Credit card travel insurance is real but narrower than the marketing suggests, and the restrictions cluster in predictable places. Trip length is the first: coverage typically applies only to trips under a defined maximum duration, which makes it unsuitable for long stays or open-ended expat moves. Activation conditions are the second: many cards require you to have paid for the trip, or at least the flights, with that card for cover to apply at all.
Medical limits deserve the closest look. Some premium cards carry decent emergency medical and evacuation cover, but many cards, especially basic ones, emphasize trip cancellation, delay, and baggage while offering thin or no medical cover. Pre-existing conditions are commonly excluded with no option to declare them, adventure activities are usually out, and older travelers may face age limits. Claims also tend to be reimbursement-only, with no assistance company to arrange guarantees of payment to hospitals.
So read the actual certificate of insurance, not the brochure.