Travel insurance on cruises question

[razz]

Question for those of you who taken cruises:

Not to be ghoulish but as someone who is going on a cruise in the spring with optional tours along the way, how is one's travel medical insurance applied on optional activities.
It occurred to me that those who tragically got trapped in the NZ volcano would have enormous medical costs and longterm recovery periods. Does the initial travel insurance cover these or is some additional insurance included as part of the optional tour expense?

[SteveinMN]

I'm not aware of any insurance coverage that comes with cruise-operator excursions. If anything, you get to sign a waiver for the more athletic pursuits, removing the cruise line (and, often, the tour operator) from liability if you get hurt.

That's where travel insurance comes in. Different policies offered by different companies offer a wide variety of coverages. Some policies will not cover any medical costs at all. Others cover some, up to $X for an injury incurred during the trip, but not for treatment related to a pre-existing condition. Others will cover treatment required by pre-existing conditions dating back a certain number of months -- or longer. Medical evacuation levels vary from zero to getting you to the nearest provider who can handle your medical issue to full coverage of transporting you to a hospital of your choice at home (but just to inside the door; after that it's on you). Other policies will cover pre-existing conditions. Most of these insurance policies will coordinate with your primary coverage and pay what your regular insurance does not. In some cases, that will be every expense.

It's all a matter of how much you want to pay for/gamble on. Having medical evacuation coverage might be more of an issue in a remote part of a less-developed country in which you don't speak the primary language(s).