Background The aim of this study was to explore variations in cost and choice of travel insurance in patients with cardiac disease. Methods Clinical data from patients with myocardial infarction (MI, n = 20), Marfan syndrome (MFS, n = 10) and dilated cardiomyopathy (DCM, n = 10) were input to insurance websites for a proposed ten-day holiday and data for premium cost (£) and choice of quotes (n) collated for each condition. Age-matched healthy individuals were used as controls. Results Median cost of insurance was significantly higher for MI (£233.07; interquartile range (IQR) = £222.95-£245.47 versus £24.29; IQR = £11.9-£34.09, p = <0.001), MFS (£37.43; IQR = £23.61-58.83 versus £19.20; IQR = £9.09-£27.31, p = 0.0378)) and DCM (£166.87; IQR = £129.71-£198.62 versus £23.96; IQR = £11.99-£32.44, p = <0.001) compared to controls. Choice of quotes was also significantly reduced for MI (5; IQR = 5-14 versus 89; IQR = 26-110, p = <0.001) MFS (61; IQR = 26-83 versus 105; 26-105, p = <0.001) and DCM (19; IQR = 16-28 versus 89; IQR = 26-106, p = <0.001) compared to controls. Modifiable factors, such as time after cardiac event or awaiting further investigations, and clinical factors, such as persistent symptoms and disease severity, lead to a significant increase in cost. Conclusions This study provides insight into the factors affecting cost and choice of travel insurance for patients with cardiac disease. The findings highlight ways in which healthcare professionals can support patients to obtain travel insurance.