I am from Canada and would never even cross the border into New York to shop without having insurance so being on a cruise ship travelling to foreign ports, insurance medical/ trip cancellation / trip interruption is a must. My son fell off the bed in Hawaii one year (jumping of course) and hurt his ankle. It would have cost us $5,000 to get his ankle fixed up without the insurance. Another time I got food poisoning in Bahamas and had to come home early. Another time my older son, got pneumonia days before we were to leave on a $10,000 RCCL family cruise and (we got every little penny back). Check you credit card. We have a platinum one that comes with major insurance as long as we book our holiday on that credit card. I just spoke to a lady last night at a party who had to fly her mom home from St. Maarten because the lady fell and broke her hip and needed surgery. the cost for the hospital to stabilize her and then make the flight back to Canada with a nurse on board was $30,000. nEVER TAKE A CHANCE.