It goes without saying that you shouldn’t travel without insurance, but for Nepal, especially when you’re taking on the high peaks and passes, the stakes are much higher.
In recent years, securing coverage for high-altitude trekking has become difficult and expensive, largely due to a crackdown on helicopter rescue scams in the Everest region. When I started trekking here in 2018, a comprehensive 3-week policy cost around $40 or so.
Today, premiums have soared, and the fine print is stricter than ever…
This is even more critical for the Manaslu Circuit, which is far more remote than the busy trails of the Khumbu. Since the Larkya La Pass sits at 5,106 m (16,752 ft), most standard “adventure” policies which caps at 5,000 m, are legally useless here.
In this guide, I’ll break down the specific providers I currently use for the Nepal Himalayas to ensure you don’t get stuck with a $5,000+ rescue bill in one of Nepal’s most remote mountain regions.
Overview: The Reality of Trekking Insurance for the Manaslu Circuit
The Manaslu Circuit is a Restricted Area, meaning you cannot trek solo and must hire a licensed guide through a registered agency. Because these agencies are legally liable for your safety, they will not process your Restricted Area Permit (RAP) without proof of a valid insurance policy.
While you can get advice on high altitude trekking insurance from a reputable trekking agency in Kathmandu, the reality is that rules and coverage changes so rapidly that it pays to do some additional research.
Here is the specific criteria your insurance must meet:
- Helicopter Rescue is Mandatory: Your policy must explicitly state coverage for "Emergency Helicopter Evacuation." Ground ambulance coverage is insufficient because there are no roads in the upper circuit.
- The "5,000 m Trap": The Larkya La Pass sits at 5,106 m (16,752 ft). Most standard "adventure" policies—including popular budget options like Heymondo—cap coverage at 5,000 m (16,400 ft). Crossing the pass with these policies legally voids your coverage at the most important point of the trek.
- Upfront Payment vs. Direct Billing: Helicopter evacuations cost $5,000–$10,000 USD upfront. Agencies prefer providers with "Direct Billing" (like Global Rescue) who pay the pilot immediately, rather than reimbursement policies where you must pay cash first.
Current Trekking Insurance Policies for the Manaslu Circuit Trek
Based on the latest policy updates, here are the three providers that are worth considering for the Manaslu Circuit trek, considering the remoteness of the Manaslu Region, and the altitude requirements.
- Global Rescue Top Pick This is not traditional trekking travel insurance; it is a "field rescue membership" and it's what I've been using now for the past 3 years to cover me for all my treks from the Himalayas to the Karakoram. They are the only provider that reliably pays helicopter companies upfront ("Direct Billing"), avoiding the $5,000 cash deposit nightmare. However, for 2026, the standard membership excludes activity above 4,600 m so you must now add the "High-Altitude Evacuation Package" (approx. $395). Also, remember this covers rescue only you may still want a separate medical policy (like IMG) for hospital bills.
- World Nomads: The most reliable "all-in-one" option for budget-conscious trekkers, but you have to pick the right plan. You must select the "Explorer Plan", as the Standard Plan often caps hiking at 3,000 m so you will need to verify that "Hiking/Trekking up to 6,000 m" is listed as a covered activity. Be prepared to pay the helicopter deposit yourself (reimbursement model) and fight for the money back later though.
- Garmin SAR: If you own a Garmin inReach, you might see their "SAR 100" insurance advertised for just $40/year. While you used to be able to use this, this cheaper plan now strictly exclude any activity above 5,000 m. To be covered for the Larkya La Pass (5,106 m), you must buy the "SAR High Altitude" plan, which costs a staggering $999/year. Unless you are a professional mountaineer, or doing several trips per year, this is now much worst value than Global Rescue.
Global Rescue
Global Rescue is the industry standard for high-altitude evacuation in Nepal, but it is not travel insurance; it is a "crisis response membership." I use this because they are the only provider that consistently guarantees "Direct Billing" with the major local helicopter companies (specifically Simrik Air and Kailash Helicopter).
This means when you hit the SOS button, Global Rescue pays the helicopter dispatch immediately, so you aren't forced to wire $5,000 USD from a satellite phone on the side of a mountain.
For the Manaslu Circuit, the "Standard Membership" is now not an option since it strictly excludes activity above 4,600 m (15,000 ft). To be covered for the Larkya La Pass (5,106 m), you must purchase the "High-Altitude Evacuation Package" add-on.
For a typical 14–30 day trip, this upgrade can cost an additional $495 or so currently on top of your base membership fee, but unfortunately it is non-negotiable for this trek.
The main limitation is that Global Rescue only covers the evacuation to the hospital, not the medical treatment itself. I pair my membership with a low-cost medical-only policy from HeyMondo but you can also choose one from IMG together with your Global Rescue membership (International Medical Group) to cover any actual hospital bills in Kathmandu.
How it Works
If you need evacuation from anywhere on the Manaslu Circuit, whether it be on the road in (actually the scariest part if you read my itinerary), or from remote camps like Dharamsala, or the Larkya La Pass, you will contact Global Rescue operations directly.
This is done via their app, a satellite phone call, or an inReach message. Because they are a "crisis response" company and not an insurance firm, you are speaking directly to their deployment team, not a claims adjuster.
By far, the best thing about Global Rescue is that they work on pre-signed contracts and establish relationships with the major Nepali helicopter operators (like Simrik Air and Kailash Helicopter).
They do not need to draft a new "Letter of Guarantee" for every single flight.
The result is that once they verify your location and condition, they issue a dispatch order immediately. The helicopter company trusts Global Rescue enough to fly without seeing your credit card or cash. You get off the mountain without ever opening your wallet, and Global Rescue settles the bill directly with the provider in Kathmandu.
This is quite simply, and of course things can change, so remember at any point you will NEED to read the PDS and fine print on all insurance options before you buy. Note, if you read on to compare the other options, you'll know why I personally prefer Global Rescue in the current high altitude trekking insurance climate.
World Nomads
If you prefer an "all-in-one" traditional insurance policy, World Nomads is the most reliable alternative, but you must be precise with your plan selection. You must purchase the "Explorer Plan," as the cheaper "Standard Plan" typically caps "hiking/trekking" at 3,000 m (9,842 ft) which is far below the Manaslu Circuit's requirements (or any Himalayan trekking experience for that matter).
The Explorer Plan specifically covers trekking up to 6,000 m (19,685 ft), which safely clears the 5,106 m Larkya La Pass.
The trade-off is that World Nomads operates on a "Pay and Claim" model. In my experience, this means you will likely have to pay the $4,000–$6,000 helicopter invoice upfront using a credit card and then fight for reimbursement after you return home.
While I've never had to make a claim with World Nomads I have used them in the past, and their reputation is very solid, at least with the backpacker community.
How it Works
The way it works is that your guide must call the World Nomads 24/7 Emergency Assistance Team immediately, usually via a satellite phone. You cannot just call a helicopter pilot, you must first get approval from the insurer's medical team over the phone to prove the flight is "medically necessary."
Once approved, World Nomads issues a formal "Letter of Guarantee" (GOP) and emails it to the helicopter company. This document is a legal promise that the insurer will pay the bill.
The result is that the helicopter company sits on the tarmac and waits for this email before they fly to Samagaon or the remote valleys. If you are calling at 3:00 pm and the admin team is slow, or if it's a weekend in the insurer's home country, this delay can force you to spend another night at high altitude.
That's why it's important to know that if the situation is critical and you can't wait for the email, you might have to pay the $5,000+ upfront on your own credit card and file a claim later.
Garmin SAR
The Garmin InReach SAR insurance used to be a bit of a cheat code for trekking travel insurance at high altitude. For years I just bought the cheap SAR insurance which worked with my Garmin inReach Mini device for around $49 for the entire month.
However, just like quiet tea houses in the Khumbu, all good things must come to an end I guess. The prices and schedules have completely changed, and this is now one of the most expensive trekking travel insurance options for the Manaslu Circuit.
So no, the cheaper "SAR 100" insurance ($40/year) does not cover you for the Manaslu Circuit. The policy wording explicitly excludes "mountain climbing" or trekking if you have the "intent to go above 5,000 m" (16,404 ft).
Focus on the wording "intent to go". Since the Manaslu Circuit itinerary explicitly lists a 5,106 m pass, your coverage is void from day one.
To be legally covered for the Manaslu crossing, you are forced to buy the "SAR High Altitude" plan. This costs a whopping $999.99 per year. Expensive, but worth it if you are doing a few more expeditions in that year.
How it Works
The way it works is that when you hit SOS on your device, you are texting the Garmin Response Center (formerly IERCC) in Texas. They act as a dispatcher. They will find a local helicopter company and give them your coordinates.
However, Garmin’s SAR plan is an insurance reimbursement policy, not a "direct-to-provider" service. The helicopter company knows Garmin eventually pays, but they often demand cash now (helicopter companies in Nepal are notorious for refusing to turn on the rotors until they have a guarantee of payment).
The result is that the helicopter company may (and I say may, because this is very much a case by case basis) demand a credit card hold or cash deposit (approx. $5,000 USD) from you or your trekking agency before they fly out to the Manaslu Region to pick you up.
You may then have to file a claim with Garmin’s underwriter to get that money back months later.
Can I Just Buy Cheaper Insurance Capped at 4,500 M?
I see this "hack" discussed online and sometimes in Kathmandu hostels: buy a cheaper policy capped at 4,000 m or 4,500 m, and just "hope nothing happens" on the pass itself.
Do not do this. It is a false economy that usually voids your entire policy from the moment you land in Kathmandu.
Here is why:
- The "Intent" Clause: Most insurance underwriters (including the backers for Garmin and World Nomads) have a clause regarding "intent to travel." If your itinerary includes the Larkya La Pass (5,106 m), you are intentionally traveling beyond the policy limits. This voids your coverage for the entire trip, not just the day you cross the pass. If you break your leg at 3,000 m on Day 4, the insurer can deny the claim by proving your itinerary was always "too high" for the policy.
- The "Permit" Block: You physically cannot enter the Manaslu Conservation Area without a Restricted Area Permit (RAP). To get this permit, your trekking agency must submit your insurance documents to the government. If a diligent agency sees your policy is capped at 4,500 m for a 5,106 m trek, they may refuse to apply for your permit because they are legally liable for you.
- You Miss the Best Side Trips: The Manaslu Circuit isn't just about the pass. Two of the best acclimatization hikes—Manaslu Base Camp (4,800 m) and the Tibetan Border (Rui La) day trip (4,998 m)—are well above that 4,500 m cap. Skipping these to "save money" on insurance means missing the rawest, most spectacular sections of the entire circuit.
My Verdict: If you can’t afford the extra $100–$200 for the proper high-altitude coverage, you cannot afford to trek Manaslu.
