Insurance through the cruise line is minimal as far as medical coverage goes. I use www.insuremytrip.com or www.squaremouth.com for my travel insurance. Lately, I just get medical insurance as I am willing to swallow the cost of the cruise if a medical incident happens. The cost of insurance goes up as we grow older. I choose primary coverage over secondary to avoid unnecessary paperwork. (You never know when you unexpectedly will need major medical help).