Because of my mother's age, the possibility of having to cancel is a consideration for me. But I could survive the loss if I had to cancel and had no insurance. The bigger concern to me is the cost becoming ill or of medical evacuation in case of injury. Didn't one of the cruisers on the recent Voyager Panamal Canal cruise get injured on a shore excursion, requiring a medical flight back to LA? Now that could really break the bank! While it doesn't happen often, the peace of mind is worth the relatively small additional cost.