How to Get Around in Nepal for Trekking or Climbing: What Foreigners Need to Know

You know that moment on a mountain trail when everything just stills? The crunch of your boots, the thin bite of high-altitude air, and a view so vast it feels like the Earth is holding its breath. That’s Nepal. It gets under your skin in the best way. For many, it’s not just a destination. It’s a test of spirit, stamina, and something deeper.

Every year, over 100,000 trekkers and climbers from across the globe land in Nepal chasing that feeling. Some come for Everest Base Camp (5,364m), the Annapurna Circuit (5,416m), Langtang Valley, Manaslu Circuit, or Upper Mustang — all bucket list-worthy treks. Others, especially mountaineers, aim even higher, targeting 6,000, 7,000, or 8,000 metre giants like Annapurna, Makalu, Dhaulagiri, Manaslu, and Everest itself.

The appeal is obvious: epic landscapes, ancient cultures, and the quiet pride of doing something most people only dream of. But what rarely makes it to the blogs or Instagram reels is the reality. The real cost of being in these mountains. And what happens when things don’t go to plan?

The Side of the Trail You Don’t Always Hear About

These treks and climbs aren’t as easy as they’re often made out to be. Altitude sickness doesn’t care how fit or experienced you are. A wrong step on a remote trail can quickly become an emergency. Helicopter rescues often cost thousands of dollars. And many travellers only find out mid-crisis that their insurance doesn’t cover the altitude, the activity, or much at all.

Even worse, Nepal’s rescue ecosystem has its flaws. There’s a history of wrong practices where trekkers have been pressured into unnecessary evacuations, not for their safety, but to feed a chain of commissions.

The adventure is real. But so are the risks.

Getting to the Trailhead: The Journey Before the Journey

Everything starts in Kathmandu. But getting to your actual trailhead is a whole other adventure.

If you're heading to Everest Base Camp, you'll likely be bundled into a jeep in the middle of the night en route to Ramechhap, followed by a short but dramatic flight to Lukla. For the Annapurna Circuit, you might catch a flight to Pokhara  or spend six hours on winding, not-so-safe roads. Treks like Langtang or Manaslu require long, bumpy jeep rides to Syabrubesi or Soti Khola, followed by days of hiking just to reach base camp.

The roads are rugged. Flights are frequently delayed or cancelled due to weather. And in many places, there’s no mobile signal or nearby medical help. That’s part of the allure. But it’s also where the risks start to stack up.

The No-Solo Rule: And Why It’s There

Nepal no longer allows foreigners to trek solo in most national parks and conservation areas. You’re required to hire a licensed guide and register your route. That might sound restrictive, but it’s rooted in safety.

Unregulated trekking has led to preventable accidents, missing trekkers, and emergency rescues that should never have been needed. When you’re breathless at 4,500 metres, you’ll want someone by your side who knows the terrain and the signs of trouble. Unless you are an alpinist and you know what to do in an emergency.  

When the Altitude Starts Biting

Even the fittest, most experienced trekkers can hit a wall above 3,000 metres. Headaches, nausea, and crushing fatigue are often the first signs that the body is struggling to adjust. Climb higher, and the risks become far more serious. Conditions like High Altitude Pulmonary Oedema (HAPE — fluid buildup in the lungs) or High Altitude Cerebral Oedema (HACE — swelling in the brain) can develop quickly and without much warning. The only real treatment? Immediate descent.

Take Gorakshep, for example, sitting at 5,164 metres on the Everest Base Camp trail. A trekker showing signs of HAPE here may need to be evacuated fast. Any delay in descent can be life-threatening.

And it’s not just altitude sickness. Physical injuries, sprains, fractures, and frostbite are common on rugged Himalayan trails. Add in unpredictable weather, sudden storms, blizzards, or even avalanches, and the risks multiply fast. Now imagine facing one of those emergencies at Tilicho Lake, Lobuche, or Camp 2 on an 8,000-metre expedition.

What makes matters worse is the lack of basic safety measures in some trekking operations. With over 2,000 companies competing in Nepal’s adventure market, many budget operators cut corners. Essential gear, like proper medical kits stocked with high-altitude drugs such as Diamox (acetazolamide) or Dexamethasone, is often missing. Some itineraries are dangerously ambitious, pushing trekkers to gain altitude too quickly and skipping critical acclimatisation days, despite warnings from bodies like the Himalayan Rescue Association (HRA).

In remote, high-altitude areas with limited medical infrastructure, these shortcuts can have serious consequences. Trekkers end up vulnerable, often far from help, in places where time is everything.

It’s Not Cheap: Financial Reality During Emergencies 

When things go wrong in Nepal’s remote trekking regions, the financial fallout can be steep. Helicopter evacuations, often the only practical way to rescue someone from areas far from roads, typically cost between $3,500 and $7,500, depending on the location. Rates vary: for Everest, you’re looking at $4,500 to $7,500; Annapurna evacuations usually fall between $3,500 and $5,000; and for Manaslu, it’s around $4,200 to $5,500. In more remote or complex situations, those figures can shoot past $10,000, as per 2025 estimates from Heli On Call.

Then there’s the cost of treatment once you’re off the mountain. Hospitalisation in Kathmandu or Pokhara for altitude sickness, injury, or infection can add another $500 to $5,000 or more, depending on how serious the condition is and how long you’re admitted. Something relatively straightforward, like basic treatment for AMS with oxygen and medication, might cost a few hundred dollars. But severe cases, like HAPE, requiring intensive care, can drive costs up dramatically.

For uninsured trekkers, or those with inadequate coverage, the financial strain can be devastating. What’s worse is that in most emergencies, upfront payments are expected before treatment or evacuation takes place.

Helicopters: Lifesavers, But Not Cheap

Part of the reason these rescues are so expensive comes down to logistics. In dire emergencies, Helicopter rescues are often the only way out. But they don’t come cheap. Depending on the region, chartering a helicopter costs anywhere from $1,300 to $3,000 per hour, plus landing fees, fuel surcharges, and taxes. And during peak trekking seasons, March to May and September to November, demand goes up while helicopter availability drops, pushing prices even higher. 

And that doesn’t include the cost of lost gear, missed connections, or interrupted expeditions. Most heli companies expect payment up front. If you’re caught off guard without solid insurance, the pressure to arrange funds quickly, often through family or emergency contacts back home, can be overwhelming, especially when every minute counts. After evacuation, also add another $1,000 to $5,000 for hospital care.

The Dark Side of Rescue: Fraudulent Helicopter Evacuations in Nepal

The evacuations are also fraught with fraudulent practices, and this remains a serious concern in Nepal’s adventure tourism industry. A 2018 investigation by The Guardian revealed that an estimated 35% of 1,600 rescues that year were unnecessary, costing insurers over $4 million. The scams often involve collusion between trekking agencies, helicopter operators, hospitals, and at times, even trekkers themselves, capitalising on the high cost of emergency services.

Some of the most common tactics include:

• Unnecessary evacuations: Trekkers with mild symptoms like fatigue or headaches are pressured into helicopter rescues when rest or descent would have sufficed. According to a Kathmandu-based doctor, roughly 20% of evacuations were medically unjustified.
  
  

• Overbilling and kickbacks: Helicopter companies inflate flight times, while hospitals issue fake invoices or perform needless treatments. Trekking agencies sometimes pocket commissions of up to 50% of the billed amount.
  
  

• Manipulating trust: In high-stress situations, guides often push trekkers into quick decisions, urging evacuation without proper medical evaluation.
  
  

• Inducing illness: In rare but disturbing cases, there have been reports of guides tampering with food to create symptoms that justify an evacuation.

These fraudulent practices led to the formation of Nepal’s Tourist Search and Rescue Committee in 2018, tasked with regulating rescue operations and reviewing suspicious cases. But as of 2023, such practices persist in parts of the industry. This underscores the importance of choosing ethical, reputable agencies and insurance providers that prioritise genuine medical need over profit.

The Insurance Fine Print You Skimmed

Many travellers arrive in Nepal confident that their travel insurance has them covered, until they need it. Standard global policies often have altitude caps, usually around 4,500 to 5,000 metres, and exclude anything considered mountaineering. That means routes like Everest Base Camp, Annapurna Circuit, and any climbs above these limits are often only partially, or not at all, protected.

Even when coverage exists, high deductibles are common, ranging from $100 to as much as $1,500. This means trekkers still have to pay significant sums out of pocket before their coverage even kicks in. A $750 deductible on a helicopter evacuation can delay life-saving care, especially in remote areas where operators demand full payment upfront.

Years of inflated rescue claims, overbilling, and fraudulent invoices have made global insurers increasingly cautious about covering Nepal. Between 2014 and 2019, claims from Nepal rose from 15% to 60% of total claims for some providers. In response, many insurers have sharply increased their premiums, by as much as 60–70%, or quietly withdrawn from the Nepal adventure market altogether.

In 2025, some trekkers reported being quoted over 400 Euros for policies that only covered up to 6,000 metres, proof of how risk and claim frequency have reshaped the landscape.

The result is a growing coverage gap. Travellers often find themselves underinsured or entirely unprotected just when they need help the most. These rising costs and policy limitations make it clear: for trekking and climbing in Nepal, specialised adventure insurance, not generic travel cover, is not just recommended, it’s essential.

Enter ASC360: Built for This Terrain

This is where Adventure Sports Cover 360 (ASC360) steps in. An India-based company with a full-time Nepal presence, ASC360 was created specifically to support high-altitude adventurers, trekkers, climbers, and explorers.

ASC360 does not sell general travel insurance. They offer targeted, mountain-specific protection, with boots on the ground and a plan that works.

Here’s what sets ASC360 apart:

Why ASC360 Stands Out for Trekkers and Climbers in Nepal

• Covers Altitude Up to 8,000 Metres
  Whether you're trekking to Everest Base Camp or climbing peaks like Island Peak, Himlung, or Everest itself, ASC360 covers what most policies exclude.
  
  

• Cashless Helicopter and Ground Evacuations
  No upfront payment is needed during emergencies. ASC360 handles coordination and pays the operator directly—critical for life-threatening conditions like HAPE or HACE.
  
  

• End-to-End Medical Care
  Full coverage for:
  
  

• Treatment at mountain clinics

• Hospital stays in Kathmandu or Pokhara

• Doctor consultations, medications, and diagnostics

• Post-hospital care
  
  

• 24/7 Medical Support
  On-call doctors are available any time to offer real-time medical advice—helping catch symptoms early and reduce the risk of escalation.
  
  

• Accidental Death Coverage
  Financial protection for worst-case scenarios, offering peace of mind for you and your loved ones.
  
  

• Trip Cancellation or Interruption
  Reimbursement for non-refundable costs due to health issues, natural disasters, or travel delays.
  
  

• Baggage Loss or Delay
  Insurance for lost, delayed, or damaged trekking equipment—especially important when gear is essential to your safety.
  
  

• No Deductibles, No Surprise Costs
  What’s covered is fully covered. No hidden fees or out-of-pocket expenses before support kicks in.
  
  

• Local Support That’s Local
  24/7 emergency response team based in Kathmandu, not an offshore call centre. Real people with local experience coordinate help when every minute counts.
  
  

• No Commission-Driven Evacuations
  ASC360 works only with verified, ethical partners. If you don’t need a helicopter, they won’t push for one. You’ll get honest guidance and support on the trail.
  
  

• Available Even After You Arrive in Nepal
  Forgot to buy insurance? Plans can be purchased after landing—ideal for spontaneous travellers or last-minute plan changes.
  
  

Affordable, Adventure-Specific Coverage

While helicopter rescues can cost anywhere from $3,500 to $7,500, and hospitalisation bills can range from $500 to $5,000 or more, ASC360's plans are priced with these realities in mind. Costs vary based on your nationality, route, and how long you're staying—but what you get is tailored protection that’s built for the demands of the Himalayas, not the beach. It’s coverage that works when things go wrong.

Why This Matters More Than Ever

Trekking and climbing in Nepal are more popular than ever. But the crowds are growing, the peaks are pushing limits, and the risks are shifting.

The mountains don’t care how many treks you’ve done or how many followers you have. They reward those who prepare and punish those who don’t.

If you’re stepping into this terrain, step in smart. Choose your operator and guides well. Acclimatise properly. Don’t race the summit. And make sure you’ve got backup that doesn’t disappear the minute things get hard.

Over the past decade, ASC360 has quietly built a reputation for trust and reliability where it matters most—in the mountains. With more than 450,000 trekkers and climbers covered, over 1,250 helicopter evacuations successfully executed, and a claim settlement rate exceeding 99 per cent, ASC360 has proven it can deliver when the stakes are high. 

They've paid out over $3.6 million in claims and are backed by some of the most respected trekking agencies and adventure associations in the region. 

In one recent example, during a 2024 Annapurna Base Camp trek, a trekker suffering from severe altitude sickness was evacuated and admitted to CIWEC Hospital in Pokhara within hours without paying a rupee upfront. That kind of speed, coordination, and financial ease isn’t just reassuring; it can be life-saving. This is the kind of dependable support every adventurer deserves to have behind them.

Nepal isn’t just a destination. It’s a commitment. A leap of faith. A challenge you rise to meet. But while the mountains are wild and unpredictable, your safety doesn’t have to be. Go for the view. Climb and get to the summit. Leap. But do it with your eyes open and your support system in place.

Because the Himalayas will always be wild, and that’s exactly why we go.

Comparison Chart 

Traditional Insurance vs ASC360

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To know more or get covered, visit www.asc360.com or call the 24/7 Kathmandu support line at +977-9702657161.