Travel insurance is the product you are told to buy about everything and where almost everything you buy is a slight of hand. The card at checkout wants to sell you "bag delay cover" for a flight you could rebook for less than the premium. Meanwhile the two coverages that actually protect you are easy to skip and hard to price-shop. Here is the honest split.

The one you must never skip: medical + evacuation

A normal emergency room abroad is fine; a medevac — flying you home with a medical team — can run into six figures, and your domestic health plan very likely will not cover treatment overseas or the repatriation. This is the single line item that genuinely protects your savings.

• Medical maximum: look for at least 100k USD of cover, more for remote or high-altitude trips.
• Emergency evacuation & repatriation: the expensive part — confirm it's included and not a tiny sub-cap.
• Direct-pay vs reimburse: a insurer that guarantees payment to the hospital beats one that asks you to front 20k and claim later.

If you buy only one thing, buy the medical-and-evacuation policy. Everything else is optimization.

The second one worth it: trip cancellation for real, big prepaid costs

If a non-refundable, high-value trip would genuinely hurt to lose — a two-thousand-dollar honeymoon, a cruise, a once-a-year flight bundle — cancel-for-any-reason (CFAR) or standard trip cancellation is worth the ~4–8 percent of trip cost. For a flexible 120 dollar weekend flight? Skip it. You're insuring a loss you'd happily absorb.

The add-ons that are usually noise

• Bag delay / lost luggage: the payout is capped low, the paperwork is brutal, and airlines already owe you a decent claim for delayed bags. Rarely worth the premium.
• Rental-car "collision": often already covered by your credit card — check before double-paying.
• Phone/gadget cover: your home contents policy or carrier usually beats a per-trip gadget rider.

Read the three exclusions that sink real claims

Insurance does not fail at the moment of loss; it fails at the fine print months earlier. Before paying, hunt for:

1. "Pre-existing medical condition" lookback windows — a clause that quietly voids evacuation for a condition you already have.
2. Activity exclusions — skiing above a certain altitude, motorbiking (a huge one in Southeast Asia), snorkeling, anything "adventure" may be excluded unless you add a rider.
3. Reasonableness & documentation clauses — no claim without a police report, an original medical invoice, a checked-bag receipt. Know the receipts you'll need to keep.

How I decide, in one line

Insurance is for rare and catastrophic, not for annoying and cheap. If losing it would be a disaster — a medical bill, a huge prepaid trip — cover it. If losing it is an inconvenience you'd shrug off — a delayed bag, a phone — self-insure and pocket the premium.

Honest disclaimer: I am not an insurance adviser and policies vary enormously by country and insurer. This is a framework for choosing, not a substitute for reading your actual certificate of insurance and its exclusions.