We buy insurance for every cruise, to the tune of anywhere from $125 to $250 for the two of us for a cruise. We used to buy insurance through the cruise lines, but changed to Travel Guard because they waive pre-existing conditions if you buy the policy within 14 days of booking. One or two others do the same, but the cruise lines' insurance doesn't. This is important, too. Health, death, lost luggage, missed ship, bankrupt cruise line, etc.....all covered. When we had to cancel a cruise when my wife's father died, they didn't want to pay off because HE died of a pre-existing condition. When I reminded the claims guy of their waiver policy, he said that he'd never heard of it (With Travel Guard, only their Super Saver policy has the waiver). He checked into it and called me back to tell me I was right, and that they would pay off. They did. As a scuba diver, I also have a DAN (Divers Alert Network) policy that covers me in the event of a diving accident or death. We would never book without insurance. Your choice, of course, and it does add up if you cruise much...but to us, it's an intelligent investment.