What if you book more than a year in advance? Here's a far-fetched but real-life example. In November, 2019 I made a deposit on a future cruise at the end of one in Hawaii. Good for 2 years, didn't have to decide where or when, and it gave you a discount in addition to a credit for the deposit. Sometime in early 2021 I applied the deposit to a trip off Belize and Guatemala in October, 2021. From what I've seen, you cannot buy travel insurance more than a year ahead of time. I was planning to buy it closer to the trip date (no pre-existing conditions at the time) but hadn't when they sent me a note in May of this year. The COVID situation in Belize was dicey. Did I want to book another cruise instead? So, I switched to Alaska. I leave tomorrow.
I do have a pre-existing condition now but of course Medicare will cover. How and when would they have expected me to buy insurance if I'd stuck with Belize and Guatemala? First payment made almost 2 years in advance and the actual itinerary chosen more than a year in advance.
And, to those in general good health- that was my situation for years but I also realized that I was kayaking, walking on glaciers, snorkeling, etc. and thus just as subject to a Stuff Happens incident as some with pre-existing conditions who were less adventurous.