Lots of things to consider especially when on longer trips, cruises, etc. For example, Medicare and even some private insurance doesn’t cover you when you’re outside the country. Also, on cruises, just about any medical need is chargeable, usually at very high rates. And as many have mentioned, getting transported back home in the event of a serious medical issue can cost in the 10s of thousands of dollars. This isn’t simply something that chronically ill people have to think about, but surprise injuries even a heart attack can happen to anyone. I’ve started to purchase insurance for all international trips.