Certainly it does. We buy insurance through Alliance (sp?? Not sure how it's spelled), all the time when we buy tickets through AA and it covers medical evac. It doesn't "take you home" like Skymed, but it definitely has medical evac, as well as medical coverage, etc. I'm not sure that it covers trip cancellation, but that is not that important to us, as we figure we can reschedule a hotel and we usually get frequent flyer tickets, which on AA, you can reschedule the DATES without any penalty, if you keep the same flight itinerary.