COLLEGE PARK, M.d. – People in America adopt hundreds of thousands of children every year, but not all of them receive health insurance once adopted into their second home. A study by University of Maryland (UMD) School of Public Health, out today in Health Affairs , reveals major differences in coverage depending on adoption type (domestic or international) and citizenship status of the adoptive parent.

“Adopted children generally have more and different health needs – such as cognitive or physical difficulties – than non-adopted children. Previous studies, many of which did not differentiate between different types of adoptees, found adopted children were consistently insured,” said study co-author Jamie Fleishman .

“Our study, which considered four types of adoptee, found a very high uninsured rate for some adopted children – particularly those adopted internationally by non-citizens living in the United States.” The study found that almost one-third (30.7%) of the children in this group has no health insurance at all.

Fleishman is a Chinese transnational adoptee who was adopted from China to an American parent. She graduated from UMD in 2024 with a masters in public health (MPH), focusing on health equity, and her master’s thesis was the foundation of this study.

The UMD researchers analyzed insurance coverage over five years (2018 – 2022,) comparing adopted and non-adopted children up to 17 years old who live with their head of household, using data from the American Community Survey (ACS) , which includes over three million adopted and non-adopted children. The study distinguishes between international and domestic adoptions and further distinguishes international adoptees by householder citizenship, because international adoptees of U.S. citizens are, similar to a U.S.-born child, eligible for public insurance coverage such as Children’s Health Insurance Program (CHIP) or Medicaid.

“The findings clearly show that we must not treat adopted children as a single group. International adoptees and domestic adoptees are very different. The citizenship status and other factors such as income of adoptive parents are also different. So policies need to be tailored to these differences,” said Dahai Yue , co-author and assistant professor in SPH’s Department of Health Policy and Management. Yue was Fleishman’s MPH advisor.

The study compared four different groups of adopted children in the U.S. against a control group of non-adopted children: domestic adoptions, international adoptions by U.S. citizens, international adoptions by non-U.S. citizens and children who live with a biological relative, such as a grandparent, but who is not their biological parent.

Children adopted internationally by non-U.S. citizens living in the U.S. have the highest uninsured rate at 30.7%. They also had lower rates of private and public health insurance than other adoptee groups, by 12.1 percentage points and 9.1 percentage points respectively. The non-U.S. citizens adopting these children were also more likely to be the same race as the child, more likely to have an income below the federal poverty line and less likely to own a home than other groups.

The study also highlights a significantly high uninsured rate (7.3%) for children who are living with relatives other than their biological parents, and who are also more likely to live in lower-income families.

“There are likely multiple factors behind these disparities which were not examined in this study. But the data is clear: These groups are not homogenous, despite previous research often treating them as a single population. These children are worthy of policy attention to ensure all children have access to health care in the United States,” said Yue.

Key Findings

Children adopted internationally by non-U.S. citizens living in the U.S.

• Almost one-third (30.7%) of this group has no health insurance at all.
• This group has lower rates of private health insurance (by 12.1 percentage points) and of public health insurance (by 9.1 percentage points) than other adoptee groups.
• The non-U.S. citizens adopting these children were also more likely to be the same race as the child, more likely to have an income below the federal poverty line and less likely to own a home than other groups.

Other adopted and non-adopted children

• Children who are living with relatives other than their biological parents also have a significantly high uninsured rate (7.3%).
• Children who are the most likely to have private insurance coverage are children adopted domestically (56.2%), children adopted internationally to U.S. citizens (89.1%) and nonadopted children (63.8%).
• Children who are most likely to have public insurance coverage, such as Medicaid, are those adopted domestically, and those who live with relatives other than their biological father or mother.
• International adoptees of U.S. citizens were the most insured compared to non-adopted children – in fact, they were more insured than nonadoptees.

When it comes to traveling, I’ve been to several places around the world over the last few years.

As I continue to travel and explore the world, I am continuously concerned about my safety when traveling solo. That’s why I’ve reached out to the rest of the women on the AllEars team to share the tips we swear by when it comes to traveling safely. 

No matter how many times I’ve done it, I still get nervous when it comes to traveling solo. It’s hard not to at times! You hear lots of stories online that can be scary and create anxiety around the thought of going anywhere alone. (Thank you, Liam Neeson and the movie Taken specifically.)

Our entire team travels constantly, those on and off camera! From solo trips to Disney World and Disneyland to heading to Hong Kong and Tokyo, we have been across the globe and have picked up a trick or two along the way. While we want to see and do everything, our top priority when traveling alone as women is safety. (Frankly, everyone should be concerned about being safe!)

Starting off first, be vigilant! Keep your head on a swivel at all times. It doesn’t matter if you’re in a new country or at the mall in your hometown; you always need to be aware of your surroundings. That means no mindless scrolling or listening to music as you walk from destination to destination.

I know, we all love to check TikTok every 5 minutes (and I’m super guilty of that), but the more distracted you are, the easier a target you are. If you have headphones in, you might not be able to hear when someone is walking up to you. Next, we always make sure that someone knows your location. Personally, my husband, mom, dad, brother, sister-in-law, and friends all have my location, so they know where I am no matter what.

I utilize Find My Friends on my iPhone, but I have also used Life 360 in the past just to make sure that trusted people in my life knew I was safe and where I was supposed to be. I also let them know when I’m supposed to arrive at my location and when I’m checking out. If it’s a longer flight, I also make sure to share my flight tracking number with my family as an extra precaution.

It’s also important to share your Uber or Lyft ride details with people when you’re in a car alone. You can have your friends or your family track your specific ride just for peace of mind. These ride-share apps also have safety features that will ask you if you’re okay if your car veers off the path or stops for too long. I’ve been in cars that had to take detours because of unexpected wrecks, and the app will send me a notification asking me to confirm my safety, which I really appreciate.

Uber also recently introduced a new feature that will allow women to select women drivers specifically. According to Uber, the new feature is called Women Preferences. Its features are “designed to give women riders and drivers more choice, more confidence, and more flexibility when they use Uber.” These new features are being tested in Los Angeles, San Francisco, and Detroit for now, but we are really hoping they expand to new areas soon.

When it comes to where we stay, our entire team shared the same sentiment. Make sure you read LOTS of reviews, and if you’re staying at an Airbnb, consider only staying at locations that have a female host or a couple. When reading reviews, make sure that you’re reading reviews from women and their experiences at each location as well. Yes, other people can write helpful reviews, but women tend to understand what safety precautions we’re looking for and can reiterate if a location has what we need.

Another major tip is to not post anything online that would share your exact location. While we do love a good Instagram post, including anything like your exact hotel, hotel room number, any future plans, and more can put you in a dangerous situation. Many people on our team go the extra mile and don’t post at all until they are home from their trips. If you’re being extremely cautious, that is definitely the route to go!

Next, never ever admit that you’re traveling solo! This one is one that’s a tough habit to learn, but we highly encourage you to do so. If people strike up a conversation with you, just say that you’re meeting someone soon or that your friend is in the bathroom. I’ve even gone so far as to fake a phone call when I was uncomfortable in a situation and traveling alone. It might feel strange at first, but there’s safety in numbers (even if those numbers aren’t real.)

I also like to keep pepper spray or other self-defense items when I can, but you can’t always bring them with you. Disney World is a great example of a place where we’ve traveled alone and had to leave our pepper spray keychain at home. That’s when we consider how to use other items like our Owalas if ever necessary. (Those water bottles could definitely be a weapon if needed!)

We also love to utilize fanny packs or other small bags that go in front of our bodies when traveling solo. Sure, they might not seem as cute as a Loungefly at times, but it’s infinitely safer to keep your important items with your name and information close to your chest, where it is much harder to grab. Pickpockets are everywhere, and while they might not initially be after your personal information, they might get it when they grab your wallet or passport.

If you’re driving yourself, always hustle to your car (stay off that phone) when leaving a location, and be sure to check under and behind your seats. Be sure to lock your car as soon as you get in, and if you’re really uncomfortable, don’t be afraid to ask for security to escort you to your car. We’ve done it before, and we will happily do it again if it makes us feel safe. Keep your head high when walking, too, even if you don’t feel confident, just fake it for those walks alone. 

Finally, no matter what, our ultimate tip is to trust your gut! The entire team agrees on this point that if you feel unsafe, even if there’s no tangible reason to feel that way, remove yourself from the situation. Trust your intuition and yourself. There have been many times when our gut has told us something was off, and we have decided to trust it. No one knows you like you know yourself, so be confident in what you feel.

At the end of the day, we love solo traveling! It’s offered us so many experiences and helped us grow as people. We love seeing the world and would hate to miss out on it, but we also want to make sure we can continue to travel as safely as possible. As always, be sure to keep following AllEars for more travel tips and tricks.

Tips about Air Travel

What are your best solo travel tips? Tell us in the comments! 

Post a Comment

Travel insurance is one of those trip essentials many Americans consider yet far fewer commit to.

In an era of flight disruptions, economic uncertainty, and evolving travel habits, we wanted to understand how travelers are actually approaching trip protection in 2025. Are they playing it safe with coverage, or still rolling the dice?

To find out, we surveyed more than 2,300 travelers across the U.S. to explore how often they buy travel insurance, how much they spend on it, and what kinds of vacation expenses they’re most likely to protect. The results reveal not just how many Americans are buying travel insurance, but also who’s buying it, why they’re doing so, where it’s most common, and how past travel disruptions are influencing attitudes toward trip protection across the country.

Who’s Buying Travel Insurance and Who’s Still Skipping It?

Despite rising travel costs and increasingly unpredictable trips, many Americans still hesitate to insure their vacations. Our survey found that 58.6% of U.S. travelers have purchased some form of travel insurance in the past, whether directly or through a credit card or membership benefit. Still, 41.5% say they’ve never purchased any kind of travel insurance, highlighting a persistent divide between the cautious and the carefree.

When it comes to 2025 trips specifically, that divide deepens. 63% of travelers say they haven’t secured any type of travel insurance for their past or upcoming 2025 vacations. Just over one-third (36.7%) have some form of protection in place — 25% purchased coverage outright, while 11.7% are passively protected via credit cards or memberships.

There are some noticeable generational differences, as well. Millennials are the least likely to insure their 2025 trips, with 65% traveling without any coverage. Meanwhile, the frequency of flying matters: Travelers who fly 3 to 5 times per year (38.4%) and 6 to 10 times (43%) are more than twice as likely to purchase standalone travel insurance for their 2025 trips compared to those who fly just 1 or 2 times annually (19%).

Income level also correlates closely with insurance adoption. Among Americans earning over $200,000, 34% have insured their 2025 personal trips — nearly double the rate of those earning less than $50,000 (17%).

Where you live plays a role, too. Coastal high-population states and higher-income regions show a stronger commitment to coverage:

States Most Likely To Insure Their Vacations:

• Maryland: 49% insured their 2025 trips
• California: 48.2%
• Louisiana: 48.1%
• Texas: 46.6%
• Delaware: 46%
• New Jersey: 45.3%
• North Carolina: 45.3%

States Least Likely To Insure Their Vacations:

• Colorado: 22.6% insured their 2025 trips
• Montana: 23.3%
• Iowa: 23.4%
• Idaho: 25%
• Michigan: 25.5%
• Indiana: 26%
• Kansas: 26%

In general, Midwestern and Western landlocked states are less likely to insure their trips, perhaps reflecting regional attitudes toward travel risk or fewer perceived barriers to cancellation or delays.

Consistency also remains elusive. While 19.3% of travelers say they always or usually buy travel insurance, a much larger portion (37%) say they never do. Another 32.2% say they purchase insurance about half the time or occasionally. The remainder of travelers rely on credit cards or membership-based coverage.

Even among those who do buy coverage, cost plays a major role. The majority of Americans (59%) spend less than 5% of their total trip budget on travel insurance, while 37.5% spend 5% to 10%, and only 3.6% exceed the 10% mark.

What Travel Purchases Do Americans Protect?

When it comes to trip protection, Americans are most likely to cover the big-ticket items. Flights top the list, with 54.8% of travelers saying they’re most likely to insure their airfare. Car rentals (44.8%) and hotel bookings (34.6%) follow closely behind. Interestingly, hotel coverage is more common than protection for vacation rentals, such as Airbnb, which are insured by 27.3% of travelers. Meanwhile, less expensive or more spontaneous experiences — like concerts (12.3%), tours or excursions (11.4%), and train tickets (7.3%) — are far less likely to be covered.

This pattern suggests a clear logic: Travelers are more inclined to insure bookings with higher upfront costs or stricter cancellation terms, such as flights and rentals, while skipping protection for flexible or lower-stakes purchases.

However, regional habits reveal interesting exceptions. In California, Colorado, Kansas, Oklahoma, and Utah, travelers are more likely to insure car rentals than flights, perhaps a trait attributable to road trip culture or the need to drive in these spread-out regions. Meanwhile, travelers in Connecticut, Delaware, Kansas, Kentucky, Louisiana, New Hampshire, Ohio, and Wisconsin are more likely to insure Airbnbs than hotels. This may be because Airbnbs often involves higher upfront costs and stricter cancellation policies, prompting some travelers to be more cautious about protecting their stay.

Generational trends also shape what people protect. Gen Z stands out as the most likely generation to insure concerts, shows, and event tickets. 18.4% of Gen Zers say they’re likely to insure concerts, compared to 13% of millennials, 9.8% of Gen Xers, and only 7.3% of baby boomers. Gen Z is also more likely than millennials to insure flights, hotels, and Airbnbs, suggesting they’re more cautious about unexpected disruptions and protecting their travel investment.

When asked where they would cut back first to save money, travelers overwhelmingly pointed to flight upgrades — things like business or first class seats — as their first sacrifice. High-end hotels and resorts ranked second on the list of droppable luxuries, followed by fine dining. Notably, more travelers would give up fancy meals on their vacations than forgo travel insurance.

Do Travelers See the Risk or Just Hope for the Best?

Even if plenty of Americans are skipping travel insurance, most aren’t totally in the dark about the risks. When asked how risky it is to travel without insurance in 2025, a combined 91% of travelers acknowledged at least some level of risk. However, the perceived risk tends to be low: The largest share of travelers (43.2%) view going uninsured as only slightly risky. So while most people are aware of potential issues, many don’t see them as urgent or serious enough to prompt action, such as purchasing insurance.

At the state level, there’s a clear overlap between the places where travelers perceive greater risk without travel insurance and those where insurance is more commonly purchased. For example, New Jersey, North Carolina, and Texas all appear in the top states for both perceived risk and actual insurance adoption. 

States Where Travelers See the Biggest Risk in Going Uninsured:

• Texas: 31% think skipping insurance is very risky
• Virginia: 29.8%
• North Carolina: 28.3%
• Georgia: 26.8%
• New Jersey: 24.6%

On the flip side, states with the lowest perceived risk also tend to lag in insurance uptake. Hawaii, Iowa, Kentucky, Nevada, and Rhode Island lead the nation in downplaying the risk of traveling uninsured, with as many as 18.8% in Rhode Island believing it’s not risky at all.

States Where Travelers See the Smallest Risk in Going Uninsured:

• Rhode Island: 18.8% think skipping insurance isn’t risky at all
• Kentucky: 17.6%
• Hawaii: 16.7%
• Iowa: 14.9%
• Nevada: 14.9%

Frequent flyers, however, take a far more cautious stance. Those who travel often are more than twice as likely as the average traveler to say that going without insurance in 2025 is extremely risky. This elevated risk awareness may reflect firsthand experiences with delays, cancellations, or emergencies — challenges that infrequent travelers might underestimate.

Who’s Paid the Price for Skipping Travel Insurance?

While many travelers view trip insurance as an optional add-on, those who’ve skipped it and suffered the consequences often feel differently. According to our survey, 17.3% of U.S. travelers say they’ve lost money at some point because they didn’t have travel insurance. That may sound like a small share, but for those affected, the financial sting is real.

The most common loss was between $101 and $499, reported by 45% of those who’ve been burned. Another 28.9% said they lost between $500 and $999, with smaller groups reporting even steeper losses. These setbacks often become teaching moments: 64% of affected travelers say the experience has made them more likely to purchase travel insurance in the future.

Certain states stand out for the financial fallout. In Virginia, 28% of travelers say they’ve lost money by skipping travel insurance — the highest rate of any state. It’s no coincidence that Virginia also ranks as the second-most risk-averse state in our survey when it comes to trip protection, showing how personal financial losses can shift perspectives fast.

Frequent travelers are also more likely to have lost money by going uninsured. The more you fly, the more likely you are to encounter issues like cancellations, lost luggage, and last-minute itinerary changes. That exposure may be why seasoned flyers take insurance more seriously.

Despite these hard lessons, the overwhelming majority — 82.7% — say they’ve never lost money because of a lack of insurance. That may be one reason many still see trip coverage as a “nice-to-have” rather than a travel essential.

Are Attitudes Toward Travel Insurance Changing in 2025?

Travelers in 2025 are beginning to reconsider their stance on trip coverage, but only slightly. When asked whether they’re more likely to purchase travel insurance now compared to 2 years ago, 43.8% said yes, while 42.6% said no. That slim margin shows that while perceptions are starting to shift, many Americans remain unconvinced they need to purchase travel insurance.

The strongest shift is happening among younger travelers. Gen Z leads all age groups, with 49.7% saying they’re more likely to buy travel insurance today than in the past. Millennials, however, are more resistant to change. Only 40.3% say they’re more likely to purchase travel insurance now, while 46.5% say they’re not.

Among those who are now more inclined to buy insurance, the most common reason is simple: peace of mind. Nearly 64.5% of travelers say that avoiding the stress of emergencies is their top motivator. Logistical challenges are also pushing people toward coverage: 41% cite concerns over cancellations or delays, while 37.9% say travel feels more unpredictable overall.

For those who still avoid travel insurance, cost remains the biggest barrier. When asked why they skip it, travelers pointed to the following reasons:

• “It’s too expensive”: 48.6%
• “My trips aren’t expensive enough to justify it”: 37.7%
• “I’ve never had a trip go wrong”: 24.8%
• “I rely on flexible or refundable booking options”: 23.7%
• “I don’t understand what’s covered”: 13.9%

Ultimately, the decision to insure or not often comes down to how much risk a traveler is willing to accept and how much they’re willing to pay to reduce it.

Hot Tip:

Methodology

To understand how Americans view and use travel insurance in 2025, we conducted an online survey of 2,359 U.S. travelers across 45 states between July 9 and July 17, 2025, drawing from a diverse sample across age groups, income levels, and travel frequency. Respondents answered a mix of questions about their travel insurance habits, perceived risk, spending behavior, and past experiences with trip disruptions. We also analyzed differences by state. Because of limited respondent counts, Alaska, Montana, North Dakota, Vermont, and Wyoming were excluded from state-level analyses.

Final Thoughts

While most Americans acknowledge some level of risk when traveling uninsured, the decision to actually buy coverage remains deeply personal and deeply divided. Some travelers have learned the hard way, losing hundreds due to canceled plans or emergencies, while others continue to roll the dice, betting on flexibility or luck.

This study shines a light on how many insure their trips, which expenses they value most, and how travel behavior varies by state, income, and generation. As trip uncertainty grows, so does the need for clear, informed decisions. For travelers looking to protect their next adventure, understanding the best credit cards that offer travel insurance is a smart place to start.