• Look at covered cancellation reasons rather than assuming every unexpected event qualifies.
• Ask whether pre-existing conditions, adventure activities, cruises or particular destinations are excluded.
• Verify overseas coverage with the traveler’s existing health insurer. Medicare generally provides very limited coverage outside the United States, but private plans differ.

Squaremouth recommends at least $50,000 in emergency medical benefits and $100,000 for medical evacuation on international trips. Those are useful reference points rather than universal rules: remote destinations, cruises and travelers with more complex health risks may require higher limits.

READ MORE: Unveiling Top Travel Credit Cards for Your Wanderlust

A full comprehensive policy may be unnecessary for a low-cost domestic trip with flexible bookings. Travelers whose card already covers cancellation and delay could instead consider travel medical insurance to fill the most serious gap. Frequent travelers may find an annual multi-trip policy more economical, while expensive, prepaid itineraries may justify comprehensive single-trip coverage.

Conclusion

Squaremouth’s findings reflect a wider travel-industry problem: benefits are becoming more visible, but their conditions are not. Banks sell cards through simple promises—points, lounges, protection—while the product governing a claim remains a dense insurance certificate.

Comparison platforms such as Squaremouth make standalone policies easier to examine, and providers including Allianz Travel, Travelex and Seven Corners offer everything from comprehensive plans to medical-only and annual coverage. Yet standalone insurance also carries exclusions, deadlines and documentation requirements; it is not automatically superior simply because it was bought separately.

The sensible model is layered protection. Use the card for the risks it covers well, then insure the exposure it leaves behind. As the U.S. State Department advises travelers to consider medical and evacuation protection—particularly where care is limited—the real question is not whether a card “includes travel insurance.” It is whether its actual limits match the trip being taken.