We just booked Mariner for next June in Alaska. Our insurance is about $650. One of the largest exposures is medical and medical evacuation. Our policy has no pre-existing condition clause if purchased by final payment on the cruise. This is rather unusual and will no longer be available after this year (according to the TA). I checked the website that compares policies and most have either a pre-existing condition clause while others require you to buy the insurance at the time of your deposit for the clause to be waived,meaning you lay out the money as much as 7 or 8 months early.