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When should I book?
Again, this is going to be a flexible answer. It's not unprecidented to book a cruise 12 months or more in advance, especially if you need a certain room. For instance, some rooms have overhead pullman beds or sofa-beds for 3rd and 4th guests, or two adjoining rooms, but they are in limited quantity, so you may have to book well in advance before these rooms sell out. And you may get a better deal the further ahead you book. However, cruise lines do not like to sail with less than full capacity, so the price will fluxuate over time. Cruise line pricing, I think, only comes in 2nd to confusing airline pricing.
Usually when you book early, you have the option of paying a deposit, or paying the entire amount. If you pay the deposit, the balance is due 60 days or more prior to sailing, depending on the cruise length and other factors. Since your booking may be well in advance, there can be some risks involved, such as unforeseen illness, schedule conflicts, loss of a job, or even the travel agent that going out of business. However, when you book ahead, there is usually some sort of cancellation policy. If you cancel early enough, you may be able to get your entire deposit back; but the later you cancel, the less money will be refunded. And the travel agent may also have a cancellation fee regardless of whether you get a full refund from the cruise line or not.
Booking later will certainly reduce your risks, but it will also reduce your room selection, and perhaps dining preference. However, its sometimes possible to obtain a great deal if the ship is not at capacity and you book the last minute. Of course, you may also have a harder time taking a week or two off from work if you don't schedule your vacation well in advance. The simple answer is the more flexible you are, the later you can probably book a cruise.
Do I need cruise insurance?
I always buy it. In perspective; the amount of money you are paying for everything else, cruise insurance is not that expensive. And if you need it, not having it could be very expensive. Insurance typically covers several aspects of the cruise. First, insurance may provide protection if you have to cancel the trip at the last minute. The cruise line won't generally refund your money for a late cancellation, but insurance may. You may need some migitating circumstance, such as a critical illness, death of a family member, or other uncontrollable event. Even the insurance may not refund your money if you just simply get cold feet at the last minute, and don't want to go.
Cruise insurance also typically provides some coverage should you lose your luggage, either on the flight to the ship or boarding the ship. And even more importantly, should you miss the ship if your flight is delayed, cruise insurance may pay for flying you to the next port-of-call so you can catch the ship enroute. However, most importantly, cruise insurance often has provisions to pay for medical issues, either to cover costs of seeing the ship's doctor or worse, if you have to be evacuated via helicopter, or return to the US from an island. Without insurance, such an evacuation could cost you thousands.
Be aware that there are a couple of sources for cruise insurance; the cruise line itself, your travel agent, or purchasing it on-line yourself. Its been my experience that the cruise line's rates are quiet competitive, and often cheaper. And it's been my understanding (as I have never had to use it) that if the insurance is through the cruise line, they will help you with the logistics of obtaining coverage while on-board. In contrast, if you buy it through your travel agent, you are on your own, and if you have to make a lot of phone calls while on-board to obtain coverage, the phone bills may exceed any savings you may have achieved. Some travel agents like to push 3rd-party insurance - I suppose for the extra commission, so be aware of what options you have.
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