You can get travel insurance for extended trips. I'm American and I've taken multiple 6-month trips abroad (usually after quitting a job). Backpacking just isn't part of the American culture.
Regular travel insurance != health insurance. It will basically cover you getting stabilized and shipped back home but then you're on your own. (And lost travel deposits.)
Don't even bother with the travel insurance, pay for health care out of pocket in another country. Travel insurance is only needed for traveling in America for the reason you stated.
IMO travel insurance sometimes makes sense. Circumstances like high altitude trekking that may require expensive evacuation. Expensive non-refundable trips, especially those that a broken ankle before or during the trip could put a rapid stop to.
That said, I've only purchased travel insurance maybe a half-dozen times out of probably hundreds of trips.
You need to make sure it covers that altitude. They top out around a certain altitude in the fine print you usually need to pay a little extra for altitudes like Kilimanjaro. Make sure it has helo evacuation covered for all altitudes.
Good point. The few times I was up at that sort of elevation or higher, the insurance was always through someone the guide company specifically recommended. Fortunately, I've never had any significant altitude issues.
