Are you talking about trip cancellation insurance or medical insurance outside the US?
Trip cancellation insurance could be worthwhile for a very costly trip that is at risk due to your personal circumstances. I looked into it for one trip that was going to cost me 5-figures. It turned out to be difficult because of the complexity of my itinerary, and the covered reasons were not inclusive enough. Since it was a domestic trip, I did not regard the medical coverage.
For international travel, you might compare policies that are medical insurance that don't include trip cancelation -- something like what Ex Pats and long-term travelers use.
