My husband and I were younger and very healthy. He became ill, with a high fever, on our Alaskan cruise. One visit to the ship's doctor with some lab work showed that it was way more than an infection. We were taken to a local Alaskan hospital. I had 3 hours to get our belonging off the ship as it was going to sail. Long story short, my husband had a terrible illness, way over the heads of the local hospital. They stabilized him and recommended we fly home. I called the insurance company who worked with the hospital, pieced together our flight home (which alone would have cost a couple thousand dollars for a regular coach flight...last minute). Picture being in a little hotel room--sick, tired, and afraid--no computer--late at night with no travel agencies and trying to figure out how to get from Alaska to PA in a hurry. Now picture being in the middle of the ocean or in a foreign country and how much worse that would be! The insurance company paid for that flight, paid for the hotel the night before the flight, the taxis on both ends, the unused portion of the cruise, and the Alaskan hospital bill since it fell under our deductible. If the Alaskan doctor thought it was necessary, we would have been flown first class or even medical evacuation. And, yes, medical evacuation can cost between $20 to $40,000. The lower end will fly you to the nearest hospital. The higher end will fly you to the hospital of your choice. BIG DIFFERENCE. By the way, the little Alaskan hospital was full of cruise ship passengers. Some were getting patched up to get back to the ship, some were being sent home or elsewhere.