Quick summary
Palau has no legal dive-insurance requirement, but Belau National Hospital in Koror — which does have a recompression chamber, confirmed 9 April 2026 — cannot treat major trauma or cardiac cases. A medevac to Manila or Guam runs $20,000 to $60,000 or more, an ER visit $80 to $800 and a hospital day $100 to $1,200. Dive operators and insurers recommend $250,000 in evacuation cover.
Dengue and Zika risk peaks from May to November, so an October trip still sits inside the elevated window. Below: what a Palau emergency costs, the clauses your policy must name, and the entry fees to settle before you book.
Belau National Hospital cannot treat major trauma, cardiac events or complex cases. Those patients leave by air. The old version of this guide told readers the hospital had no hyperbaric chamber. It does: Koror’s national hospital houses a recompression chamber, confirmed as of 9 April 2026.
For travelers from North America, Europe and Australia, the question is whether their policy covers a serious illness or a decompression hit. The policy that pays for one is the same one that pays for the other.
The expensive part is the flight.
Is dive insurance actually mandatory in Palau?
No Palauan law, immigration rule or airline condition requires a visitor to hold dive insurance. The requirement is contractual: a policy that does not name scuba diving will not pay for a diving accident. Dive operators and insurers recommend $250,000 in emergency evacuation plus at least a $10,000 medical limit for Palau, levels that match what a real emergency costs.
Austria’s Foreign Ministry, whose Palau advisory was updated on 9 July 2026, advises its citizens to carry insurance covering emergency airlift to Manila or Guam and to verify decompression-chamber coverage for diving accidents. The US State Department keeps Palau at Level 1, exercise normal precautions. That rating says nothing about the size of an uninsured medical bill.
The policy wording matters, not the passport stamp.
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What a Palau medical emergency really costs
Belau National Hospital in Koror is the country’s main referral facility. Its chamber means a mild decompression hit may be treated on the island rather than flown out.
Medical evacuation from Palau to Manila or Guam runs $20,000 to $60,000 or more, according to Palau medical-cost figures published by travel-insurance providers in 2026. An emergency-room visit costs $80 to $800, and a hospital bed $100 to $1,200 a day.
The same arithmetic holds across the region: dive trips elsewhere in Micronesia need the same $250,000 evacuation floor. The same audit applies to medevac insurance for Papua New Guinea.
What your dive policy must actually cover
Three inclusions decide whether a Palau claim survives: scuba diving named as a covered activity, hyperbaric treatment for decompression sickness, and a depth limit deeper than your planned profile. The diver must also hold a recognised certification, and the accident must fall inside the policy’s depth limits. Scubaid’s guide to diving insurance notes that standard travel policies routinely exclude hazardous activities including scuba diving unless a specific endorsement is added. Dive endorsements commonly cover recreational depths of 18 to 40 metres; technical diving below 40 metres or on mixed gas needs a specialist policy.
DAN separates transportation from treatment. Membership covers emergency medical transportation and travel assistance, capped at US$150,000 on Regular membership and US$500,000 on DAN’s Enhanced membership. Accident medical expenses, the hospital and chamber bills themselves, are not part of Enhanced membership at all. They come from a separate dive accident policy such as the Guardian Plan, which pays up to US$500,000 per incident and is open to non-divers as well.
DAN’s dive accident insurance requires joining DAN first; membership and accident cover are separate purchases. Dive accident insurance starts at US$42 a year.
Enhanced membership also carries severe infectious disease and quarantine cover of up to US$5,000. That includes $250 a day for quarantine to a $1,500 maximum, plus $3,000 for a severe infectious disease evacuation.
Entry, fees and timing to verify
The Palau Pristine Paradise Environmental Fee is US$100 per international air ticket, charged once and in force since 1 January 2018. It is collected with the ticket rather than at the airport.
US passport holders enter visa-free for up to 360 days under the Compact of Free Association, according to EntryBrief’s 2026 entry guide, with no visa fee at the airport. All visitors sign the Palau Pledge on arrival and complete an online entry declaration, a requirement in place since December 2017. Reef-toxic sunscreen is illegal in Palau. Only zinc-oxide or titanium-dioxide products are permitted.
Timing changes the risk profile more than any other variable. Dengue and Zika risk peaks from May to November, when mosquito numbers climb, and on 10 October 2026 Palau is still inside that window. Cyclone season runs November to April, when trip-cancellation cover earns its premium. Both windows are documented in Pack Lightly’s July 2026 Palau insurance guide.
Where the rules change by departure point
Dive cover is sold by the same global insurers everywhere. But the membership tier, the currency of the cap and the pre-existing-condition terms differ by where you live.
North America. DAN Americas membership is priced in US dollars: US$40 a year for Regular and US$75 for Enhanced. Family membership costs US$60 and US$100, respectively. Membership and dive accident insurance are open to residents of the United States and Canada.
Europe, including the UK. DAN Europe membership runs from roughly £40 a year for basic cover to £120 or more for plans that add trip cancellation, equipment cover and travel assistance, according to the dive-insurance resource Scubaid. Scubaid describes DAN’s core benefit as recompression chamber coverage, with general hospitalisation, trip cancellation and a flight home after a non-diving injury generally outside it.
Australia. DAN World’s Diving Insurance Plan pays up to 150,000 Australian dollars per incident on its Master Plan and 300,000 on the Preferred Plan for treatment outside Australia. The Master Plan has a 50-metre depth limit. Residents aged 12 to 79 are eligible. Pre-existing condition charges are excluded for the first 12 months after the policy takes effect.
Sort cover before the November weather shift
DAN requires evacuation to be arranged through DAN TravelAssist before the flight; arranging your own transport can reduce or deny the benefit. Diving injuries and illnesses must also be reported to the insurer within 24 hours to keep a claim valid.
- Read the certificate, not the summary: search the policy PDF for scuba, hyperbaric and depth, and treat a missing keyword as a denial waiting to happen.
- Call the assistance line, not the sales line, and ask what you would owe if decompression sickness in Palau required evacuation to Manila.
- Confirm the chamber: ask your operator or Belau National Hospital whether the Koror recompression chamber is accessible for your dates before you commit to a deep itinerary.
- Watch: your renewal date. DAN’s dive accident terms are dated 1 January 2024 and the Australian plan April 2025, so confirm the wording still names hyperbaric treatment before you renew.
Checking the wording now takes minutes. Budget the permit separately from the fee, and ask the Koror State Government or your operator for the current price.
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Questions? Answers.
Is dive insurance really necessary for Palau?
No law requires it, but a policy that does not name scuba diving will not pay for a diving accident. Dive operators and insurers recommend $250,000 in evacuation cover and at least a $10,000 medical limit, and Belau National Hospital’s recompression chamber cannot handle major trauma or cardiac cases.
What should my policy explicitly mention?
Scuba diving as a covered activity, hyperbaric treatment for decompression sickness, and a depth limit deeper than your planned profile. Check the certificate definitions rather than the marketing summary, and note that DAN Enhanced membership covers evacuation but not accident medical expenses, which need a separate dive accident policy.
Does standard travel insurance solve the problem?
Often not. Standard policies routinely exclude hazardous activities including scuba diving unless a specific endorsement is added, and dive endorsements commonly stop at recreational depths of 18 to 40 metres. Technical diving below 40 metres needs a specialist policy.
What medical conditions are not covered by travel insurance?
Hazardous activities such as scuba diving without an endorsement, and pre-existing conditions. DAN World’s Australian plan, for example, excludes pre-existing condition charges for the first 12 months after the policy takes effect. Report any illness or injury to your insurer within 24 hours to keep a claim valid.
