While you technically can find cruise lines that do not strictly mandate travel insurance, in 2026, many major operators—such as P&O Cruises and several European-based lines—have made "suitable cruise cover" a mandatory requirement for boarding. Even when not required, cruising without insurance is an immense financial risk. Medical evacuations at sea via helicopter can easily exceed $50,000, and onboard medical centers do not typically accept land-based health insurance or Medicare. Standard travel insurance may not suffice; you specifically need "Cruise Cover" to handle unique risks like missed ports of call, cabin confinement due to illness (like Norovirus), and itinerary changes. If you are denied boarding for failing to show proof of insurance where it is mandatory, you will likely forfeit your entire cruise fare. Therefore, while it may not always be a legal barrier to entry, it is functionally essential for any responsible traveler.