Every time I book a trip these days, it seems that I’m asked if I’d like to purchase travel insurance. Some of the queries are pretty low-key, while others almost border on alarmist, as the perils and possible financial losses that could befall me on my trip are described in graphic detail. Truth be told, if I wasn’t so well traveled, I might be afraid to even venture outside of my own living room after listening to some of the high-pressure doomsday sales pitches.

To be fair though, there are reasons for the aggressive travel insurance sales tactics. First and foremost everyone wants happy clients, and if a medical emergency happens and a client loses a lot of money when they have to cancel a trip, then they are not happy. On the other hand if a client is reimbursed for their covered expenses through travel insurance, they are happy campers.

Second, many policies also protect commissions, so agents get paid even if clients cancel. And last but certainly not least, there’s a high commission to be made on most travel insurance policies, so it only makes sense to try and upsell clients.

But do you really need travel insurance?

Well, that depends on many things. There are several types of travel insurance, so in the end it really depends on the type of coverage you need, and your own personal situation. With that in mind, here’s a short primer on the different types of travel insurance, along with a few reasons you may or may not need the coverage.

Trip Cancellation Insurance

Trip cancellation insurance is pretty straightforward. If you have to cancel the trip, you will be reimbursed for any non-fundable deposits and other expenses that result from the cancellation. Typical policies allow for cancellations due to illness, injury, weather and unforeseen disasters. Additionally, you can purchase a “cancel for any reason policy”; which offers comprehensive coverage; however that type of policy usually has to be purchased within 10 to 30 days of your initial deposit. The same is true for policies that cover pre-existing conditions.

Generally speaking, if you or any member of your family has a pre-existing condition or a chronic illness, trip cancellation insurance is prudent. That said, if you just booked a cheapie cruise and can afford to lose the deposit, then you may be ahead of the game to skip the trip cancellation insurance. Many frequent travelers “self-insure” against trip cancellation. In other words, they forego the expensive policies and instead ante up when they do have to cancel a trip. If they only have to cancel one out of every 20 trips, they’re usually still ahead of the game.

In my 40-plus years as a travel writer, I’ve only had to cancel one trip; and in that case Delta Airlines waived my cancellation penalty because it was due to a major hurricane. That’s not unusual. The same thing happened when I was stuck in London after 9-11 – British Airways waived all cancellation and change fees. So even though trip cancellation policies insure against these perils, in most cases when there’s a big weather issue or a disaster, the airlines step up and waive their penalties.

Travel Medical Insurance

Travel medical insurance covers medical costs that you incur while away from home – in most cases, at least 100 miles away from home. Typically it pays secondary to your own medical insurance; which means it covers what your personal medical insurance policy doesn’t cover.

That said, it’s a good idea to find out what your personal medical plan covers, including if it offers coverage away from home, and outside the US.

It also pays to do a little research and find out if the country you plan to visit has a national healthcare plan. You’ll also need to find out if visitors are covered under that plan. If so, then you’re in good shape. Be diligent in your research though, and don’t just rely on word of mouth.

For example, I always thought that since the Republic of Ireland has national healthcare, that tourists were also covered. It turns out they have a tiered plan, and only visitors from EU countries are eligible for coverage. And I only found that out after a friend ended up in the hospital in Ireland. On the other hand, another friend who broke her arm in New Zealand was fully covered by their universal accident insurance.

It’s also important to remember that Medicare does not include coverage outside the US. Some Medicare supplement plans do provide this coverage, so if you plan to travel a lot in your retirement years, then choose a Medicare supplement plan that includes overseas coverage.

Generally speaking, it’s a good idea to purchase travel medical insurance if you or anyone in your party has a pre-existing condition. And it goes without saying that if your personal medical policy doesn’t extend outside of your home area, then travel medical insurance is also a good idea.

Additionally if you do have a pre-existing condition, you want to make sure it is not excluded from your travel medical insurance policy. To include pre-existing conditions, travel medical policies usually have to be purchased shortly after you make your initial deposit for the trip. Be sure and also find out what exactly constitutes a pre-existing condition, as sometimes even something as simple as seasonal allergies can disqualify you from coverage if you don’t purchase a policy that includes pre-existing conditions.

Medical Evacuation Insurance

Medical evacuation insurance covers transportation back home if your are injured or have a serious illness while you’re on the road. It should be noted that an air ambulance trip back to the US can cost $50,000 to $100,000; and air ambulance companies expect either an insurance assignment or payment-in-full at the time of service. Suffice it to say that everyone should have this coverage, because you never know when you will need it.

For example, even if you are young and healthy, a simple fall could immobilize you, and require medical evacuation in an air ambulance. I have known several people who’ve had to mortgage their homes in order to pay for air ambulance transportation, so don’t get caught unprotected.

Additionally, you might want to check your wallet for existing coverage. For example, I recently discovered that I have $25,000 of medical evacuation coverage through my AAA Premier membership. The extra coverage is great, but I still carry an annual $100,000 medical evacuation policy, as $25,000 won’t cover a major evacuation. So start digging and see what hidden benefits you can discover. You may have more coverage than you think.

So What’s a Traveler to Do?

Once you’ve decided what type of travel coverage you need, check with your bank, credit union, auto club and credit card companies to see if they provide any type of travel insurance as a member benefit. Once you know what you already have, you can begin shopping for additional coverage.

The best way to shop for travel insurance is to contact your insurance agent. A reputable insurance agent can point out the pros and cons of different offerings, and help you find a policy that meets your needs. Insurance agents also offer annual policies that are much more affordable than per-trip policies; in fact, you may be able to get yearly coverage for all of your trips, for less than you’d pay for single trip coverage through a travel professional.

Additionally, once you have coverage be sure to carry the insurance cards and other documentation with you. You should also know who to contact in an emergency. Some plans require that you contact them when you are hospitalized overseas, while others require relatively little paperwork. Even if you have travel coverage, if you don’t know how to use it, you still could be left out in the cold. So become an educated consumer, do your research and have a plan of action in place, in case you become injured or fall ill on the road.