We have never travelled without it. Our insurance does not cover medical evacuation and that is the main reason we get it -- and trip cancellation coverage for medical or work. My aunt had to use it within one week of sailing after she hurt her leg and got all her monies back ($1,900 worth) and only paid $88 for the insurance! We saw a horror show at CC a decade ago where someone had a heart attack and they had helicopter evacuation and the woman had to sign a guaranty for the $25,000 fee -- they didn't have insurance! It's a great comfort should anything happen and I think it's worth the small amount you pay!
You make what is really the most important point, you need to do your homework and find out what your insurance covers.
DW and I work for corporations with thousands of employees, some of whom may travel overseas, so international coverage for healthcare has always been part of our group health insurance. Last time we changed insurance companies, the rep was questioned about that by someone wanting to know how much extra they charged us for that coverage. He said nothing, because on average, medical procedures cost LESS outside the U.S., so the insurance company actually saves money if you get treatment overseas.
Now, if you are on MEDICARE, you NEED to buy international medical coverage because MEDICARE does not cover you outside the U.S.
Now, I did have the sad experience in 2012 of my mom having a stroke 6 weeks before a cruise that she did not buy
travel insurance on. I called the
travel agent, and she contacted HAL and Alaska Airlines and they refunded her money that day. Travel Agent says that isn't unusual, because not doing so could generate HORRIBLE bad publicity for the cruise line.
Finally, there is no way to measure the value of the peace of mind you get from the insurance.
Having said this, and having done 9 cruises, and trips around the world, I have only purchased Travel Insurance once in my life. It was for a
Disney Cruise. I felt the insurance was worth it for the following reasons:
1) The trip was in Winter and cross country so weather could case delays
2) The trip was December 26 to January 3, a peak holiday travel period where heavy demand could cause delays.
3) It was the most expensive trip (by almost double) we have ever taken. I would not be happy about losing my money on a cheaper cruise, but I would be REALLY unhappy if I had lost that much money, so the peace of mind was worth the cost of the insurance.