Travel Guard
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Travel Guard's Adventure Sports Bundle lets backpackers add optional coverage for high-risk activities without buying unnecessary add-ons if they're not doing them. The bundle explicitly covers bungee jumping, skydiving, mountaineering, and similar pursuits with medical expense and emergency evacuation protection up to $1M, which matters when you're injured far from a major hospital.
This works best for backpackers who plan a mix of trekking and occasional extreme sports. If you're doing serious mountaineering or extreme activities regularly, you'll want to compare the evacuation limits and activity exclusions against other specialist providers.